Renal Health Plus | The Human Kidneys | General Ways Of Protecting You Kidney | Diagnostic Center | FAQ

Renal Health Plus
 
Kidney diseases, especially End Stage Renal Disease (ESRD), are already the 7 th leading cause of death among the Filipinos. One Filipino develops chronic renal failure every hour or about 120 Filipinos per million population per year. More than 5,000 Filipino patients are presently undergoing dialysis and approximately 1.1 million people worldwide are on renal replacement therapy. Reliable estimates reveal that the number of these patients will double in 2010.

In the past, chronic glomerulonephritis was the most common cause of chronic renal failure. Today, diabetes mellitus and hypertension have taken center stage in the causation of ESRD which together account for almost 60% of dialysis patients.

The cost of medical treatment for kidney disease is really exorbitant, beyond the reach of ordinary patients. Renal transplantation is limited due to the expense and the shortage of donors. The best that can be done at present is to focus efforts on the prevention of progression of renal diseases. Strict blood pressure and glycemic control and adoption of “ healthy lifestyle” play a major role in reducing if not totally controlling the epidemic of renal failure and this could be achieved through proper education.

This Renal Health Plus provides educational information related to the prevention, diagnosis and treatment of kidney diseases.

The Human Kidneys 

• Kidneys are important parts of the urinary system. They are found at each side of the spine, below the rib cage of the human body. Each kidney is as big as a fist, weighs ¼ pound and looks like a kidney bean.

• The kidneys perform vital life-maintaining functions as monitors and regulators of body fluid. They excrete fluids when the body has an excess of them and retain the substances necessary for the body’s continuing function. They produce and release a variety of chemicals to keep the body healthy and filter the entire blood supply every 2 minutes, excreting waste materials through the urine.

• The kidneys also produce erythropoietin, a hormone that controls the production of red blood cells by the bone marrow.

• They also are involved in the regulation of blood pressure. This probably happens through the regulation of blood volume and the amount of sodium in the body as well as the production of substances such as the angiotensin.

General Ways of Protecting your Kidneys 

• Exercise regularly

• Eat healthy diet

• Maintain ideal body weight

• Avoid smoking

• Avoid taking medications or herbal supplements without advice of physician

• Consult doctor right away if with symptoms

• Drink lots of water and avoid excessive salt

• Have annual physical check-up especially if with or with family history of hypertension, diabetes or renal failure

• If hypertensive and diabetic,

  • Take medications regularly
  • See the doctor regularly
  • Know blood sugar and blood pressure goals and make sure targets are met
  • Make sure the doctor checks the kidneys regularly

Diagnostic Service

Diagnosis of kidney ailments and kidney related health diseases is pivotal in providing effective therapeutic plan. The National and Kidney and Transplant Institute offers a wide range of the latest and state of the art diagnostic tools to quickly and accurately diagnose kidney diseases.

Please click on the Division/Department below to know more about their respective services:

• Laboratory Medicine

• Radiology

• Nuclear Medicine

• Urology

FAQ 

Question:
What are the signs and symptoms of kidney disorder?
       
Answer:
The main symptom of kidney disorder is fluid retention or edema. Patients may have puffiness around the eyes, swelling in the feet and legs and water in the lungs leading to difficulty of breathing

Any change in urination may also indicate kidney problem. This may consist of pain or unusual sensation during voiding, increased or decreased frequency of urination, difficulty in initiating urination, frequent urination at night, change in color of urine, blood in the urine or bubbly appearance of the urine.

Kidney failure results in the retention of various body wastes which cause anorexia, vomiting, difficulty in sleeping and generalized body weakness. This is often evaluated by measuring serum creatinine and blood urea nitrogen.

The presence of protein and red blood cells in the urine is also an indication of kidney disorder. In glomerulonephritis, proteinuria and hematuria are commonly seen because the glomeruli have become inflamed. Proteinuria is also the earliest manifestation of diabetic nephropathy. Pallor and weakness are also among the indications of kidney failure due to anemia secondary to low erythropoietin production by the failing kidneys.

Hypertension is also a major consequence of kidney disorder. Initial evaluation of all newly diagnosed hypertensive patients should include serum creatinine and electrolyte levels (sodium and potassium) particularly among young hypertensive subgroup.

Repeated urinary tract infections, back pain or pain in the lower abdomen may indicate the presence of kidney stones and may also cause blood in the urine.
      
Question:
What diseases commonly affect the kidneys?
       
Answer:    
Infection is the most common disorder of the kidneys and the urinary tract. Uncomplicated urinary tract infections are very easy to treat

Stones are solid residues in the urinary tract that may cause obstruction to the flow of urine which in turn may lead to infection of the kidneys and subsequent scarring.

Glomerulonephritis is inflammation of the glomeruli, the small vessels in the nephron. If not treated, patients may suffer slow progressive damage to the kidneys and develop renal failure.

