Diseases of the kidney

The kidneys are located on both sides of the spine and are among the best-perfused organs. Their main task is the filtering of the blood and thus the production of urine, but also a blood pressure regulation and the production of some hormones is one of the tasks of the kidneys.
Diseases of the kidney can be felt with pain in the flank region, problems with urination or blood pressure derailment. The following is a brief explanation of the most important kidney diseases as well as a link to the main article of the disease with detailed information.

classification

Below are the most common kidney diseases classified in:

  1. Inflammation of the kidney
  2. Structural kidney disease
  3. Functional kidney disease
  4. Other kidney diseases

Inflammation of the kidneys

Renal body inflammation / glomerulonephritis

The kidney bodies ( glomeruli ) are the smallest functional unit of the kidney and form the filter system of the kidney. Inflammation of the renal corpuscles can have many causes. They can occur after infections with certain pathogens (post-infectious) or in the context of various (auto-) immunological diseases. Most of them arise because antibody complexes are deposited in the kidney corpuscles. Symptoms of renal insufficiency are due to the emerging defect of the filter system. This allows blood and proteins to enter the urine, which are normally retained by the filter. As the filtration capacity decreases, edemas can develop due to the ingestion of fluid. In the final stage it can come to chronic kidney failure.

Pyelonephritis

Kidney pelvic inflammation is one of the most common kidney diseases. The renal pelvis is the last stop within the kidney before the filtrate (primary urine) enters the ureter, through which it passes into the bladder. Ascending urinary tract infections can take the opposite route and enter via the bladder ("cystitis") and the ureter in the renal pelvis and trigger an inflammation there. Symptoms typically include severe flank pain in the kidney area and painful urination. Although kidney pancreas is a relatively severe disease, it can usually be treated well with antibiotics and cured in 1-2 weeks.

In addition to kidney infection

The adrenal glands are directly adjacent to the kidneys, but are considered to be independent organs. Their main task is the production of different hormones. Inflammations of the adrenals usually occur as autoimmune reactions, which means that the immune system attacks the body's own structures. The result of inflammation can be adrenal insufficiency, in which adrenal hormone production is so severely restricted that a healthy hormone balance can no longer be maintained. The lack of adrenal hormones (including cortisol, aldosterone and sex hormones) causes symptoms such as nausea, weight loss, hypotension or low blood sugar.

Structural kidney disease

Kidney stones

Kidney stones are widespread in the population, about 5% of adults suffer from it, sometimes even without knowing it. The stones consist of various urinary components, mostly calcium or uric acid stones. When these components of the urine are greatly increased, they can no longer be sufficiently excreted through the kidney and form stones within the kidney or the urinary tract. If stones are present individually and in favorable locations such as the renal pelvis, they can remain asymptomatic and are often unnoticed. If a kidney stone bottlenecks, this can lead to strong wave-like pain, the so-called renal colic. Also problems with urination are possible. To remove kidney stones, various surgical methods are available.

renal cysts

Renal cysts are fluid-filled cavities of the kidney tissue, which occur especially in increasing age. In the over 60-year-old population, one in five is affected. Single renal cysts usually cause no symptoms. Very large cysts can cause problems and must be "emptied" by puncture. Rarely, a renal cyst can cause inflammatory reactions that should be treated with antibiotics. It is important to distinguish between a renal cyst and a cystic kidney. The latter is an independent genetic disease in which virtually the entire kidney tissue of cysts is infected ( polycystic kidney disease ). More serious are symptoms such as hypertension or kidney failure.

Kidney cancer / renal cell carcinoma

Renal cancer is usually a so-called renal cell carcinoma . This cancer is relatively rare and occurs especially in old age, the disease peak is 60-80 years. Symptoms of kidney cancer include bloody urine, flank pain, and weight loss. Since this cancer is poorly responsive to chemotherapy, the treatment of choice is a radical surgical removal of the entire affected kidney, including the adrenals and lymph nodes.

Calcified kidney

If more calcium is accumulated in the kidneys, the clinical picture of the calcified kidney develops. The causes for this are, as already suspected, in a disturbed calcium metabolism. A quick and painless diagnosis in this case, the ultrasound examination.

Functional kidney disease

Diabetic Kidney Disease

Diabetic kidney disease (medically diabetic nephropathy ) is a loss of function of the kidney, which develops as a result of the diabetes mellitus diabetes mellitus. Constantly elevated blood glucose levels, in combination with a high level of blood pressure, can lead to damage to the fine renal vessels and the kidney filter system. For example, larger molecules such as proteins, which are normally held by the filter in the body, enter the urine. Over time, kidney tissue is destroyed and chronic kidney failure can occur. Diabetic nephropathy is the most common cause of dialysis treatment in Germany.

Acute kidney failure

Acute renal failure is a serious condition that usually requires hospitalization. However, it usually does not appear as an independent disease, but in the context of far-reaching diseases, for example. In multiple organ failure, sepsis or burns. It is characterized by the fact that renal function decreases acutely and urinary excretion falls below 500 ml / day (normally 1.5-2 liters). The patients then store fluid in the form of edema, for example in the legs or lungs, the latter causing respiratory distress. In the treatment of acute renal failure, especially the treatment of the triggering cause plays a role. Using diuretics (water-removing drugs) can be tried to increase kidney function. In severe cases, dialysis is necessary.

Renal Failure / Chronic Renal Failure

Renal insufficiency is a kidney function loss, with acute renal failure also being a form of renal insufficiency. In chronic renal failure, for example, in the context of diabetes or other diseases, divided into various stages of the filtration performance of the kidney divided, which usually decreases in the course of the disease. In addition to the accumulation of excess fluid in the body, especially the lack of excretion of certain substances is a problem. For example, the blood concentration of urea increases as the filtration performance of the kidney decreases. Urea in toxic amounts can cause various types of damage in the body, such as in the brain, heart or skin. The treatment of renal insufficiency is complex and includes approaches such as diets, hydration, diuretics and end-stage dialysis.

renal artery stenosis

A "stenosis" is a narrowing, in this case of the renal artery. The kidney is involved in the regulation of blood pressure. If there is too little blood in the kidney due to a narrowing of the renal artery, the kidney incorrectly "measures" a low blood pressure and initiates various mechanisms to increase the general blood pressure. However, since this is actually not degraded in the rest of the body, but only in the kidney, arises in the body high blood pressure. Common causes of renal artery stenosis are vascular diseases such as arteriosclerosis, which mainly occurs in older smokers. Therapeutically, the renal artery can be re-expanded by surgery, but also various antihypertensive drugs are used.

Kidney Disease: What You Should Know | UCLAMDCHAT Webinars (December 2019).


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