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Nephrology: The Renal Tale


What Does Nephrology Treatment Mean?

Human body works continuously at cellular level in order to bring about vital functions such as respiration, blood circulation, digestion, excretion etc which in turn balance the metabolic rate. The nutrients are filtered and the excess/un required ones are expelled out of the body in the form of urine. A pair of kidneys, ureters, a single bladder and urethra work in unison for the above stated purpose and form the urinary/renal system. MedcureIndia guides its readers with all the pathologies associated with it in the following lines.

Causes Of Nephrologic Diseases:

  • Inflammation along the urinary tract mainly occurs due to viral/bacterial/fungal infections due to unhygienic conditions e.g UTI urinary tract infection. In severe cases, septic shock may also result.
  • Dehydration also leads to electrolytic imbalance leading to recurrent renal allergies and infections.
  • Excess smoking/alcohol/drugs may cause overload of toxins in the blood, damage to renal vessels i.e vasculitis leading to renal disorders.
  • Prolonged and uncontrolled hypertension and diabetes leads to glomerulonephritis, nephritic syndrome and chronic renal failure.

Signs & Symptoms Of Nephrologic Disorders:

  • Pain in lower back region, painful urination, mild to high grade fever occur during bacterial/viral infections and allergies of the urinary tract and kidney stones.
  • Change in the color of urine, ranging from dark orange, red to brown
  • Reduction in the quantity and frequency of urination.
  • Swelling of eyes, hands and feet due to retention of fluids.
  • Nausea, vomiting, seizures
  • Leakage of certain elements may occur due to faulty filtering of blood in the kidney owing to existing pathologies. These include:

Proteinuria: protein in urine.

Haematuria: blood in urine.

Uremia: uric acid in urine.

Diagnostic Tests For Nephrologic Diseases:

  • The most commonly and routinely recommended are kidney function tests including blood and complete urine analysis.
  • Glomerular filtration rate GFR test is a type of blood test which tells about how much of blood the kidneys can filter, also how efficiently they can expel waste products and water from the body. Serum creatinine and serum urea tests measure the level of these waste products in blood which ideally should be flushed away from body.
  • Urine tests detect presence of any abnormal pus cells, proteins, blood, creatinine in urine which otherwise are not present. Urine culture tests tell about the presence and number of micro-organisms present in urine.
  • Imaging techniques such as ultrasound, CT and MRI detect kidney stones, kidney tumors, sites of pelvic trauma.
  • Biopsy: This is done in cases of urinary tract cancer where a part of the cancer mass is removed surgically to study its nature, type and aggression.

Types Of Nephrologic Diseases:

These are studied according to the anatomy of the urinary system.

  1. Diseases involving the kidney:

Depending upon the onset and duration of the disease, they are classified as acute and chronic kidney diseases.

  • Acute kidney disease: They last from a few days to a few weeks time and are mostly cured by medications.
  • Chronic kidney disease: These develop over a period of time due to some underlying systemic diseases such as hypertension or diabetes. Long term use of medications may or may not suffice the symptoms; surgical intervention may be used. Glomeruli are a collection of renal vessels which filter the blood in the kidneys. High levels of blood pressure and glucose in blood tend to damage and cause collapse of the glomerulus leading to a faulty filtration of blood. In extreme cases, chronic renal failure occurs due to accumulation of toxins in the blood. Diabetic nephropathy occurs in type II diabetes in which the kidneys perform faulty filtration and begin to leak a protein called albumin in urine (proteinuria).

Other diseases include:

  • Kidney stones: These are small to big grain sized masses of either calcium, magnesium, phosphate, ammonium, uric acid or cystine. These elements get filtered from the blood into the glomerulus and are passed onto the tubular structures. On their way they may get calcified within the kidney, or in the urinary passage called ureter, in the bladder or the urethra. They hamper the normal passage of urine leading to painful urination. They also may cause erosion of the renal tissues causing blood to appear in urine (heamaturia).
  • Glomerulonephritis: It is an inflammatory condition of the glomerulus. It is mostly caused by bacterial/viral/fungal infections, chronic use of drugs or maybe congenital in nature (rarely).
  • Nephrotic syndrome: It is a condition in which excess protein is allowed to pass into the urine. Damage to the renal vessels due to drugs or trauma often leads to this condition. As a result, protein levels in blood and body are reduced leading to symptoms like swelling of hands and feet.
  • Renal tubular acidosis: It is an electrolytic imbalanced condition in which the renal vessels fail to filter and excrete acids from the body. As a result the acidic component of the blood is raised leading to acidosis.
  • Polycystic kidney disease: It is a genetic disorder in which multiple small fluid filled sacs called cysts are seen in the parenchyma of kidney. It impairs the blood filtering capacity of the kidney, leaking toxins in the urine as well as raising their levels in the blood. A cyst may routinely be seen in the kidney due to trauma in the pelvic region or any infection. However it is totally different from a polycystic one and not as complicated as the latter.
  • Alport syndrome: Genetic disorder leading to hearing loss, eye abnormalities and blood in urine due renal inflammation.
  • Goodpasture syndrome: It is an autoimmune disorder where the body produces cells against the basement membrane of the tissues in lungs and kidneys. As a result, blood leakage in lungs and kidneys takes place.
  1. Diseases involving the ureter:

These are a pair of long muscular tubular structures connecting kidney on each side with the bladder in the midline, carrying urine.

