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Kidney Diseases

Gilbert Ng

Ms. Whillier

2004.03.10

The primary functions of the kidneys are to work as filters and keep a dynamic balance in the bloodstream. The kidneys perform these tasks by tubular reabsorption that selectively keeps substances and removes waste. The waste removed is then collected and left in the urine for evacuation.

The kidneys are paired organs and share the workload, but should the body have only one, the single kidney can do the work of both. On rare occasions a person may be born with only one kidney, in such cases the person is still able to live a normal life. Usually a person may have only one kidney due to kidney loss, damage, disease or donation.

Kidney disease can range from minor infections to fatal kidney failure. The “big five” of ailments for the Kidney are peylonephritis, Glomerulonephritis, Kidney Stones, Gout and Uremia.

The most common form of kidney disease is pyelonephritis; inflammation of the kidney. Inflammation in the kidney is often due to bacterial infection that starts in the bladder. Other times it may be due to urine flow obstruction in the urinary tract among other causes or ailments to the other parts of the urinary system, like cystitis (inflammation of the urinary bladder).

Symptoms of the pylonephritis include fever, chills and back pain. If left untreated the infection may scar and/or impair function of the kidneys. Anti-biotics drugs are often prescribed as treatment to fight the bacteria.

The other common form of inflammation in the kidney is Glomerulonephritis, characterized by the inflammation of the Glomeruli. Glomerulonephritis may be caused by the impairment of the body’s immune system. The impaired immune system may allow anti-bodies and other large particles in the bloodstream to become trapped in the glomeruli causing inflammation and impairment of the glomeruli.

Symptoms of Glomerulonepritis include blood in the urine, swelling of body tissues, and presence of protein in the urine. Diagnosis of this type of inflammation is done through laboratory testing. Glomerulonephritis often is self-corrective and treatment is not required. However if treatment is necessary it may include immunosuppressant drugs, (drugs that suppress the body’s normal immune system), a special diet or plasmapheresis (a procedure that removes antibody containing blood).

The most famous kidney ailment is kidney stones. Kidney stones are small-crystallized substances. Commonly calcium is the substance that crystallizes in the kidney. In the case of calcium kidney stones, it may be caused by problems related to the parathyroid, but may also be caused by stress-related issues.

Symptoms of kidney stones include immense pain if they obstruct the urinary passage. Kidney stones can often be passed through urination but can be removed surgically or through lithotripsy. Lithotripsy is a technique used to breakdown the stones through ultrasound waves.

Chronic renal failure is the deterioration of kidney function over a long duration. Diseases that may cause chronic renal failure are hypertension, diabetes, cancer and AIDS. If it is diagnosed early, it may be slowed as a treatment but not reversed. The treatment maybe a simple restriction on the amount of fluid processed, or taking medication that treats the disease of cause. Eventually some patients may go beyond the point for just a delay of the failure and require permanent dialysis or transplant.

Damage to the kidneys may be caused by many complications, both localized around the kidney or that affect the whole body. Examples of this include repeated trauma to the kidneys (maybe through boxing or other physical sports) and diabetes mellitus (a disease caused by a lack of insulin provided by the pancreas) and can impair the blood flow to the kidneys.

When muscles are injured, it may release proteins. When large amounts of protein are released into the bloodstream they may hinder the nephrons causing a blockage, and impairing function.

Long-term drug use may often affect the kidney. Both prescribed and illegal drugs can damage the kidney. The kidney may become damaged when trying to filter out large quantities of these drugs, or filtering for a long duration. Or if the drug affects the substances that would normally be filtered the kidney may become senile.

Not all kidney failure is from external factors. It maybe possible that birth defects may cause the body to have only one kidney or have a deformed kidney causing impairment of the function.

Uremia, is the ailment when the bloodstream’s waste concentration, such as urea, is too high. The build up of these wastes cause symptoms like drowsiness, nausea, vomiting, breathlessness, headaches, and muscle cramps. Uremia is usually caused when blood flow to the kidneys is reduced from injuries (burns, bleeding, heart attack, etc). Treatment for uremia includes dialysis and transplant.

Gout is a complex disease that is caused by a metabolism that does not properly deal with uric acid. This disease is sometimes called the disease of kings because it may be linked with a diet with lots of alcohol and protein. When the body breaks down too many proteins it results in an elevated level of uric acid in the blood. The kidney is then unable to cope with the large concentration of uric acid and may lead to further complications of the kidney due to strain. Symptoms of the increased uric levels include sharp pains in several parts of the body, usually around joins where the acid may build up, (big toe, ankle, knee, wrist, etc.). The attack may cause the area to inflame, discolour and become tender.

If gout becomes a long-term condition, it may result in tophaceous gout. This ailment is associated with the formation of uric crystals. These uric crystals are the build up of uric acid, and become lodged in body tissues as white chalky material. The crystals can be located around the joints where destruction of the bone may ensue.

Treatments for both types of gout include complete rest of the limb and simple diet. The diet would probably include little poultry, legumes, liver and other organ meats with high water intake to reduce uric acid levels in the blood, in an attempt to reduce concentration. Along with the change in diet, a prescription that promotes the excretion of uric acid will be given.

Treatments for severe kidney disease include kidney dialysis or in more fatal cases kidney transplantation. Kidney Dialysis is also known as hemodialysis. Hemodialysis is the treatment where blood is passed through an artificial kidney. The artificial kidney contains a semi permeable membrane that filters out unwanted elements in the blood through diffusion. The blood is then returned to the body through a vein. Kidney dialysis may be temporary while the kidney recovers, or it may be a life long treatment until a kidney transplant is possible. Kidney transplantation is the act of adding or replacing a kidney to the system. Only a single kidney is required from the transplant to live normally. Kidney transplants are the most common transplant and have a high success rate, but organ donations are hard to come by.

When symptoms are reported, the diagnosis is determined by what may cause the symptoms. In most cases, a simple urine test may provide answers, other times; blood tests, x-rays and ultrasounds may be taken to examine the status of the kidney.

The kidney is probably the most important of the major organs when dealing with homeostasis, and as such the effects of kidney disease brings the body far from homeostasis. Most treatments for kidney failure tries to maintain functionality of the kidney, it does not maintain all of the kidney functions. Even though kidney dialysis is designed to act as a filter, it does not function to keep a balance, reducing the homeostatic state.

The National Institute of Diabetes and Digestive and Kidney Diseases is the leading organization that funds and coordinates research involving metabolic disorders.

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"Unit IV HOMEOSTASIS." http://www.gonzaga.k12.nf.ca/academics/science/sci_page/biology/homeostasis_notes.htm

"kidney and homeostasis." http://www.liv.ac.uk/~petesmif/teaching/1bds_mb/notes/homeo/kidney.htm