Various Kidney Diseases Explained
The Alport Syndrome is a genetic condition caused by mutations in three genes. The genes each supply a set of instructions to create a single component of type IV collagen – a protein. The protein is essential to be able to cleanse the blood by removing water and waste products, which occurs in special blood vessels in the kidneys called glomeruli. After filtering the blood, the result is the production of urine.
The genetic mutations will render the kidneys unable to separate the blood from the water. This permits the protein and the blood to enter the urine. This is the primary symptom, but it can only be detected with the use of a microscope. On occasion, children may have visible blood (red, pink, or brown) in the urine when they have a cold or the flu, but it will usually disappear afterward. This disease will slowly damage the kidneys through an ongoing process of scar tissue formation within the kidney. It develops within the glomeruli, which is the system that does the filtering. Before long, this process will eventually lead to kidney failure. The disease also affects the eyes and ears, which need collagen for internal structures in those organs. Hearing loss will often occur in childhood and slow reduction in vision.
The disease affects many more males than females. Alport Syndrome is rather rare and affects fewer than 200,000 people in the United States. For men with the disease, half of them will need dialysis by the time they reach 25, and 90 percent of them will have end-stage renal disease (ESRD) before they reach 40. Women who have the disease will also end up having ESRD, but it will take longer.
Diabetes is the primary cause of kidney disease. Many people who have diabetes are not aware of it. It is also responsible for as many as 40 to 50 percent of all the cases of ESRD. It should also be noted that 20 to 40 percent of people that have diabetes will develop some form of kidney disease.
When diabetic nephropathy is developing, the individual may not be aware of any symptoms. As it progresses down to a function level of 29 percent or less, several symptoms will be experienced and they will generally not feel well. These may include:
• Darker urine
• Swollen hands, feet, ankles, or lower legs because of retaining water
• Fatigue from the blood not carrying sufficient oxygen
• Cardiovascular disease is also a complication.
Fabry Disease, which is also called Anderson-Fabry Disease, is an inherited disease. It is rare and it affects not only the kidneys, but also the heart, skin, nervous system, and brain. Because of an inability to produce an enzyme called alpha-galactosidase A, the body is not able to break down substances such as fatty acids, oils, and waxes.
Since it cannot break down these substances, there is an excess of these substances in the blood. This results in a buildup on the walls of your blood vessels and organs that include your brain, heart, nervous system, and kidneys. It will also affect your skin, causing a rash.
These substances build up while the individual is still young. They may experience kidney failure, strokes, and heart attacks. Early death is likely at an average age of 40. The first symptoms, which will appear in children, are pain that can only be described as excruciating during exercise and greater stress levels, and fevers, reduced sweating, and a rash that appears below your navel and above your knees. Males will develop Fabry Disease more often than females.
Focal Segmental Glomerulosclerosis
When someone develops Focal Segmental Glomerulosclerosis, it means that only a part of the glomeruli (the part that filters the blood) is affected at the start of the disease. It is caused by scarring (sclerosis) of the tissue which builds up over time.
Medications, infections, and other diseases are often the cause of this kidney disease. Several symptoms are likely to occur at the same time. They include swelling around the eyes, legs, or ankles; weight gain; urine that foams from the higher concentrations of protein; less protein in your blood; and high cholesterol levels.
Focal Segmental Glomerulosclerosis is not fatal. It may be treated and maintained by medications. Dialysis will eventually be needed, and this will often lead to the need for a kidney transplant. It will continue to worsen, but treatment can slow the progress of the disease. Males have a slightly higher rate of occurrence than females.
When there is inflammation in the glomeruli (which filters the blood), it will often result in Glomerulonephritis (GN). This disease can develop over time (chronic) or appear suddenly (acute). It may also start on its own with no known cause or it may start as the result of some other disease. If the inflammation becomes prolonged, it can damage the kidneys.
Symptoms of an infection may be different, depending on whether you have the chronic or acute version. In general, you can expect to see urine that is pink or brown; urine that foams; swelling from retaining fluids in your abdomen, feet, hands, and face; and hypertension. With acute Glomerulonephritis, you may also expect to see less frequent urination and fluid in your lungs which will cause coughing. Chronic GN may also have pain in the abdomen and frequent nosebleeds.
This disease is sometimes reversible when caught early. Treatment may even lead to complete restored function. If it persists, it could ultimately cause kidney failure.
