page contents

sites

Wednesday 23 January 2013

Kidneys

Source(google.com.pk)
Kidneys Biography

The kidneys are a pair of bean-shaped organs that lie on either side of the spine in the lower middle of the back. Each kidney weighs about ¼ pound and contains approximately one million filtering units called nephrons. Each nephron is made of a glomerulus and a tubule. The glomerulus is a miniature filtering or sieving device while the tubule is a tiny tube like structure attached to the glomerulus.

The kidneys are connected to the urinary bladder by tubes called ureters. Urine is stored in the urinary bladder until the bladder is emptied by urinating. The bladder is connected to the outside of the body by another tube like structure called the urethra.


Illustration of the kidneys, urinary tract, and bladder.
The main function of the kidneys is to remove waste products and excess water from the blood. The kidneys process about 200 liters of blood every day and produce about 2 liters of urine. The waste products are generated from normal metabolic processes including the breakdown of active tissues, ingested foods, and other substances. The kidneys allow consumption of a variety of foods, drugs, vitamins and supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels. The kidney also plays a major role in regulating levels of various minerals such as calcium, sodium, and potassium in the blood.

As the first step in filtration, blood is delivered into the glomeruli by microscopic leaky blood vessels called capillaries. Here, blood is filtered of waste products and fluid while red blood cells, proteins, and large molecules are retained in the capillaries. In addition to wastes, some useful substances are also filtered out. The filtrate collects in a sac called Bowman's capsule.
The tubules are the next step in the filtration process. The tubules are lined with highly functional cells which process the filtrate, reabsorbing water and chemicals useful to the body while secreting some additional waste products into the tubule.
The kidneys also produce certain hormones that have important functions in the body, including the following:

Active form of vitamin D (calcitriol or 1,25 dihydroxy-vitamin D), which regulates absorption of calcium and phosphorus from foods, promoting formation of strong bone.
Erythropoietin (EPO), which stimulates the bone marrow to produce red blood cells.
Renin, which regulates blood volume and blood pressure.

Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys
Kidneys

What Is A Kidney

Source(google.com.pk)
What Is A Kidney Biography

This topic provides information about chronic kidney disease. If you are looking for information about sudden kidney failure, see the topic Acute Renal Failure.

What is Chronic Kidney Disease?
Having chronic kidney disease means that for some time your kidneys have not been working the way they should. Your kidneys have the important job of filtering your blood. They remove waste products and extra fluid and flush them from your body as urine. When your kidneys don't work right, wastes build up in your blood and make you sick.

Chronic kidney disease may seem to have come on suddenly. But it has been happening bit by bit for many years as a result of damage to your kidneys.

Each of your kidneys has about a million tiny filters, called nephrons. If nephrons are damaged, they stop working. For a while, healthy nephrons can take on the extra work. But if the damage continues, more and more nephrons shut down. After a certain point, the nephrons that are left cannot filter your blood well enough to keep you healthy.

One way to measure how well your kidneys are working is to figure out your glomerular filtration rate (GFR). The GFR is usually calculated using results from your blood creatinine (say "kree-AT-uh-neen") test. Then the stage of kidney disease is figured out using the GFR. There are five stages of kidney disease, from kidney damage with normal GFR to kidney failure.

There are things you can do to slow or stop the damage to your kidneys. Taking medicines and making some lifestyle changes can help you manage your disease and feel better.

Chronic kidney disease is also called chronic renal failure or chronic renal insufficiency.

What Causes Chronic Kidney Disease?
Chronic kidney disease is caused by damage to the kidneys. The most common causes of this damage are:

High blood pressure.
High blood sugar (diabetes).
Other things that can lead to chronic kidney disease include:

Kidney diseases and infections, such as polycystic kidney disease, pyelonephritis, and glomerulonephritis, or a kidney problem you were born with.
A narrowed or blocked renal artery. The renal artery carries blood to the kidneys.
Long-term use of medicines that can damage the kidneys. Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and celecoxib (Celebrex).

What are The Symptoms?
You may start to have symptoms only a few months after your kidneys begin to fail. But most people don't have symptoms early on. In fact, many don't have symptoms for as long as 30 years or more. This is called the "silent" phase of the disease.

