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Diabetes can damage the kidneys and cause them to fail. Failing kidneys lose their ability to filter out waste products, resulting in kidney disease. Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called micro albuminuria when kidney disease is diagnosed early, during micro albuminuria, several treatments may keep kidney disease from getting worse. Having larger amounts of protein in the urine is called macro albuminuria. When kidney disease is caught later during macro albuminuria, end-stage renal disease, or ESRD, usually follows. In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, ESRD, is very serious. A person with ESRD needs to have  a kidney transplant or to have the blood filtered by machine (dialysis).

Many kidney diseases can be treated successfully. Careful control of diseases like diabetes and high blood pressure can help prevent kidney disease or keep it from getting worse. Kidney stones and urinary tract infections can usually be treated successfully. Unfortunately, the exact causes of some kidney diseases are still unknown, and specific treatments are not yet available for them. Sometimes, chronic kidney disease may progress to kidney failure, requiring dialysis or kidney transplantation. Treating high blood pressure with special medications called angiotensin converting enzyme (ACE) inhibitors often helps to slow the progression of chronic kidney disease. A great deal of research is being done to find more effective treatment for all conditions that can cause chronic kidney disease.

Acute renal failure (kidney failure): A sudden worsening in kidney function. Dehydration, a blockage in the urinary tract, or kidney damage can cause acute renal failure, which may be reversible.

Kidney Transplantation

kidney transplant is an operation in which a person with kidney failure receives a new kidney. The new kidney takes over the work of cleaning the blood. There are two types of kidney transplants: those that come from living donors and those that come from unrelated donors who have died (non-living donors). A living donor may be someone in your family. It may also be your spouse or close friend. In some cases, it may be a stranger who wishes to donate a kidney to anyone in need of a transplant. There are advantages and disadvantages to both types of kidney transplants.

If you have advanced and permanent kidney failure, kidney transplantation may be the treatment option that allows you to live much like you lived before your kidneys failed. Since the 1950s, when the first kidney transplants were performed, much has been learned about how to prevent rejection and minimize the side effects of medicines. But transplantation is not a cure; it's an on-going treatment that requires you to take medicines for the rest of your life. And the wait for a donated kidney can be years long. A successful transplant takes a coordinated effort from your whole health care team, including your nephrologist, transplant surgeontransplant coordinator, Pharmacist, dietician, and social worker. But the most important members of your health care team are you and your family.

Although medicine cannot reverse chronic kidney disease, it is often used to help treat symptoms and complications and to slow further kidney damage. Most people who have chronic kidney disease have problems with high blood pressure at some time during their disease. Medicines that lower blood pressure help to keep it in a target range and stop any more kidney damage. You may need to try several blood pressure medicines before you find the medicine that controls your blood pressure well without bothersome side effects. Most people need to take a combination of medicines to get the best results. Your doctor may order blood tests 3 to 5 days after you start or change your medicines. The tests help your doctor make sure that your medicines are working correctly.

Medicines may be used to treat symptoms and complications of chronic kidney disease. These medicines include:

Erythropoietin (rhEPO) therapy and iron replacement therapy (iron pills or intravenous iron) for anaemia.

Medicines for electrolyte imbalances.

Diuretics to treat fluid buildup caused by chronic kidney disease.

ACE inhibitors and ARBs. These may be used if you have protein in your urine (proteinuria) or have heart failure. Regular blood tests are required to make sure that these medicines don't raise potassium levels (hyperkalemia) or make kidney function worse.

Both erythropoietin (rhEPO) therapy and iron replacement therapy may also be used during dialysis to treat anemia, which often develops in advanced chronic kidney disease.

Erythropoietin (rhEPO) stimulates the production of new red blood cells and may decrease the need for blood transfusions. This therapy may also be started before dialysis is needed, when anaemia is severe and causing symptoms.

Iron therapy can help increase levels of iron in the body when rhEPO therapy alone is not effective.
Vitamin D helps keep bones strong and healthy

Dialysis

Dialysis, the more common form of kidney-replacement therapy, is a way of cleaning the blood with an artificial kidney. There are two types of dialysis: haemodialysis and peritoneal dialysis.

