Kidney Disease and Urology

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• QHow can I slow kidney disease caused by diabetes?

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  A American Diabetes Association answered

  If you already have some kidney damage caused by diabetes, it's not reversible. But you can slow down the rate of damage and keep it from getting worse. You'll want to keep blood glucose and blood pressure levels on target, lose weight if needed, and continue to take your medications. In addition, these steps can help:

  1. Change the way you eat. Many people find that lowering the amount of sodium in their meal plan helps lower blood pressure. If you usually have large servings of protein-rich foods such as meat, chicken, and fish, your health care team may recommend that you eat fewer protein-rich foods to protect your kidneys. A registered dietitian can help you plan how to make these changes.
  2. Watch out for your kidneys when you have special X ray tests. Some special X ray tests use a liquid dye for better images. However, these dyes can harm the kidneys. The doctor may decide to do a test without dye or take other measures instead.
  3. See your doctor right away for bladder or kidney infections. If you have pain or burning during urination, a frequent urge to urinate, cloudy or reddish urine, nausea, a fever, or pain in your back or on your side below the ribs, you may have an infection in your bladder or kidneys. Left untreated, infections can damage your kidneys.

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• QWhat can I do to prevent kidney damage from diabetes from getting worse?

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  A Dr. Caitlin E. Carter, MD , Nephrology, answered on behalf of Scripps Health

  Diabetes is the most common cause of kidney disease and kidney failure in the United States.

  Typically, diabetes takes many years to cause kidney damage. If you have decreased kidney function or protein in your urine (microalbuminuria) from diabetes, consider these important steps to prevent worsening your kidney function.

  Even small improvements can lower your risk of progressive kidney disease. These steps include:

  • Achieve good blood pressure control. Taking an ace inhibitor or an angiotensin-receptor-blocking medication can help lower blood pressure. It also has specific effects on the kidney that protect the kidney from damage caused by diabetes. If you have kidney disease, it is important to control your blood pressure. The target for each person may vary but generally is less than 140/90.
  • Stop smoking if you smoke. It increases risk for renal function deterioration, including diabetic nephropathy.
  • Maintain a healthy body weight.
  • Control your diabetes with a goal hemoglobin A1C less than 7 percent with diet and medications.
  • Control you cholesterol with diet and medications if necessary.
  • Limit your dietary sodium intake to less than 2,000 mg per day. This helps to lower your blood pressure and helps your medication work more effectively.
  • Follow up with your nephrologist (kidney specialist) routinely to make sure you are doing everything you can to prevent kidney disease from worsening.

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• QWhat is diabetes insipidus?

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  A American Diabetes Association answered

  Diabetes insipidus is a condition characterized by frequent and heavy urination, excessive thirst and an overall feeling of weakness. This condition may be caused by a defect in the pituitary gland or in the kidney. In diabetes insipidus, blood glucose levels are normal.

• QHow can kidney problems caused by diabetes affect my daily life?

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  A National Kidney Foundation answered

  Insulin and certain medications used by people with diabetes are cleared by the kidneys. If you have diabetes and chronic kidney disease, check with your doctor to see if any dosing changes need to be made based on your level of kidney function.

  Because diabetes is a leading cause of kidney disease, it's important that those with diabetes control their blood sugar levels. Blood sugar control typically involves a combination of diet, physical activity and medication.

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• QWhat is a varicocele embolization?

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  A Dr. John C. Lipman, MD , Vascular & Interventional Radiology, answered

  Varicocele embolization is a non-surgical procedure performed by an Interventional Radiologist (IR). It is an outpatient procedure performed under local anesthesia, thus avoiding the risks and complications from surgery and general anesthesia. A tiny catheter is placed in to a vein of the right neck or right groin and advanced under x-ray guidance in to the spermatic vein on the side of the varicocele (typically left but can be both). A contrast injection (venogram) is obtained during a Valsalva (bearing down) maneuver to document the reflux of contrast down the incompetent spermatic vein to the scrotum. It also depicts the collateral channels that may be present, and is the reason why the embolization procedure has a lower recurrence rate compared with traditional surgery (i.e. these collaterals cannot be seen during the surgery). Either a series of metallic coils or a sandwich of coils surrounding an injection of a sclerosant is used to close the spermatic vein as well as any collateral channels. 
• QHow are varicoceles treated?

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  A Dr. Harry Fisch, MD , Urology, answered

  If you discover you have a varicocele (a bundle of enlarged veins in the scrotum), there are several simple surgical fixes. They all involve tying off, or blocking, the distended veins in the scrotum. Which method is best depends on such things as the particulars of a man's anatomy, and the nature and location of the varicocele.
  
  The results of microsurgical varicocele repairs in thousands of men show an overall improvement in semen quality of about 60-70% and an overall pregnancy rate of about 40% without the need for assisted reproductive technology.

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• QCan kidney cysts be treated with surgery?

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  A Dr. Kyle K. Himsl, MD , Urology, answered on behalf of Los Robles Regional Medical Center

  

  Most kidney cysts do not require surgery, but some do. Watch this video with urologist Kyle Himsl, MD from Los Robles Hospital & Medical Center to learn about the circumstances where surgery is required and what procedures are used.

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• QWhat causes hematuria?

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  A Dr. David D. Buethe, MD , Urology, answered on behalf of Oak Hill Hospital

  

  Blood in the urine can indicate infection, kidney stones and various types of cancer. David Buethe, MD from Oak Hill Hospital, describes how doctors determine what issues are going on when blood in urine is found.

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• QWhat is urethritis?

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  A Dr. Kyle K. Himsl, MD , Urology, answered on behalf of Los Robles Regional Medical Center

  

  Learn some potential causes of inflammation of the urethra, as well as symptoms associated with this condition. Watch this video with urologist Kyle Himsl, MD from Los Robles Hospital & Medical Center.

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• QHow is urethritis treated?

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  A Dr. Kyle K. Himsl, MD , Urology, answered on behalf of Los Robles Regional Medical Center

  

  Depending on the cause, urethritis may be treated with antibiotics or pain medications. Watch this video with urologist Kyle Himsl, MD from Los Robles Hospital & Medical Center to learn more.