Kidney Disease | Part - 2

Image - The kidneys, two fist-sized organs

The kidneys, two fist-sized organs located on either side of the spine just above the waist, perform a life-sustaining role. They cleanse the blood by removing waste and excess fluids, maintain a healthful balance of various body chemicals, and help regulate blood pressure.

When the kidneys become diseased or dam-aged, they can suddenly or gradually lose their ability to perform these vital functions. Waste products and excess fluid then build up inside the body, causing a variety of symptoms, particularly swelling of the hands and feet, shortness of breath, and a frequent urge to urinate. If left untreated, diseased kidneys may eventually stop functioning. Loss of kidney function is a very serious and potentially fatal condition.

Causes

Kidney disease is classified as either acute (when loss of function occurs suddenly) or chronic (when deterioration takes place gradually, per-haps over a period of years). The chronic form can be particularly insidious: It may not show any symptoms until considerable, often irreparable damage has been done.

The causes of chronic kidney disease are often difficult to pinpoint. Most are the result of another disease or condition, such as diabetes, high blood pressure, or atherosclerosis - all of which impede the flow of blood inside the kidneys. Lupus and other diseases of the immune system that affect blood vessels may also trigger kidney disease by causing the kidneys to become inflamed.

Some chronic kidney diseases, most notably polycystic kidney disease (in which cysts form on the kidneys), are inherited. Others are congenital - the result of some sort of urinary tract obstruction or malformation that the person was born with and that predisposes the victim to kidney infections and diseases.

Chronic kidney disease may also result from long-term exposure to toxic chemicals or to drugs, including certain illegal drugs, such as heroin. Researchers also suspect that excessive amounts of vitamin D and protein, particularly in the diets of the elderly or the very ill, may harm the kidneys. But in many chronic cases, the precise cause remains unknown.

Acute kidney disease can occur within a matter of days following the onset of any medical condition that suddenly and dramatically reduces the flow of blood to the kidneys. Examples are a heart attack, a traumatic injury such as one sustained in an automobile accident, a serious infection, or a toxic reaction to a drug.

Inhaling or swallowing certain toxins, including methyl, or wood, alcohol; carbon tetrachloride; antifreeze; and poisonous mushrooms, can also cause the kidneys to suddenly malfunction. Marathon runners and other endurance athletes who do not drink enough liquids while competing in long-distance athletic events may suffer acute kidney failure due to a sudden breakdown of muscle tissue, which releases a chemical called myoglobin that can damage the kidneys.

Diagnostic and Test Procedures

For a diagnosis, your physician will have you undergo blood and urine tests and, if your kidneys can tolerate it, a special x-ray, known as an in-travenous pyelogram (IVP), for viewing them. If the diagnosis remains unclear, your doctor may also do a needle biopsy, using a special needle device to remove a small sample of kidney tissue for microscopic examination.

Treatment

Kidney disease is a life-threatening condition that requires medical care. Alternative treatments may be used to supplement that care, but before trying them you should discuss them thoroughly with your doctor.

Medications, especially those that control diabetes and high blood pressure, can sometimes help slow the progress of chronic kidney disease. Some medical practitioners have found that certain restrictive diets are useful, particularly if the condition is caught early. But if these measures fail, and the kidneys deteriorate to the point where they can no longer function at all, there are only two treatments: dialysis, in which artificial devices clean the blood of waste products, or a kidney transplant.

Conventional Medicine

If you are diagnosed with one of the more serious forms of kidney disease, your doctor may pre-scribe several medications. Because high blood pressure is both a cause and a symptom of the condition, you will probably receive a prescription for angiotensin-converting enzyme (ACE) inhibitors to slow the rate of injury to the kidneys or a diuretic to keep your blood pressure down. To balance your body's chemicals, which can be thrown dangerously out of kilter by malfunctioning kidneys, you may also be given drugs such as sodium polystyrene sulfonate, which lowers potassium levels, and calcium citrate, which blocks the stomach's absorption of phosphorus.

If a blood test reveals that the level of your red blood cells has fallen, your doctor may pre-scribe a medication with an iron supplement to rebuild your body's stores of erythropoietin, a natural blood-building substance. Your doctor may also recommend that you take calcium supplements to keep your bones from weakening, an occasional side effect of chronic kidney disease. Because many drugs are excreted through the kidneys, you will also need to consult with your doctor before taking any over-the-counter med-ications. You may be told to avoid ibuprofen and acetaminophen, which have been implicated as possible contributors to kidney disease.

Although the approach remains controversial in conventional medical circles, a growing number of physicians now encourage dietary changes to help manage chronic kidney disease. Some studies have shown that rigid adherence to a diet that severely restricts protein can delay or even prevent continued kidney deterioration. This is especially true of people whose kidney disease is the result of diabetes. Studies have shown that diabetics who follow a diet that keeps their blood glucose levels within a tight range can help retard the progress of kidney disease.

Dialysis treatment, which uses artificial devices to perform the kidneys' functions, is necessary for cases of advanced kidney disease. Two types of dialysis are commonly used today. He-modialysis involves a mechanical filter that cleans the blood. A surgeon implants a shunt, a small tube that connects an artery and a vein in the patient's arm or leg. Several times a week, for three or four hours at a time, another tube is connected to the shunt and the patient's blood is pumped out of the body into the hemodialyzer and then pumped back.

Another method, called peritoneal dialysis, makes use of the inner lining of the abdomen, or peritoneal membrane-which has many of the kidneys' filtering characteristics-to help clean the blood. A plastic tube is surgically implanted in the patient's abdomen. Then, during each treatment, a fluid called dialyzate is infused through the tube into the abdomen.

Waste products carried by the blood circulating through tiny vessels in the peritoneal membrane filter into the dialyzate, which is drained out after several hours. This process is repeated three to five times a day. While the fluid is in the abdomen, the patient can go about normal daily activities.

Both types of dialysis present possible complications and risks, most notably that of infection. The stress of having to continually do the procedure can also take its toll on a patient's emotional well-being. For these reasons, people with advanced kidney disease often opt for a kidney transplant. New antirejection drugs and improved follow-up care have greatly increased the success rate for such surgery. Today, the three-year survival rate for patients who receive a donor kidney from a living relative is about 75 percent; for those whose transplanted kidney comes from an unrelated deceased donor, the rate is about 60 percent.

Not every person with kidney disease is a candidate for a transplant; a patient may have an underlying condition or other medical factor that rules out such an operation.

Alternative Choices

Because kidney disease is a serious illness, you should try alternative therapies only after talking them over with your physician.

Chinese Herbs

Traditional Chinese health practitioners use several herbs in the treatment of kidney disorders. However, because many herbs can be harmful to the kidneys, you should always consult your physician before taking the advice of an herbalist or ingesting any herbal remedies.

Homeopathy

Homeopathic remedies are generally safe for the treatment of chronic kidney conditions. However, the remedies should be prescribed by a practitioner skilled in both conventional and alternative medicine, and they should never be used as a substitute for conventional medicine.

Source : Alternative Medicine

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