  • Ureteritis: Inflammation along the course of the ureter is called ureteritis. Occurs due to bacterial and viral infections, causing pain during urination along with blood and pus cells seen in urine.
  • Ureteral obstruction: It is blocking of the ureteral passage due to kidney stones or blood clots. Associated with fever, painful urination with complete or partial blockage of urine.
  • Uterocele: It is a congenital abnormality in which a sac like pouch develops at the ureter’s entry into the urinary bladder. Observation for its regressions and antibiotic coverage in newborns are the treatment options.
  • Vesicouretral reflux VUR: It is the backward flow of urine from bladder to the either one or both the ureters, most commonly seen in children suffering from urinary tract infections. Heavy anti-allergics and antibiotics are given for its correction.
  • Uteral stricture/cyst: It is a pathological narrowing of the ureter leading to partial or complete blocking of urine. It mostly requires a surgical approach for correction.
  1. Diseases involving the urinary bladder:

It is a muscular sac like organ located in the pelvic region, leads to opening of the ureters and stores urine. Its pathologies include:

  • Interstitial cystitis/bladder pain syndrome: It is a condition of chronic pain and pressure in the bladder region, need to urinate frequently. Subsides by strong antibiotic medications.
  • Haemorrhagic cystitis: It is the appearance of blood in urine along with symptoms of interstitial cystitis. Same lineage of treatment is adopted.
  • Bladder cancer: It is 10 percent more common in females than males. The first symptoms are blood in urine and dark orange color of urine. It is always a painless phenomenon in the beginning. However urination later becomes painful with reduction in the frequency of urinating.
  • Underactive/lazy/hypotonic bladder: Bladder distends and contracts due to the activity of detrusor muscle. Due to the hypotonicity of the muscle, urinary expulsion may become difficult and much more quantity of urine may get stored in the bladder leading to extreme pain and pressure.

Diseases Of Urethra:

It is a small tubular structure at the apex of bladder for the expulsion of urine from the body. It diseases include:

  • Urethritis: Inflammatory condition of the urethra, often associated with urinary tract infections causing fever and pain during urination.
  • Urethral stricture: It is narrowing of the urethra, may occur secondary to urethriris, due to trauma or instrumentation such as catheterization.
  • Urethral diverticulum: It is a small pouch/sac which develops along the course of urethra, common in females than males. Causes urgent urges to urinate, blood and ous cells also occur in urine.

Treatment Of Nephrologic Diseases:

  • Medications: Most commonly used include anti-allergics, antibiotics and anti-inflammatory to subside the bacterial/fungal infections and pain/inflammation respectively. Patients are also encouraged to increase the fluid intake capacity.
  • Bladder training sessions: These are done in cases of cysts, strictures, diverticulums and bladder cancer where the urination is painful and the urges are strong. Patient is asked to follow a proper urine schedule and a strict diet to help reduce the pain and expel urine timely. Stents may also be placed surgically in the ureter and urethra if the stricture becomes very narrow, thus restoring the normal urine flow.
  • Lithotripsy: It is a laser assisted surgical approach for the treatment of kidney stones along the urinary tract. It is a totally noninvasive an outpatient department procedure. However in cases of huge chuncks of stones, a proper invasive surgical approach for its complete removal becomes mandatory.
  • Use of catheter: A long tube called catheter is inserted in to the urethra and connected to the bladder for the passage of urine in cases of  acute anueria i.e no urine passage due to infections or as a part of surgical procedures.
  • Dialysis: It is the last resort in cases of chronic kidney failures, nephrotic syndromes and glomerulonephritis where the kidneys totally fail to filter toxins from blood. Hence an artificial machine is used for the blood purification of expulsion of waste products. This procedure increases the life expectancy by 10-12 years, however the machine is quite cumbersome to use and the patient remains quite bed ridden. Peritoneal type of dialysis is done by patients at home with or without assistance, whereas hemo-dialysis also can be done at home and also while travelling.
  • Kidney transplant: In extreme cases, a kidney transplant may be required taking into consideration the parameters of both the donor and that of the recipient.

Complications & Risk Factors Associated With Nephrologic Diseases:

  • Obesity, alcohol, smoking collectively increase the risk chances for failure of treatment in chronic renal diseases.
  • High levels of blood glucose in diabetics further deteriorate the kidney functions.
  • Uncontrolled hypertension leads to damage of the renal blood vessels.

Success Rate Of In India:

The overall success rates are quite good. Acute and chronic infections are totally taken care of my medications. Cases of chronic renal failures are 90 percent successfully managed with dialysis. Surgical approaches for correction of strictures, kidney stones are almost always a success with 1.5 percent of recurrence chance.

Why Medcureindia?

Team MedcureIndia primarily focuses on the well being of its clients. We secondarily aim at recommending highly qualified nephrologic professionals to our clients seeking help. We not only believe in complete dissolution of the pathology, but also in getting the correction done at the most affordable rates.

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