IgA Nephropathy (Berger’s Disease)
When a certain type of antibody called Immunoglobin A (IgA) builds up in your kidneys it is called IgA Nephropathy or Berger’s Disease. The cause of this buildup is unknown. When it occurs, which can be at any age, it will generally cause some degree of inflammation, but this can vary greatly – sometimes causing no noticeable effect for decades.
For a long time, it was believed that this form of kidney disease did not cause long term problems. After researching the matter, it was discovered that 50 percent of cases ended with kidney failure. It can also cause blood clots. It occurs most often in people under 30 and often in children.
IgA Nephropathy has many symptoms but these will only be noticeable after it has progressed for some time. They may include:
• Cold and flu symptoms
• Urine that is foamy and dark-colored
• Occasional pain in the abdomen, sides, and loins
• Prone to more frequent allergies
• Infections in the urinary tract (mostly girls).
In most instances, kidney stones are not going to cause permanent damage to the kidneys. These stones can form in the kidney and do not cause a problem until they go into the ureter – the tube that goes from the kidneys to the bladder. If it becomes stuck in the ureter, it will block urine coming from that kidney. Most kidney stones are made of calcium.
Kidney stones vary in size from small enough to easily pass through the ureter, to being as big as golf balls. The larger ones usually have to be treated (broken up) before they can be removed surgically. Ongoing problems with kidney stones may lead to chronic kidney disease, and ultimately to renal (kidney) failure.
Symptoms of a kidney stone will vary. While in the kidney there are usually no symptoms, but once it enters the urethra, or blocks it, you may notice the following symptoms:
• Pain that is severe in your lower back
• Blood in your urine
• Fever with chills
• Sensation of burning while urinating
• Foul-smelling or cloudy urine.
Minimal Change Disease
When present, the Minimal Change Disease (MCD) results in a loss of protein in the blood. When operating normally, the kidneys filter the waste products out of the blood and leave the proteins to continue to circulate. While not yet understood how, the filters become damaged and protein is allowed to be removed from the blood – a problem called proteinuria.
The damage to the filters is so small that it can only be seen under an electron microscope. An ordinary microscope cannot detect it. When a child develops the Nephrotic Syndrome, they are automatically treated for MCD before the biopsy because it occurs so often in children.
Medications for MCD (usually steroids) will usually be sufficient to eliminate this problem, but it will take longer in adults. When treated quickly and properly, it may lead to healing but it may return later in life. If not treated and there are high quantities of protein in the urine, it may result in Nephrotic Syndrome.
Nephrotic Syndrome is a disorder in which there is too much protein being removed from the blood and passing into the urine. As with some other kidney diseases, it is caused by damage to the glomeruli, which allows more protein to be lost into the urine.
This problem has several possible causes, but it is not known for certain. Symptoms may include weight gain from fluid retention in your ankles, feet, and around your eyes; foam in your urine; a lack of appetite; and fatigue.
Among the various common kidney diseases, this condition can lead to several problems – some of them severe. You may develop frequent infections, blood clots, elevated cholesterol levels, malnutrition, hypertension, sudden kidney failure, and infections. Other complications may include heart disease and anemia.
Polycystic Kidney Disease or PKD
An individual that has Polycystic Kidney Disease (PKD), also called polycystic renal disease, has inherited it. The disease causes cysts to develop in the kidneys, which will enlarge them, damage them, and gradually cause them to fail. Although the cysts are benign, they are filled with fluid and can become rather large.
There are several symptoms of this disease. They may include pain in the side or back, an enlarging of your abdomen and feeling full, urinary tract infections, kidney stones, headaches, and urine with blood in it.
PKD can also lead to the formation of cysts in the liver and other parts of your body. This condition may not be noticeable for years. It currently affects about 500,000 people in the U.S.
Causes of Kidney Disease
Although it certainly cannot always be prevented, especially when the cause is genetic, kidney disease is a problem that can often be stopped before it ever becomes serious or even gets started. Taking certain steps for common health problems can help your overall health to stay strong for many years.
If you have diabetes, which continues to be the main cause of kidney disease, you can reduce the risk by controlling your blood sugar. When you have higher levels of sugar in your blood for long periods, it will damage the glomeruli. This leads to an increasing inability to thoroughly cleanse the blood, and the overload of toxins will destroy the kidneys and cause other problems, too.