Haemodialysis: It is a system of purifying the blood of a person whose kidneys are not running commonly and is the choice of Renal replacement remedy for patient who need dialysis acutely and for many patients as preservation therapy. There are three styles of haemodialysis: Conventional haemodialysis, each day haemodialysis, and Nocturnal haemodialysis. The most recent dialysis machines available on the market are highly automatic and continuously display an array of protection-crucial parameters, which includes blood and dialysate drift prices; dialysis answer conductivity, temperature, and pH; and analysis of the dialysate for evidence of blood leakage or presence of air. The drug remedy followed include supplements of vitamins, calcium, iron, phosphate binders, Antipruritics.

Peritoneal Dialysis: Peritoneal dialysis (PD) is a remedy that uses the liner of your stomach (stomach area), called your peritoneum, and a cleaning answer referred to as dialysate to smooth your blood. The two maximum not unusual styles of PD are Non-stop ambulatory PD (CAPD) and Non-stop cycler-assisted PD (CCPD). Mild lower back ache or abdominal fullness may additionally occasionally occur at some point of peritoneal dialysis. Complications may encompass infections within the abdomen, hernias, high blood sugar, bleeding within the stomach, and blockage of the catheter. Peritoneal dialysis may be improvised in situations inclusive of combat surgery or Catastrophe alleviation the use of surgical catheters and dialysate crafted from automatically to be had clinical solutions to offer transient renal substitute for people and not using a different options.

  • Track 5-1Haemodialysis
  • Track 5-2Peritoneal dialysis

Nephrology is a specialty of medicine that concerns itself with the study of normal kidney function, kidney problems, the treatment of kidney problems and renal replacement therapy (dialysis and kidney transplantation). Systemic conditions that affect the kidneys and systemic problems that occur as a result of kidney problems are also studied in nephrology. A physician who has undertaken additional training to become an expert in nephrology may call themselves a nephrologist or renal physician. Kidneys are essential to our health. Kidneys sit just below the rib cage, toward your back.

The kidneys, two bean-shaped organs about the size of a fist, act as a filtering system for the body. Kidneys are the organs that help filter waste products from the blood. They are also involved in regulating blood pressure, electrolyte balance, and red blood cell production in the body. Renal pertaining to the kidney; called also nephric. Renal clearance  tests laboratory tests that determine the ability of the kidney to remove certain substances from the blood

Kidney or bladder stones are solid build-ups of crystals made from minerals and proteins found in urine. Bladder diverticulum, enlarged prostate, neurogenic bladder and urinary tract infection can cause an individual to have a greater chance of developing bladder stones. If a kidney stone becomes lodged in the ureter or urethra, it can cause constant severe pain in the back or side, vomiting, Hemartia (blood in the urine), fever, or chills.

Bladder stones are hard masses of minerals in your bladder. Bladder stones develop when urine in your bladder becomes concentrated, causing minerals in your urine to crystallize. Concentrated, stagnant urine is often the result of not being able to completely empty your bladder. If bladder stones are small enough, they can pass on their own with no noticeable symptoms. However, once they become larger, bladder stones can cause frequent urges to urinate, painful or difficult urination and hematuria.

Kidney stones (nephrolithiasis): Minerals in urine form crystals (stones), which may grow large enough to block urine flow. It's considered one of the most painful conditions. Most kidney stones pass on their own but some are too large and need to be treated.

 

Acute kidney injury (AKI), formerly known as acute renal failure is a syndrome characterized by the rapid loss of the kidney's excretory function and is typically diagnosed by the accumulation of end products of nitrogen metabolism  (Urea and Creatinine) or decreased urine output, or both. AKI may lead to a number of complications, including metabolic acidosis, high potassium levels, uremia, changes in body fluid balance, and effects on other organ systems, including death. People who have experienced AKI may have an increased risk of chronic kidney disease in the future. Management includes treatment of the underlying cause and supportive care, such as renal replacement therapy.

Chronic Kidney Diseases includes complications like high blood pressureanaemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. The two main causes of chronic kidney disease are diabetes and high blood pressure. High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases.

End-stage kidney disease is also called end-stage renal disease (ESRD). End-stage kidney disease is the last stage of chronic kidney disease. This is when your kidneys can no longer support your body's needs. Chronic kidney disease (CKD) is when there is permanent damage to your kidneys.   This is when the kidneys do not work well enough for you to live.  If this happens, you will need dialysis or a kidney transplant to live.

