Kidney Disease and Urology

Kidney Disease and Urology

Kidney Disease and Urology
The kidneys are amazing organs. One of the kidney’s major functions is to filter and remove waste products and excess fluids from your body. Each and every day, your kidneys filter over 200 quarts of fluid to produce about 2 quarts of urine that is stored in the bladder, and ultimately removed through a process called urination. Your kidneys also play an important role in removing drugs, regulating blood pressure, controlling the production of red bloods cells and helping promote strong, healthy bones by producing an active form of vitamin D.

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    A answered
    If you have nephrotic syndrome (a group of symptoms caused by kidney damage), you should call your doctor for the following reasons.

    1. You are having symptoms of nephrotic syndrome including:
    • a puffy face and/or eyes
    • swelling in your feet, ankles, legs, hands, arms and/or abdomen
    • foamy urine
    • loss of appetite
    • fluid retention that may cause unintentional weight gain
    • proteinuria (large amounts of protein in your urine, identified during a urinalysis)
    • hypoalbuminia (low levels of protein in your blood, identified during an analysis of a blood sample)
    • hyperlipidemia -- high levels of fats and cholesterol in your blood
    • fatigue
    2. Your symptoms of nephrotic syndrome worsen or persist rather than improve with treatment.

    3. You experience new, additional symptoms including cough, fever, headache or changes in urination (discomfort and/or infrequency).

    4. You develop sores on your skin.
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    As your kidneys fail, your blood urea nitrogen (BUN) and blood creatinine levels will rise. You may also experience nausea, vomiting, a loss of appetite, weakness, increased fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin if you have diabetes. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.
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    People with diabetes can get a kidney transplant if their kidneys fail. Once you get a new kidney, you may need a higher dose of insulin. Your appetite will improve so your new kidney will break down insulin better than your injured one. You will use steroids to keep your body from rejecting your new kidney. If your new kidney fails, dialysis treatment can be started while you wait for another kidney.

    Sometimes it is possible to perform a pancreas transplant along with a kidney transplant. Your doctor can advise you about this possibility.
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    A Nephrology, answered on behalf of
    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.
    • 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% 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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    What Cancers Do Urologists Treat?
    Urologists treat cancers of the entire urinary tract, says Timothy Atkinson, MD, from Frankfort Regional Medical Center. Learn the specific types of cancer, including bladder and prostate cancer, in this video.
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    A , Gynecology, answered
    Varicoceles can present with testicular/scrotal pain or discovered incidentally during an infertility work-up (i.e. varicoceles can lead to diminished/absent sperm counts). Varicoceles can be felt on physical exam or be detected on a scrotal ultrasound. Having the patient bear down (Valsalva) is an important maneuver to detect the varicocele. 
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    A , Gynecology, 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. 
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    Tight control of glucose lowers the risk of all complications from diabetes, including kidney disease. Other measures are keeping high blood pressure under control, quitting cigarette smoking and following a diet for diabetes, as prescribed by your doctor or healthcare professional. In addition to these measures, once kidney disease and albuminuria have developed, medications called angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) should be prescribed to slow down the progression of kidney disease.
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    A Urology, answered on behalf of
    To diagnose a cystocele (prolapsed bladder), your healthcare provider will ask about your medical history and give you a physical exam. You may also have a cystourethrogram (also called a voiding cystogram), which is an x-ray taken of the bladder while you urinate. You’ll be given a special dye called a contrast medium. This helps show the bladder and urethra on the x-ray, allowing your healthcare provider to see the shape of your bladder and look for problems. You may need other tests to see if there are any problems in the other areas of your urinary system.
     
    A cystocele is graded during diagnosis. Grade 1 means the bladder sags only a short way into the top of the vagina. Grade 2 means the bladder sags down to the lower opening of the vagina. Grade 3 means the bladder sags out of the lower opening of the vagina.
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