How well your kidneys work is called kidney function. As your kidney function gets worse, you may:

Urinate less Than Normal.
Have swelling from fluid buildup in your tissues. This is called edema (say "ih-DEE-muh").
Feel very tired or sleepy.
Not feel hungry, or you may lose weight without trying.
Often feel sick to your stomach (nauseated) or vomit.
Have trouble sleeping.
Have headaches or trouble thinking clearly.

How is Chronic Kidney Disease Diagnosed?
Your doctor will do blood and urine tests to help find out how well your kidneys are working. These tests can show signs of kidney disease and anemia. (You can get anemia from having damaged kidneys.) You may have other tests to help rule out other problems that could cause your symptoms.

Your doctor will do tests that measure the amount of urea (BUN) and creatinine in your blood. These tests can help measure how well your kidneys are filtering your blood. As your kidney function gets worse, the amount of nitrogen and creatinine in your blood increases. The level of creatinine in your blood is used to find out the glomerular filtration rate (GFR). The GFR is used to show how much kidney function you still have. The GFR is also used to find out the stage of your kidney disease and to guide decisions about treatment.

Your doctor will ask questions about any past kidney problems. He or she will also ask whether you have a family history of kidney disease and what medicines you take, both prescription and over-the-counter drugs.

You may have a test that lets your doctor look at a picture of your kidneys, such as an ultrasound or CT scan. These tests can help your doctor measure the size of your kidneys, estimate blood flow to the kidneys, and see if urine flow is blocked. In some cases, your doctor may take a tiny sample of kidney tissue (biopsy) to help find out what caused your kidney disease.

How is it Treated?
Chronic kidney disease is usually caused by another condition. So the first step is to treat the disease that is causing kidney damage.

Diabetes and high blood pressure cause most cases of chronic kidney disease. If you keep your blood pressure and blood sugar in a target range, you may be able to slow or stop the damage to your kidneys. Losing weight and getting more exercise can help. You may also need to take medicines.

Kidney disease is a complex problem. You will probably need to take a number of medicines and have many tests. To stay as healthy as possible, work closely with your doctor. Go to all your appointments. And take your medicines just the way your doctor says to.

Lifestyle changes are an important part of your treatment. Taking these steps can help slow down kidney disease and reduce your symptoms. These steps may also help with high blood pressure, diabetes, and other problems that make kidney disease worse.

Follow a diet that is easy on your kidneys. A dietitian can help you make an eating plan with the right amounts of salt (sodium) and protein. You may also need to watch how much fluid you drink each day.
Make exercise a routine part of your life. Work with your doctor to design an exercise program that is right for you.
Do not smoke or use tobacco.
Do not drink alcohol.
Always talk to your doctor before you take any new medicine, including over-the-counter remedies, prescription drugs, vitamins, or herbs. Some of these can hurt your kidneys.

What Happens if Kidney Disease Gets Worse?
When kidney function falls below a certain point, it is called kidney failure. Kidney failure affects your whole body. It can cause serious heart, bone, and brain problems and make you feel very ill. Untreated kidney failure can be life-threatening.

When you have kidney failure, you will probably have two choices: start dialysis or get a new kidney (transplant). Both of these treatments have risks and benefits. Talk with your doctor to decide which would be best for you.

Dialysis is a process that filters your blood when your kidneys no longer can. It is not a cure, but it can help you feel better and live longer.
Kidney transplant may be the best choice if you are otherwise healthy. With a new kidney, you will feel much better and will be able to live a more normal life. But you may have to wait for a kidney that is a good match for your blood and tissue type. And you will have to take medicine for the rest of your life to keep your body from rejecting the new kidney.
Making treatment decisions when you are very ill is hard. It is normal to be worried and afraid. Discuss your concerns with your loved ones and your doctor. It may help to visit a dialysis center or transplant center and talk to others who have made these choices.