When you have high blood pressure along with diabetes, it increases your risk. People who have this combination account for more than 70 percent of all newly diagnosed patients. Having high blood pressure alone can cause kidney disease and be responsible for its failure.
Obesity also plays a strong part in its development. This is because it is often a big factor in the development of diabetes and hypertension. Other causes of kidney disease may include:
• Infections (viral and bacterial)
• Strep throat
• Birth defects
• Autoimmune diseases
• Taking stronger than recommended doses of NSAIDs
• Various medications
• Cardiovascular disease
• Family background
• Blockage of urine in the kidneys
• Toxins – alcohol, cocaine, and heavy metals
• Being older than 60.
Symptoms of Kidney Failure
Kidney failure will lead to death unless fast treatment is received. Failure is reached when the kidneys are only able to filter 10 percent of the waste products from your blood. In acute kidney failure, this occurs suddenly and is most common in people who are already in the hospital and often in intensive care.
After the kidneys fail, which may take a few days, intensive treatment is necessary to keep that person alive. If their overall health is otherwise good, complete recovery may be possible. The symptoms include:
• Lower output of urine
• Retention of fluid in legs, feet, and ankles
• An irregular heartbeat
• Pain or pressure in the heart
• A loss of appetite
• Fatigue and weakness
• Difficulty breathing
• Possible coma.
Diagnosing Kidney Disease
The presence of kidney disease is determined by what is called the glomerular filtration rate (GFR). The rate is measured on a scale of 1 – 100. Healthy kidneys should function at 100, or 100 percent. As long as the function rate is 60 percent or more, they are considered healthy. Kidney disease is present when the GFR ranges from 15 to 60 percent. When the GFR is less than 15 percent, it reveals kidney failure. There are five stages of kidney disease based on this scale.
Diagnosing kidney disease will usually involve several tests. They may involve:
• Blood tests
• Measuring urine output over 24 hours
• Analyzing the urine
• Ultrasound and CT scans
• Biopsy of the kidney.
Treatments for Kidney Disease
After kidney disease has been diagnosed, the doctors will prescribe a plan of action to treat it. Treating this disease often results in maintenance, which may slow down the rate it progresses. It will also involve treating some of the causes – if known – to minimize further damage. Controlling blood pressure, diabetes, and cholesterol levels are very important, as well as losing weight and getting to a healthy BMI.
Where the cause is unknown, which is often the case, only symptoms can be treated. A trial and error of medications and diet recommendations may be used as well. Treatments for kidney disease may include:
1. Dietary Restrictions
• Reducing salt
• Eliminating foods high in cholesterol
• Control diabetes
• Eating more fruits and vegetables, low-fat dairy foods, and whole grains
• Stop smoking
• Increase exercise (30 minutes on 5 days each week)
• Reduce alcohol intake.
• ACE inhibitors
• Angiotensin receptor blockers (ARBs)
3. In Cases of Kidney Failure
• Kidney transplants
Treatments to Prevent Complications
If you have already had kidney failure, the doctor will take some steps to prevent a recurrence – if possible. They may include:
• Ensure balanced fluids in the blood
• Medications to control the potassium and calcium in your blood
Preventing Kidney Disease
The statistics reveal that it certainly is better to prevent kidney disease than try to remedy it afterward. Although hemodialysis may help, it still has problems because it will only improve the function of filtering the blood by six percent. Besides, only slightly more than half of the patients that go on dialysis will be alive in three years.
If you think you might be able to get a kidney transplant, your chances of that happening are also limited. There are currently more than 98,000 people on the waiting list for kidneys, and there were only about 20,000 transplants performed in 2016.
Rather than wait until you have chronic kidney disease to try and prevent or stop it, you can take some steps now to help yourself live a longer life. Preventing kidney disease involves the same steps needed to stop it from becoming more complicated after you already have it. Starting beforehand can save you a lot of trouble and enable you to live a more enjoyable life. The steps you can take include:
• Do not use tobacco
• Limit your alcohol
• Keep blood pressure under control
• Eat a low-salt and low-fat diet
• If you have diabetes, control blood sugar
• Regularly exercise for 30 minutes on five days per week
• Keep hydrated
• Get a physical exam annually
• Maintain a healthy weight.
Kidney disease does not have to destroy your life. It currently kills more people than prostate or breast cancer. Taking care of yourself better can help you keep on living the life you want to live.