Hypertension occurs with many cases of kidney diseases. Prolonged hypertension damages the small arteries in the kidneys. This may start a vicious cycle: damaged kidneys cause more serious hypertension which in turn brings more damage to the kidneys.

Diabetes may also damage the kidneys. It is the leading cause of chronic renal failure in many countries.

Abnormalities in the urinary tract that are congenital or inborn may consequently lead to poor function, obstruction or infection of the kidneys.

Some drugs, herbal medicine, solvents and insectides can also harm the kidneys.
      
Question:    
What are the warning signs of kidney disease?
       
Answer:    
Puffiness of the eye area
Progressive swelling of parts of the body usually at the ankles
Back pain on the lower part just below the ribcage
Changes in urination (increased or decreased frequency of urination, frequent urination at night, pain or unusually sensation during voiding, hesitancy or difficulty in initiating urination, change in color of the urine, blood in the urine)
New onset of high blood pressure
        
Question:
What are the symptoms of Urinary Tract Infection (UTI)?
       
Answer:    
Not everyone with UTI has symptoms, but most people get at least some. These may include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad and to feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone and some men experience fullness in the rectum. It is common for a person with UTI to complain that despite the urge to urinate, only a small amount of urine is passed.

The urine itself may look milky or cloudy, even reddish if blood is present. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea or vomiting.
       
Question:    
How can UTI be prevented?
       
Answer:    
There is no proven way to prevent UTI, but the following suggestions maybe helpful:

• Drink plenty of liquids about 6-8 glasses/day to flush bacteria out of the urinary system,

• Schedule frequent bathroom breaks

• Women should drink water before and after sex so they will urinate a good volume with a steady stream afterward. This will help eliminate any bacteria that may have entered the urinary bladder.

• After defecating, women should not wipe in the direction of the vagina to avoid spreading bacteria from the gastrointestinal tract

Question:    
How should patients with hypertension be treated?
       
Answer:    
Treatment of hypertension can be achieved through non-pharmacologic and pharmacologic means. It consists of the following

• Lifestyle modification

• Weight loss

• Exercise

• Low salt, low fat diet

• Stop smoking

• Less alcohol consumption

• Cope with stress

• Regular intake of antihypertensive medications      

Question:    
How are kidney stones prevented from developing?
       
Answer:    
The simplest and most important lifestyle change to prevent all kinds of kidney stones from developing is to drink more liquids. Water is the best. It is recommended that water intake should be at least 2 liters per day. There are many proponents of various “cures” by drinking other liquids such as buko juice, pito-pito tea, sambong tea and many other teas but scientific studies have not proven their efficacy and safety.

Therapeutic Options
Treatment of kidney diseases may involve the following: medical therapy such as medicines and dietary changes, dialysis and transplantation

• Because kidney failure is already irreversible at later stages, treatment focuses on controlling the symptoms, minimizing complications and slowing the progression of the disease.

• Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension, diabetes, congestive heart failure, UTI, kidney stones, obstructions of the urinary tract, glomerulonephritis, and other disorders should be treated appropriately.

• Medications such as iron supplements and erythropoietin injections may be needed to control anemia. Blood transfusion may be given but they are less preferred.

• Fluid intake may be restricted, often to an amount equal to the volume of urine produced. Dietary protein restriction may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Salt, potassium, phosphorus and other electrolytes may be restricted.

• Dialysis and kidney transplantation may be required eventually when end stage renal disease ensues or when 85-90 percent of kidney function is lost.

• Hemodialysis uses a special filter called a dialyzer that functions as an artificial kidney to clean the blood. During treatment, blood travels through the tubes into the dialyzer which filters out wastes and extra water. Then the cleaned blood flows through another set of tubes back into the body. The dialyzer is connected to the machine that monitors blood flow and removes wastes from the blood. Hemodialysis is usually performed 2 to 3 times a week. Each treatment last for 4 hours.

• Peritoneal dialysis is another procedure that removes extra water and wastes from the body. This type of dialysis uses the lining of the abdomen to filter the blood. This lining is called the peritoneal membrane and acts as the artificial kidney. A mixture of minerals and sugar dissolved in water called dialysis solution travels through a soft tube into the abdomen. The sugar, called dextrose, draws wastes, chemical and extra water from the tiny blood vessels in the peritoneal membrane into the dialysis solution. After several hours, the used solution is drained from the abdomen through the tube, taking the wastes from the blood with it. Then the patient fills his abdomen with fresh dialysis solution and the cycle is repeated usually 3 to 4 times a day. Each cycle is called an exchange.

• Kidney transplantation surgically places a healthy kidney from another person into the body of the patient with end stage renal disease. The donated kidney does the work that the 2 failed kidneys used to do. It is generally not necessary to remove the diseased kidneys. A donated kidney may come from an anonymous donor who has recently died or from a living person usually relative. The kidney that the patient receives must be a good match for his body. The more the new kidney is like his own, the less likely will his immune system reject it. The patient will be made to take special drugs called immunosuppressives to help trick his immune system so it would not reject the transplanted kidney.