What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney
What Is A Kidney

Kidney Disorder

Source(google.com.pk)
Kidney Disorder Biography

Erythropoiesis-stimulating agents (ESAs): Patients with chronic kidney disease often develop anemia due to a lack of erythropoietin produced by the kidneys. Anemia is a condition with too few red cells and is characterized by fatigue and tiredness. After excluding other causes of anemia, the doctor may prescribe erythropoiesis-stimulating agents (ESAs) such as Procrit (erythropoietin), Aranesp (darbepoetin), or Omontys (peginesatide). ESAs stimulate the bone marrow to produce red cells and reduce the need for blood transfusions.

ESAs may have serious side effects. These include the risk of strokes, heart attacks, and blood clots. Worsening hypertension and seizures as well as serious allergic reactions are other side effects.


Phosphate binders: The doctor may recommend a diet low in phosphorus if one's serum phosphorus levels are high. If dietary restriction of phosphorus is unable to control the phosphorus levels, the patient may be started on phosphate binders. When taken with meals, binders combine with dietary phosphate and allow for elimination without absorption into the bloodstream. Binders are divided into large classes, including calcium-based binders such as Tums (calcium carbonate) and PhosLo (calcium acetate) and non-calcium based binders like Fosrenol (lanthanum carbonate), Renagel (sevelamer hydrochloride) and Renvela (sevelamer carbonate).

The calcium-based binders may cause hypercalcemia. Lanthanum and sevelamer do not contain calcium. While non-calcium based binders are much more expensive, the doctor may favor these if a patient's blood calcium levels are high. All phosphate binders may cause constipation, nausea, vomiting, bowel obstruction, and fecal impaction. Phosphate binders may interfere with the absorption of other medications if these are taken together. Always check with the doctor to confirm the suitability of taking these medications together with other drugs.

Vitamin D: Vitamin D deficiency is very common in patients with chronic kidney disease. The first step in treating metabolic bone disease is to ensure that there are adequate reserves of vitamin D in the body. The doctor may prescribe over-the-counter vitamin D or prescription-strength vitamin D (Drisdol) based on the patient's vitamin D levels.

As kidney disease progresses, activated forms of vitamin D may be prescribed. These drugs include Calcitriol (Rocaltrol), Paricalcitol (Zemplar), or doxercalciferol (Hectorol). These drugs are prescribed to control secondary hyperparathyroidism when the correction of nutritional vitamin D deficiency, administration of calcium supplementation, and control of serum phosphate have been ineffective.

The use of activated vitamin D may cause hypercalcemia (high calcium levels). The symptoms of hypercalcemia include feeling tired, difficulty thinking clearly, loss of appetite, nausea, vomiting, constipation, increased thirst, increased urination, and weight loss. Other side effects include diarrhea, nausea, swelling, allergic reactions, viral infections, high blood pressure, inflammation of the throat and nose, and dizziness. The doctor will recommend regular blood tests to follow the patient's kidney function, calcium, phosphorus, and parathyroid hormone levels.

Kidney Disorder

Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder
Kidney Disorder

The Kidney

Source(google.com.pk)
The Kidney Biography

MoreChronic Kidney Disease Medications
Erythropoiesis-stimulating agents (ESAs): Patients with chronic kidney disease often develop anemia due to a lack of erythropoietin produced by the kidneys. Anemia is a condition with too few red cells and is characterized by fatigue and tiredness. After excluding other causes of anemia, the doctor may prescribe erythropoiesis-stimulating agents (ESAs) such as Procrit (erythropoietin), Aranesp (darbepoetin), or Omontys (peginesatide). ESAs stimulate the bone marrow to produce red cells and reduce the need for blood transfusions.

ESAs may have serious side effects. These include the risk of strokes, heart attacks, and blood clots. Worsening hypertension and seizures as well as serious allergic reactions are other side effects.


Phosphate binders: The doctor may recommend a diet low in phosphorus if one's serum phosphorus levels are high. If dietary restriction of phosphorus is unable to control the phosphorus levels, the patient may be started on phosphate binders. When taken with meals, binders combine with dietary phosphate and allow for elimination without absorption into the bloodstream. Binders are divided into large classes, including calcium-based binders such as Tums (calcium carbonate) and PhosLo (calcium acetate) and non-calcium based binders like Fosrenol (lanthanum carbonate), Renagel (sevelamer hydrochloride) and Renvela (sevelamer carbonate).

