Nephrology: Kidney Ailments, Causes, Diagnosis & Treatment

Kidneys are vital organs that play a crucial role in major bodily functions including flushing out of toxins, maintaining the volume of body fluids, acid-base balance, electrolyte balance, fluid osmolality, urine excretion etc. These bean shaped organs that are located in the vertebrates usually measure up to 12 centimetres in length, receive blood supply from renal arteries both from right and left sides that branch out from the abdominal aorta amounting up to 20% of the cardiac output.

Besides flushing out various waste products into the urine or excretion, kidneys are also responsible for other functions including reabsorption, secretion of hormones like erythropoietin, calcitriol, promoting absorption of calcium, blood pressure regulation, etc.

Given the complexity of its functions, kidneys require utmost care and that’s why you need eminent nephrologists or kidney specialists at Fortis Hospital, Bannerghatta for preventing various renal related ailments.

What Is Nephrology?

Nephrology derived from the Greek word ‘Nephro’ means kidney and is suffixed with ‘logy’ – the study. It essentially means the study of kidneys – its functions, ailments and treatments. The specialist who treats kidney related health conditions is called as Nephrologist.

It is a general misconception among many people that the only kidney related condition is kidney failure, and it can be managed with dialysis, renal transplant being the last resort. However, kidney being one of the complex structures in the human body gets affected by various ailments including diabetic nephropathy, hydronephrosis, interstitial nephritis, kidney stones, kidney tumour, kidney failure, renal stenosis, renovascular hypertension etc.

Thanks to the medical advancements many kidney related conditions can be managed with the help of medications and lifestyle changes. Our team of eminent nephrologists at Fortis Hospital, Bannerghatta treat various renal ailments, besides performing hugely successful renal transplants.

Types of Kidney Ailments:

Kidney Stones:

Kidney stones also known as renal calculi, nephrolithiasis or urolithiasis is a commonly heard renal ailment that happens due to deposits of hard minerals and acid salts clumping together in concentrated urine. Kidney stones can cause intense pain by the sides of the abdomen and during urination. Nausea, vomiting, blood in the urine are other common symptoms. Conservative treatment includes drinking lots of water to flush it out and with medication. In case of kidney stones, larger in size the doctor might recommend lithotripsy.

Polycystic Kidney Disease:

A genetic disorder, Polycystic Kidney Disease causes numerous cysts filled with fluid, growing in the renal organs. Though a common and harmless occurrence, if not treated on time this condition can impair kidney functioning and lead to its failure.

Urinary Tract Infections:

UTI is a result of bacteria invading the urinary system including bladder and urethra. The symptoms include pain in the lower abdomen, fever, chills, pain in urination. UTI is treated with a dose of antibiotics. However, a delay can cost poor functioning of kidneys.

Glomerulonephritis:

Glomeruli are extremely tiny structures located in the kidneys, that filter the blood. Glomerulonephritis is inflammation of these small structures and is often caused due to congenital abnormalities, drugs and infections. Can be treated with medication.

Diabetic Nephropathy:

Diabetic Nephropathy is found in diabetics with poor control over blood sugars. It is one of the chief causes behind Chronic Kidney Failure (CKD) and End Stage Renal Failure (ESRD) as it slowly interferes with the functioning of kidney cells, damaging blood vessels.

Hydronephrosis:

When the kidney swells up due to urine accumulation and unable to get drained into the urinary bladder due to an obstruction, that condition is called as hydronephrosis. It can happen in one or both kidneys and is caused due to kidney stones, blood clot, scarred tissue from previous surgery, congenital factors. In certain cases, prostate enlargement, pregnancy, UTI too may lead to hydronephrosis and is resolved by addressing the underlying cause.

Interstitial Nephritis:

Interstitial Nephritis is characterized by the inflammation of kidney tubules. Interstitial nephritis is often a result of allergy to medication, other reasons being prolonged usage of antibiotics, nonsteroidal anti-inflammatory drugs. In certain cases, it could be a result of autoimmune disorder like lupus erythematosus, high concentration of calcium, low levels of potassium and infections.

Kidney Cancer:

Kidney cancer or tumour happens when cells grow uncontrollably and are malignant. Kidney cancer in most cases is found in the tubules and is also known renal cell carcinoma. Prolonged usage of medications, smoking, genetic conditions are prime reasons and is found more in males than in females.

Renal Artery Stenosis:

When the arteries carrying blood to one or both kidneys narrow down due to atherosclerosis or hardening of the arteries, it is called as Renal artery stenosis. If not treated on time, it can cause poor kidney functioning.

Renovascular Hypertension:

In certain cases, when arteries supplying blood to the kidneys get narrowed down, it triggers hormonal response from the organs causing renovascular hypertension. It is treated with medication, revascularization surgery.

Kidney Failure:

Kidney failure is a condition where renal organs lose the ability to perform functions efficiently and fail to filter wastes from the blood. It can be either acute or chronic and is caused due to various factors including diabetes, hypertension, long use of certain drugs, cardiovascular issues, scarring of the liver tissue etc. If not treated on time and managed, it can lead to End Stage Kidney Failure. Kidney transplant remains the only option at this stage, without which it is fatal.

How Are Kidney Ailments Diagnosed?

The functioning of kidneys can be determined through various blood tests and diagnostic tools.

• Blood tests measures the amount of creatinine – the waste product in blood. If it is out of range, it is an indication of poor kidney function.
• Urine tests analyses the concentration of protein or blood in the urine, besides presence of albumin, creatinine and Albumin & Creatinine ratio (ACR).
• Other tests include MRI, CT-Scan, ultrasound to see if there are any blockages.
• In case of kidney cancer, a biopsy – tissue sample from the kidney is extracted to know the type of cells and tumour.

How Are Kidney Ailments Treated?

Lifestyle changes like eating healthy diet, less salt, greasy foods, walking, keeping blood sugars and blood pressure under control, quitting smoking, walking, working out regularly will take you a long way in maintaining your kidney health.

Fortis Hospital, Bannerghatta road has the best nephrologists in the city and these following procedures are available.

Medicines:

Certain kidney related ailments can be controlled with medications like diuretics, calcium reducers and vitamins. However, remember this forms the conservative management and it is crucial to keep up with lifestyle changes and timely medication schedule.

Dialysis:

Dialysis is a procedure that removes waste products and extra fluid from the blood artificially, when kidneys fail to perform the same. It is done by inserting a catheter in to the body and diverting it to machine for it to be purified of all bodily wastes. In certain cases, the dialysis can be just a temporary arrangement till the kidneys recover fully. But in case of chronic kidney failure, renal transplant is the only option.

Kidney Transplant:

Kidney transplant is the last resort for the patients suffering End Stage Renal failure. A healthy, functioning kidney from a donor – either from a surviving or a cadaver is transplanted into the patient’s body. In many cases, the surgeon may choose to retain the older kidneys in the body, before placing the donated organ, unless there is a medical reason to remove it. Diseased kidneys in the case of tumours will get removed.

The donated kidney is placed in the lower abdominal region as it is easy to connect to arterial blood vessels and urinary bladder. The surgery that may take up to 4 to 5 hours and patient would be wheeled into transplant care unit post operation for 24/7 attention from the experts. Kidney transplant surgery is usually safe, but few patients may be at the risk of rejection, as the immune system may fight back the new organ. To prevent and lessen the rate of rejection, the patient will be administered immunosuppressants and would continue on these medications for rest of the life.

Kidney from a living donor starts working immediately but if it is a from a deceased donor, it may take 2 to 4 weeks for the organ for getting back into action.