 

  • Track 8-1Chronic Kidney Diseases
  • Track 8-2Acute Kidney Injury
  • Track 8-3End Stages Renal Diseases

Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which malignant (cancer) cells are found in the lining of tubules (very small tubes) in the kidney. There are 2 kidneys, one on each side of the backbone, above the waist. Tiny tubules in the kidneys filter and clean the blood. They take out waste products and make urine. The urine passes from each kidney through a long tube called a ureter into the bladder. The bladder holds the urine until it passes through the urethra and leaves the body. Renal cell carcinoma may remain clinically occult for most of its course. Only 10% of patients present with the classic triad of flank pain, hematuria, and flank mass. Surgical resection remains the only known effective treatment for localized renal cell carcinoma, and it is also used for palliation in metastatic disease. Targeted therapy and immune modulatory agents are considered standard of care in patients with metastatic disease. Kidney cancer: Renal cell carcinoma is the most common cancer affecting the kidney. Smoking is the most common cause of kidney cancer.

 

Glomerular disease can occur by itself (eg, affecting only the kidney), or may be associated with an underlying medical condition that affects other organ systems, such as lupus, diabetes, or certain infections. Glomerular disease can develop suddenly (called Acute), or develop slowly over a period of years (called Chronic). Treatment of glomerular disease depends upon its cause and type. Many diseases affect kidney function by attacking the glomeruli, the tiny units within the kidney where blood is cleaned. Glomerular diseases include many conditions with a variety of genetic and environmental causes, but they fall into two major categories:

Glomerulonephritis (gloh-MEHR-yoo-loh-nef-RY-tis) describes the inflammation of the membrane tissue in the kidney that serves as a filter, separating wastes and extra fluid from the blood.

Glomerulosclerosis  (gloh-MEHR-yoo-loh-skleh-ROH-sis) describes the scarring or hardening of the tiny blood vessels within the kidney

Hydronephrosis:  Hydronephrosis is a structural situation that commonly takes place while the kidney swells because of the failure of regular drainage of urine from the kidney to the bladder resulting in the distension and dilation of the renal pelvis and calyces. Treatment for hydronephrosis ordinarily makes a specialty of getting rid of whatever is blockading the glide of urine and the treatment choice depends on the underlying purpose of the disorder. It can have an effect on human beings of any age and is once in a while spotted in unborn toddlers at some stage in ordinary pregnancy ultrasound scans (this is known as antenatal hydronephrosis).Whilst no motive may be detectable it's miles called as Idiopathic hydronephrosis (unilateral) and while there is a definable reason it's miles Secondary hydronephrosis (bilateral).Unilateral maybe extramural, intramural or intraluminal and it is normally visible in youngsters. Hydronephrosis may additionally or won't cause signs. The most important symptom is ache, either in the side and returned (called flank ache), stomach or groin. Symptoms depend on the motive and severity of urinary blockage hazard elements like kidney stones, urinary tract infections might also lead to hydronephrosis. An ultrasound can be used to commonly diagnose the disease

Paediatric Nephrology: The Division of Paediatric Nephrology specializes within the prognosis and control of children with a variety of acute and continual kidney-related problems. The division evaluates and treats high blood pressure, Haematuria, Proteinuria, Renal tubular acidosis, Nephrolithiasis, Glomerulonephritis and kidney failure Most of the pediatric kidney diseases are congenital, some of them familial with a unique heredity. The “Renal Mitochondrial Cytopathies” are a group of uncommon sicknesses which are characterized by way of frequent multi-systemic involvement and severe variability of phenotype, consisting of renal involvement. Neonatal Bartter syndrome is seen between 24 and 30 weeks of gestation which is a unprecedented inherited illness within the thick ascending limb of the loop of Henley. It is characterized by low potassium stages, accelerated blood pH (alkalosis), and regular to low blood stress. In the paediatric and neonatal intensive care gadgets Acute kidney damage (AKI) is a common problem wherein Renal replacement therapy (RRT) is frequently implemented in kids in whom the supportive remedy isn't to the mark to the touch the metabolic needs. Haematuria & Proteinuria are the most generally determined paediatric problems. Treatment alternatives can vary widely relying on your child’s level of sickness. Some kidney problems may also require diet changes, medicinal drug, or surgical operation to correct an anatomical defect, whilst others may require long-time period dialysis or a kidney transplant