The calcium-based binders may cause hypercalcemia. Lanthanum and sevelamer do not contain calcium. While non-calcium based binders are much more expensive, the doctor may favor these if a patient's blood calcium levels are high. All phosphate binders may cause constipation, nausea, vomiting, bowel obstruction, and fecal impaction. Phosphate binders may interfere with the absorption of other medications if these are taken together. Always check with the doctor to confirm the suitability of taking these medications together with other drugs.

Vitamin D: Vitamin D deficiency is very common in patients with chronic kidney disease. The first step in treating metabolic bone disease is to ensure that there are adequate reserves of vitamin D in the body. The doctor may prescribe over-the-counter vitamin D or prescription-strength vitamin D (Drisdol) based on the patient's vitamin D levels.

As kidney disease progresses, activated forms of vitamin D may be prescribed. These drugs include Calcitriol (Rocaltrol), Paricalcitol (Zemplar), or doxercalciferol (Hectorol). These drugs are prescribed to control secondary hyperparathyroidism when the correction of nutritional vitamin D deficiency, administration of calcium supplementation, and control of serum phosphate have been ineffective.

The use of activated vitamin D may cause hypercalcemia (high calcium levels). The symptoms of hypercalcemia include feeling tired, difficulty thinking clearly, loss of appetite, nausea, vomiting, constipation, increased thirst, increased urination, and weight loss. Other side effects include diarrhea, nausea, swelling, allergic reactions, viral infections, high blood pressure, inflammation of the throat and nose, and dizziness. The doctor will recommend regular blood tests to follow the patient's kidney function, calcium, phosphorus, and parathyroid hormone levels.

The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney
The Kidney

Kidney Disorders

Source(google.com)
Kidney Disorders Biography
Unfortunately, however, millions of Americans are not getting enough of this so-called "sunshine" vitamin. Now it turns out that one group in particular is almost universally lacking in vitamin D. According to a study slated for publication in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN), kidney disease patients who have low blood protein levels and who start dialysis during the winter are at extremely high risk of being seriously deficient in vitamin D.

Ishir Bhan, MD, of Massachusetts General Hospital, and his research team studied data from 908 U.S. dialysis patients in the Accelerated Mortality on Renal Replacement (ArMORR) cohort. The scientists' goal was to investigate routinely measured clinical and demographic characteristics to see if they could figure out which patients with end-stage renal disease (ESRD) on dialysis are at increased risk for vitamin D deficiency.

The results showed that 79% of the patients in the study were vitamin D deficient. The strongest predictors of a lack of vitamin D were being African-American, female, the winter season, and low blood levels of the protein albumin. In fact, when all these factors came together, the result was that every single kidney disease patient was deficit in vitamin D.

Specifically, the researchers found that if black dialysis patients had low blood albumin levels during the winter season, the likelihood they would be vitamin D deficient increased from 90% to 100% for women and from 85% to 100% for men. Their white counterparts fared only slightly better, with their risk of vitamin D deficiency rising from 82% to 94% in women and from 66% to 92% in males.

"This research identifies risk factors for nutritional vitamin D deficiency in the dialysis population and may provide clues to its biology in this population," Dr. Bhan said in a statement to the media.

So what is going on here that makes ESRD patients on dialysis so vulnerable to vitamin D deficiency? The scientists pointed out in their media statement that although previous studies have suggested that patients on dialysis have an impaired ability to generate vitamin D when they are exposed to adequate sunlight, their study indicates that skin-based production of vitamin D is likely to be important in patients with ESRD.

Although the researchers did not discuss the issue in their paper, their findings raise a which-came-first type issue. Is it possible vitamin D is at least part of the cause of serious kidney disease, and not merely a byproduct of the illness? With a growing number of chronic and serious illnesses -- including heart disease
Kidney Disorders
Kidney Disorders
Kidney Disorders
Kidney Disorders
Kidney Disorders
Kidney Disorders
Kidney Disorders
Kidney Disorders
Kidney Disorders
Kidney Disorders