KIDNEY DISEASES

Acute Kidney Infection (AKI)

Acute Kidney Infection and Symptoms

Acute pyelonephritis is a sudden and severe kidney infection. It causes the kidneys to swell and may permanently damage them. Pyelonephritis can be sometimes life threatening. A kidney infection is caused by bacteria travelling from your bladder into one or both kidneys. Seek prompt medical treatment if you develop signs of one such infection.

SYMPOTOMS

Fever
Chills
Back, side or groin pain
Abdominal pain
Frequent urination
Strong, persistent urge to urinate
Burning sensation or pain when urinating
Nausea and vomiting
Pus and blood in your urine
Urine that smells bad and is cloudy
Fatigue
Confusion
Irregular heartbeat
Chest pain or pressure
Seizures or coma in severe cases
Fluid buildup in lungs causing shortness of breath.

Prevalence of Actute Kidney Infection

AKI can occur in pregnant women as well as in anyone who has a weakened immune system.
Having a urinary tract blockage for example having stones in the kidney or something abnormal in your urinary tract structure.
In men who have an enlarged prostate gland.
Having damage to nerves around the bladder while having a spinal injury.
Using a urinary catheter for a period of time.
Having a condition that causes the urine to flow the wrong direction in which case the risk could be found in childhood or adulthood.

Diagnosis of AKI

Learn about the investigations and the diagnosis

A urine sample to test bacteria, or blood or pus in your urine.
A blood sample to get culture done which is a lab test for bacteria or other organisms in your blood.
An ultrasound, CT scan or a type of X-ray called a voiding cystourethrogram.Here a contrast dye is inserted to take X-ray of the bladder when full and while urinating.

Treatment of AKI

a) Antibiotics for kidney infection

Antibiotics are the first line of treatment for kidney infections. The drugs to be used and the duration will be decided by your doctor depending on your health and the results of urine and blood tests.
The entire course of antibiotics must be taken to get clear of the infection.
A repeat urine test and culture is recommended after the course is completed.
If infection is still present you may be advised to go through another course of antibiotics.

b) Hospitalization for severe kidney infections

If your kidney infections are severe , you may be advised to get admitted to the hospital.
Treatment might include antibiotics and intravenous fluids.
Your duration of stay at the hospital will be decided by the doctor in charge.

c) Treatment for recurrent kidney infections

A medical problem such as a misshapen urinary tract that can cause repeated infections in the kidney.
You would be referred to a kidney specialist (nephrologist ) or urinary surgeon(urologist).
A surgery might be needed to repair the structural abnormality.

d) Dialysis

Dialysis is considered when a person's kidney cannot filter around 120 to 150 quarts of blood each day.
Dialysis is an option in cases where there has been a chronic, or long term illness, or any injury or short term illness that affects the kidneys.
Dialysis may be considered until your kidneys recover.
Dialysis is an artificial process of removing waste products and excess fluids from the body.

DO YOU HAVE QUESTIONS ABOUT AKI?
TELE CONSULT WITH YOUR UROLOGIST

Patient safety is our priority

Pre-surgery preparations, anaesthesia and surgery

- Your doctor should be informed of the other medications you are consuming.

- In case of surgery , do inform the anaesthetist if you are allergic to any drugs.

- Fasting will be instructed by your doctor according to the need of the surgery.

- Do bring all your medications along with their prescriptions.

- Make sure to carry all paperwork, x-rays, test reports regarding your case.

- Depending upon the results obtained, your doctor will decide whether you should go through IV fluids along with antibiotics or surgery for correcting abnormalities or even dialysis as the case may be.

Risks and complications

- Watch out for repeated symptoms after the treatment is over.

- Serious complications of kidney infections could lead to kidney scarring which can lead to chronic kidney disease, high blood pressure and kidney failure.

- Septicemia or blood poisoning wherein the bacteria that has affected your kidney can spread to your bloodstream.

- Pregnant women who develop kidney infections may deliver low birth weight babies.

DO YOU HAVE QUESTIONS ABOUT AKI?
TELE CONSULT WITH YOUR UROLOGIST

What's important after discharge?

- Drink enough fluids especially water that can help you remove bacteria from your body when you urinate.

- Urinate as soon as you need to do so.

