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Kidney Disorders

 

We have all had a bladder/kidney infection from time to time or possibly have suffered from a kidney stone, or may possible suffer from acute or chronic renal failure or know someone who does.  Problems with kidneys are often caused by secretions of substances that cause our blood pressure to rise.  This in turn may damage the working units of the kidney (the nephron).  So along with the medications depicted on the medication page for high blood pressure, it may be easier to understand if we discuss them at the same time.

 

Structure of the Kidneys

 

The kidneys are found in the lumbar area with the right kidney a little lower than the left. They can assume different locations depending on the position of the body.  They are protected by a covering of fibrous tissue, a layer of fat and thin outer covering

 

Bladder infections are often caused by the introduction of bacteria through the urethra. That is the tube that runs from your bladder to the outside of your body.  These are usually controlled by Sulfa or Cipro.  Tetracycline is another antibiotic that may be used.   The main thing here with infection is to get a culture and sensitivity of the urine before we start taking the antibiotic. Drinking cranberry juice every day is good also for bladder infections as it makes the atmosphere much more difficult for the bacteria to survive.  It won’t cure or stop an infection but will help prevent one.

 

Nephritis is an inflammation in the kidney itself and is also treated with antibiotics.

 

Kidney Stones are hard mineral deposits that collect in the kidney.  They can pass into the urine and larger stones may stick in the ureter and make it difficult to leave the body.  Sometimes they can be crushed into much smaller pieces so they can be eliminated without difficulty.  The method used is a form of ultrasound. When crushed with the ultrasound the pieces are then excreted in the urine.  In the past, surgical extraction was necessary and in the rare instance today, they may have to be extracted surgically.

 

Kidney Failure happens when disease or substance abuse prevents the kidneys from working properly.  It must be treated aggressively using hemodialysis.  Sometimes a Kidney  Transplant is needed. 

Dialysis  is performed with a machine.  The blood is pumped out of the body through a Fistula made from the patients own vessel or through a line directly into the venous system.  It then is pumped through an artificial kidney to filter out imperfections and toxins.  This “kidney”  looks something like the tube returns at your drive through bank only filled with tiny saran wrap appearing tubes that will not allow large particles to go back into your body. This is usually done on a routine schedule 3 days a week.  The artificial kidneys are then sent to be repurified and are reused on the same patient a few times.  If this is being done because of an overdose, you will sometimes see it done daily or even continuously for a few days but at a slower rate. 

Kidney Transplants may be preformed when kidney failure is severe. The most likely candidate for donation is a family member of course, but they may test several people before there is a good match and may take a long time.  Once a transplant is preformed there is another group of drugs which must be taken for life.  These are the medications given to prevent the body rejecting this foreign object.

 

  National Kidney Foundation        Polycystic Kidney disease     Medline= Kidney Disease

 

 

 

 

Thrombophlebitis

This is a blood clot which may form in either the deep or superficial veins. Often starting as phlebitis ( a localized inflammation red and very warm to the touch ) in one of the extremities.  This phlebitis quickly turns into a clot formation. This thrombus (clot) forms quickly in areas where blood flow is slowed allowing the collection of platelets and fibrin from which clots are formed.  This disorder is frequently progressive and if not caught early enough and resolved, can lead to Pulmonary embolism and death.

Clinical signs and symptoms of Thrombophlebitis vary with the site and length of the affected vein.  It may occur without giving any symptoms prior to the discovery, but can also produce severe pain, fever, chills, malaise, and possibly swelling of the  affected arm or leg.

Diagnosis is made from

  • the redness heat and swelling in the affected limb.

  • confirmation made through doppler ultrasound

Before the full diagnosis can be made we must rule out such things as:

  • arterial occlusive disease

  • lymphangitis

  • cellulitis

The goals of treatment are to control thrombus development, prevent complications, and relieve pain.

Symptomatic measures include:

  • bed rest with the affected extremity elevated

  • warm moist soaks to the affected area

  • analgesics

  • heparin initially then to coumadin later to prolong clotting time if you are to have surgery and are taking coumadin you must let your physician know and it must be stopped several days prior to surgery

The best preventative medicine is to get up and moving after surgery as soon as possible and don't sit for long periods of time. If you must remain sitting for a long period of time like on a long road trip or airplane trip:

  • Move your legs around and flap your feet

  • Do NOT cross your legs

  • Elevate your legs above your heart as much as possible

Thrombophlebitis                                                                      National association for Paget's disease

Thrombophlebitis what you should know                                Living with Paget's

 

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