Nephrology

Chronic kidney disease, also known as chronic kidney failure, is a condition that occurs when the kidneys aren’t working properly and are beginning to lose their function.

Signs and symptoms of chronic kidney disease can develop over time if kidney damage progresses slowly. The loss of kidney function can lead to a buildup of fluid, body waste, or electrolyte imbalances.

Depending on its severity, loss of kidney function can cause nausea and vomiting, loss of appetite, fatigue and weakness, sleep problems, urinating more or less frequently, decreased mental sharpness, muscle cramps, swelling of the feet and ankles, dry and itchy skin, high blood pressure that is difficult to control, shortness of breath due to fluid buildup in the lungs, and chest pain due to fluid buildup around the lining of the heart.

Treatments include measures to help preserve kidney function, control signs and symptoms, reduce complications, and slow disease progression. Damaged kidneys may need treatment for end-stage kidney disease.

Kidney stones are hard deposits of minerals and salts inside your kidneys. A kidney stone won’t usually cause symptoms until it moves around within the kidney or passes into one of the tubes that connect the kidneys to the bladder, called ureters.

If a stone gets lodged in the ureters, it can block the flow of urine, causing the kidney to swell and the ureter to spasm which can develop symptoms, such as severe sharp pain in the side and back below the ribs, pain that radiates to the lower abdomen and groin, pain that comes in waves with fluctuating intensity, pain or burning sensation while urinating.

Other signs and symptoms can include pink, red, or brown urine, cloudy or foul-smelling urine, a persistent need to urinate, urinating more often than usual, or urinating in small amounts, nausea and vomiting, and fever and chills due to an infection.

Treatment for kidney stones varies depending on the type of stone and the cause. Small kidney stones won’t require invasive treatment and can be passed by drinking water, taking pain relievers, and medical therapy. Larger stones that cause bleeding, kidney damage, or ongoing urinary tract infections may require more extensive treatments, such as surgery, sound waves to break up the stones, a scope to remove the stones, and parathyroid gland surgery.

Genetic kidney diseases are inherited conditions passed from parent to child, caused by mutations in specific genes which can increase the risk of kidney dysfunction or failure.

Polycystic kidney disease is a genetic kidney disease caused by this gene mutation. The two main types of polycystic kidney disease are autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD). Autosomal dominant polycystic kidney disease is the most common form of polycystic kidney disease and occurs when clusters of cysts grow in the body, mainly in the kidneys.

Symptoms of autosomal dominant polycystic kidney disease include, high blood pressure, pain in the belly, side, or back, blood in the urine, a feeling of fullness in the belly, increased size of the belly from enlarged kidneys, headaches, kidney stones, kidney failure, and urinary tract or kidney infections.

Treatments include blood pressure management, breathing support, dialysis, growth therapy, kidney transplant, and pain management.

Hypertension or high blood pressure is a common condition that affects the body’s arteries by increasing the amount of pressure the blood places on blood vessels as they move through the body.

Uncontrolled high blood pressure can cause arteries in and around the kidneys to narrow, weaken, and harden. If the kidneys’ blood vessels are damaged, they may no longer function properly and won’t be able to remove the waste and extra fluid from the body. Extra fluid in the blood vessels can increase blood pressure even more, causing more damage to the kidneys resulting in kidney disease.

As kidney disease worsens, symptoms such as edema, weight loss, loss of appetite, nausea, or vomiting, drowsiness, fatigue, sleep problems, headaches or trouble concentrating, increased or decreased urination, generalized itching, numbness, dry skin, or darkened skin, muscle cramps, and chest pain or shortness of breath may develop.

Treatments include, medicines, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) and lifestyle changes, such as physical activity, maintaining a healthy weight, following a healthy diet, managing stress, and quitting smoking.

Glomerular disease is a condition that damages the kidneys by attacking the tiny filter called glomeruli.
Glomeruli filter waste, remove extra fluids from the blood, and keep blood cells and protein circulating in the bloodstream. When glomeruli are damaged, they leak some of those products into the urine.

Signs of glomerular disease include high blood pressure, foamy urine, pink or light brown urine, swelling in the face and/or around the eyes, hands, feet, and ankles.

Treatments include lifestyle changes, such as maintaining a healthy weight, keeping salt intake low, maintaining normal blood pressure levels, managing blood sugar if diagnosed with diabetes, taking all prescribed medications, and quitting smoking.

Dialysis is a treatment for late-stage kidney disease, chronic kidney failure, and end-stage renal disease (ESRD). The two types of dialysis include hemodialysis and peritoneal dialysis. These dialysis treatments help the kidneys perform normal functions, such as filtering waste and excess fluid from the blood. Dialysis is needed until a kidney transplant is received, and the new kidney starts working.