- Empty the bladder after intercourse.

- Avoid using products such as deodorant sprays in your genital area.

- Work with your doctor to manage kidney and other chronic conditions.

- Keep your diabetes and blood pressure under control.

- A healthy lifestyle should be your priority.

- Be active, eat a balanced diet and drink alcohol only in moderation.

DO YOU HAVE QUESTIONS ABOUT AKI?
TELE CONSULT WITH YOUR UROLOGIST

KIDNEY DISEASES

Chronic Kidney Disease

CKD and Symptoms

Having a severe kidney infection or repeated kidney infections can damage the kidneys. They can lead to chronic kidney diseases.

SYMPOTOMS

Anemia
Dark urine
Back, side or groin pain
Decreased mental alertness
Decreased urine output
Strong, persistent urge to urinate
Burning sensation or pain when urinating
Nausea and vomiting
Pus and blood in your urine
Edema-swollen feet, hands and ankles
Fatigue
Confusion
Hypertension ( high blood pressure)
Insomnia
Itchy skin , can become persistent
Loss of appetite
Male inability to get an erection
Muscle cramps
More frequent urination at night
Muscle twitches
Protein in urine
Sudden change in body weight
Unexplained headaches

Prevalence of CKD

Babies(0-2) very rare
Children (2-18) rare.
Young adults (19-40)very common
Adults (41-60) very common
Seniors (60+) very common

Diagnosis of CKD

Learn about the investigations and the diagnosis

A urine sample to test bacteria, or blood or pus in your urine.
A blood sample to get culture done which is a lab test for bacteria or other organisms in your blood.
A kidney ultrasound or IVP (intravenous pyelogram -a special x-ray ) showing scarring.
Nuclear medicine scan.
Computed tomography ( CT )
Micturating cystourethrogram ( MCU ) in rare cases.

Treatment of CKD

Anemia treatment: Some kidney diseases patients with anemia will require blood transfusions. The patient may have to take iron supplements, either in the form of daily ferrous sulphate tablets, or occasionally in the form of injections.

Phosphate balance: Patients with kidney diseases may not be able to eliminate phosphate from the body properly. In such cases they will be advised to reduce their nutritional phosphate intake. Reduce dairy products, meat, eggs and fish.

High blood pressure: High blood pressure is a common feature in chronic kidney disease patients. It is important to bring down the blood pressure in order to protect the kidneys, consequently slowing down the progression of the diseases.

Skin itching: Antihistamines , such as chlorpheniramine may help in giving relief to such problems.

Anti-sickness medicines: When toxins build up in the body because the kidneys are not functioning well, the patient may feel nausea. Medications to relieve this condition would be prescribed to help them feel better.

End-stage treatment: Dialysis

Dialysis is considered when a person's kidney cannot filter around 120 to 150 quarts of blood each day.

Dialysis is an option in cases where there has been a chronic, or long term illness, or any injury or short term illness that affects the kidneys.

Dialysis may be considered until your kidneys recover.

Dialysis is an artificial process of removing waste products and excess fluids from the body.

DO YOU HAVE QUESTIONS ABOUT CKD?
TELE CONSULT WITH YOUR UROLOGIST

Patient safety is our priority

Risks and complications

• Watch out for repeated symptoms after the treatment is over.
• Serious complications of kidney infections could lead to kidney scarring which can lead to chronic kidney disease, high blood pressure and kidney failure.
• Septicemia or blood poisoning wherein the bacteria that has affected your kidney can spread to your bloodstream.

DO YOU HAVE QUESTIONS ABOUT CKD?
TELE CONSULT WITH YOUR UROLOGIST

What's important after discharge?

• Drink enough fluids especially water that can help you remove bacteria from your body when you urinate.
• Urinate as soon as you need to do so.
• Empty the bladder after intercourse.
• Avoid using products such as deodorant sprays in your genital area.
• Work with your doctor to manage kidney and other chronic conditions.
• Keep your diabetes and blood pressure under control.
• A healthy lifestyle should be your priority.
• Be active, eat a balanced diet and drink alcohol only in moderation.

