Kidney Centre

Compiled by Dr. P.D.Gulati

KIDNEY CARE : Some commonly asked questions

GENERAL BASICS IN KIDNEY DISEASE

  • 1:1 What do we understand by kidneys and the urinary tract ?

    The two kidneys are situated at the back of abdominal cavity

    • Each kidney weighs 150 gm; contains one million filtering units called Nephrons' the filter is called 'glomerulus' which is attached to long coiledcollecting tube
    • Excess of water and waste substances are removed from the body in the urine, through the 'Ureter' 'bladder' which when filled causes a sensation to pass urine through the terminal tube called 'Urethra'.
  • 2:0 What do the kidneys do ?

    The kidneys

    • Control the amount of water in the body,
    • Remove the waste substances and excess of potassium, phosphates from the blood;
    • Play important role in the formation of red blood cell through production of hormone called 'Erythropoetin;'
    • Control blood pressure through hormone called renin; and
    • Keep the bones healthy through vitamin D3.
  • 2:1 Kidney and Blood Pressure : Blood pressure implies the force of blood flow through the arteries and depends upon the size of arteries , force with which the heart pumps blood and the amount of water and salt in the body; kidney cells secrete a hormone called 'renin' which also plays an important role in regulation of blood pressure.
    2:2 Kidney and Anemia : kidneys produce a hormone called 'Erythropoetin' - a substance that controls the rate at which bone marrow produces red blood cells; Besides kidney failure patients have lack of iron and vitamin B12 and folic acid due to decreased in fact of food.
    2:3 Kidney and Bones
    • when kidneys fail, phosphorus accumulates in the blood which causes calcium to be drawn out of the bones. In order to correct this, avoid eating phosphate containing foods such as meat, cheese, nuts, dried beans, soft drink etc.
    • Healthy kidneys change Vit D to a more active form (Vit D3) . When kidneys fail level of calcium in the blood and bones falls.
  • 3:1 What is urine and its significance in kidney diseases?

    Urine is composed of excreted water containing unwanted waste substances filtered from the blood by the kidneys Simple urine test provides enormous information to the doctor; leakage of sugar occurs in diabetes, bile in hepatitis, proteins in nephrits. Damage to the kidney filter leads to leakage of albumin through urine, protein of much smaller size called microalbumin, starts leaking early in the urine diabetes;

  • 4:0 What are the diseases that affect the kidneys ?

    4:1 Diabetes Mellitus : Kidney involvement occurs at a fast pace if control of both diabetes and blood pressure is poor; eye changes are usually present.

    4:2 High Blood Pressure Sudden rise of BP can damage the kidneys in a relatively short period; whereas lesser grades of hypertension cause slow kidney damage our several years which may remain symptomatic;. Patient of high blood pressure should have the tests of kidney function done at 6 month interval, and get regular check up and medication so as to keep BP below 130/80 mmkg.

    4:3 Nephritis and Nephrotic Syndrome is allergic inflammation of the kidneys, occurs usually in children after an episode of throat infections or skin boil, recovers fully; less than 5 percent children develop sustained hypertension and albumin and blood in urine) and may even develop kidney failure. a fair number of them develop hypertension and kidney failure . Nephritis is the commonest cause of kidney failure in adults .Nephrotic syndrome is a disease of children and adults both .Protein leakage in the urine occurs in large qualities; remission with medicine (steroid) is satisfactory in children relapses are frequent . In adults, high blood pressure occurs; a large number of their develop kidney failure.

    4:4 Kidney Stones & Infections Stones in the kidney are quite common in North India (Stone belt); exact cause is not known; some elements in food and water or may be in the soil where vegetables are grown could possibly cause kidney stones; large stones cause blockage of the ureter, can cause irreversible damage to the kidney; if in both kidneys it may lead to high blood pressure and kidney failure recurrent. Infection in the kidneys may cause kidney damage and kidney failure.

    4:5 Drugs & Kidneys Pain killers, antibiotics, Non-steroidal drugs (NSAIDS) like brufen etc may cause kidney damage if taken without proper medical advice; heavy metals used in several indigenous preparation have posed additional problem , few antibiotics like sulpha , penicillin cause alltergic type acute renal failure; which often recovers if detected and treated in time.