Chronic kidney sickness (CKD) is a completely not unusual medical problem in aged patients and is related to multiplied morbidity and mortality. As life expectancy maintains to enhance worldwide, there may be a growing prevalence of comorbidities and risk factors which include hypertension and diabetes predisposing to a excessive burden of CKD within the population. About 1 in 10 human beings have some diploma of CKD. It can broaden at any age and numerous situations can result in CKD. It turns into greater not unusual with increasing age and is extra commonplace in ladies. The envisioned glomerular filtration price (eGFR) can be used as a analysis test for the ailment. Some diseases inside the kidneys are as a result of issues (mutations) in genes.  People have about 25,000-30,000 genes.  Some illnesses may be resulting from a mutation in just one of the two copies of a gene, with the mutated gene being strong sufficient to conquer the impacts of the alternative, normal gene.  This is known as Autosomal Dominant Inheritance. Polycystic kidney ailment is a maximum commonplace genetic disease that impacts the kidneys and other organs. Clusters of fluid-crammed sacs, referred to as cysts, increase in the kidneys and interfere with their potential to filter out waste products from the blood. Genetic checks or DNA evaluation can be used to check the presence and severity of the disorder.

  • Track 13-1Polycystic Kidney Disease

Urinary Tract Infections : Urology ,also referred to as  Genitourinary surgical procedure ,is a branch of medication that focusses on surgical and medical sicknesses of the urinary tract system and an infection in any part of the urinary device, is referred to as  an Urinary tract infection. When it affects the decrease urinary tract it is called a Bladder contamination (cystitis) and while it impacts the upper urinary tract it's far known as kidney infection (Pyelonephritis) The organs under the area of urology consist of the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs. A number of the common illnesses consist of Benign prostatic hyperplasia, Urinary incontinence, UTI, Urethral stones and many others. Risk elements  of UTI consists of woman anatomy, sexual intercourse, diabetes, weight problems, and circle of relatives records .A number of the diagnostic exams encompass Urinalysis, urine microscopy. However, women with terrible cultures may also nevertheless improve with antibiotic remedy. As signs can be indistinct and without dependable checks for urinary tract infections, analysis can be difficult within the aged. The mainstay of remedy is antibiotics. Phenazopyridine is on occasion prescribed in the course of the primary few days similarly to antibiotics to help with the burning and urgency every so often felt throughout a bladder infection

Nephrology nursing: Nephrology nursing includes both stopping disease and assessing the health needs of patients and families. It includes: Improvement in affected person care, reduced cost of kidney care provision, Accountability and assurance towards case, Addition to the present day assemblage of nursing getting to know, Enhancement of nursing as a calling. Nursing Care spans the lifestyles cycle and includes sufferers who're experiencing the real or threatened effect of acute or Continual kidney disorder. Care may be extraordinarily complicated: patients may additionally have severe comorbid conditions consisting of, but now not restricted to, Cardiovascular ailment, diabetes, hypertension, infectious disease, bone disorder, or Psychiatric situations. In addition, many face psychosocial problems. The nurse's role is to help patients manipulate their lives - be triumphant at school or paintings, socialize, hold relationships, or enjoy pastimes - while efficiently handling their fitness problems. It is the sphere of nursing with an emphasis at the most outrageous notion of the discriminatingly debilitated or insecure limitless kidney sufferers. Renal Care Nursing's valuable aim is to present professional’s accurate, present day, and fabric records and cabin to surpass desires in separating concept exercise

High blood pressure (hypertension) is a leading cause of disease and kidney failure (end-stage renal disease). Renal hypertension, also called Reno vascular hypertension, is elevated blood pressure caused by kidney disease. It can usually be controlled by blood pressure drugs. Some people with renal hypertension can be helped by angioplasty, stenting, or surgery on the blood vessels of the kidney. Hypertension can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult. Once a person is diagnosed with end-stage renal diseases, dialysis a blood cleansing process or kidney transplantation are necessary. Kidneys are remarkable organs. Inside them are millions of tiny blood vessels that act as filters. Their job is to remove waste products from the blood. Sometimes this filtering system breaks down