DO YOU HAVE QUESTIONS ABOUT AKI?
TELE CONSULT WITH YOUR UROLOGIST

KIDNEY DISEASES

Kidney Cancer

About

This is a highly malignant tumor of the kidney. It is usually asymptomatic in the early stage. It is generally found in a screening ultrasound. The only effective treatment is surgical removal.
If it is a small tumor then partial nephrectomy can be done in which only the tumor is removed along with a margin of normal renal parenchyma. The procedure adapted can be laparoscopy, open surgery or robotic surgery.

Radical nephrectomy is the removal of the entire kidney with surrounding tissue. Any of the above-mentioned surgical techniques can be used depending upon the extent of tumor.

Symptoms

Blood in the urine
Pain or pressure in the side or back
A mass or lump in the side or back
Swelling of the ankles and legs
High blood pressure
Anemia, which is a low red blood cell count
Fatigue
Loss of appetite
Fever that keeps coming back and is not from a cold, flu or other infection
For men, a rapid development of a cluster of enlarged veins around the testicle, particularly the right one may indicate a large tumor in the kidney.

Diagnosis

● A biopsy can make a definite diagnosis of cancer being present.
● The pathologist analyses the sample and writes a pathology report which becomes a permanent record for diagnosis.
● The CT scan and the MRI help to conclude the presence of tumor.
● Your doctor will review all the reports and come to a conclusion as to which stage the cancer is in at the present.

Blood and urine tests: To check the number of red blood cells and urine test helps to find blood, bacteria, or cancer is present.
Biopsy: This is the removal of a small amount of tissue for examination under a microscope. This is done as an out patient by giving anaesthesia to block the awareness of pain.
Computed Tomography: ( CT or CAT ) scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these images into a detailed , 3-dimensional image that will show any abnormalities or tumors. Please note: A pet scan is not useful in renal cell carcinoma.
X-ray: An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation.
Magnetic resonance imaging ( MRI ): An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the size of the tumor also. A special dye called gadolinium is used to get a clearer picture/ This dye is injected into the veins of the patient,
Intravenous pyelogram : ( IVP ) This test is rarely performed. A dye is inserted into the patient’s bloodstream to highlight the kidney, urethra and bladder when x-ray is taken.
In any case the above process is replaced by CT scan of the urinary tract.

Procedure

● The extent of hospital stay is 3 days or fewer depending on the recovery of the patient.
● With hospice care there is extended life when compared to taking treatment at home.
● Medical costs were comparable to or higher than for patients who did not receive hospice care.

Surgery to remove part or all of the kidney.
Simple Nephrectomy: A surgical procedure to remove kidney only.
Radical Nephrectomy: A surgical procedure to remove the kidney, the adrenal gland, surrounding tissue and the nearby lymph nodes
.Radiation therapy as palliative therapy to relieve symptoms in patients who cannot have surgery
Arterial embolization as palliative therapy.
A clinical trial of a new treatment.

Risks and complications

● Formation of hernia at the trocar site.
● Abdominal wall hematoma.
● Trocar injury to a hydronephrotic kidney.
● Vascular injury.
● Splenic laceration.
● Pneumothorax.
● Complications in the gastrointestinal tract.
● Complications in the cardiovascular system.
● Complications in the genitourinary tract.
● Complications in the respiratory system and musculoskeletal system.

UPON DISCHARGE

Stop smoking and misuse of medicines that can affect your wellbeing.
Keep check on the above mentioned symptoms for renal cancer.
It takes 3 to 6 weeks to recover after kidney removal.
Pain in your belly or the side where you had the kidney removed.
Pain in shoulder if you had laparoscopy. The gas used in your belly can irritate your abdomen muscles and radiate pain to your shoulder.
Keep your incision area clean, dry and protected. Change the dressings the way your doctor has taught you.
Do not soak in bathtub or go swimming until you are fully fine as decided by your doctor.
As for diet, eat a normal diet, drink 4 to 8 glasses of water or liquid in a day.
Try to walk and be active, but nothing too much.
Depending upon your tolerance to pain, take as less of painkillers.
Try a stool softener or ask your doctor for a suitable laxative.
Call your doctor if you have a temperature above 100-degree F, your belly swells or hurts, or you have nausea or vomiting for more than 24 hours.
You cannot breathe, cannot pee, cannot drink or eat.