Kidney disease is a disorder that occurs in the kidney organs, which are two red-shaped organs on both sides of the lower back, just below the ribs.
Disorders of the kidneys will affect the body's performance in washing the blood that is filtering body waste and excess fluid that will become urine. More specifically, the kidney has several important functions, including:
Filtering body waste (including chemicals, medicines, and foods) in the blood.
Maintain a balance of salt, mineral, fluid, and blood acid levels in the body.
Produce erythropoetin, a hormone that functions in the formation of red blood cells.
Produce renin, the enzyme that helps regulate blood pressure.
Produce active compounds of vitamin D to maintain bone health.
When kidney function is impaired, waste substances from the body and fluids that accumulate in the body will cause symptoms of swelling of the ankle, nausea, vomiting, weakness, and shortness of breath.
Kidney disease can be triggered by other conditions, such as diabetes and high blood pressure. That is, a person at risk of kidney disorders if you have diabetes, high blood pressure, or have a history of kidney disease in the family.
Type of Kidney Disease
Kidney disease consists of several types, among others:
Kidney infections. Kidney infection occurs when bacteria from the bladder spread to one or both of the kidneys. This condition arises as a result of complications of urinary tract infections.
Stone ginja. Salt and minerals that should be filtered by the kidney but instead harden and buried in the kidney to form kidney stones. This usually happens because the urine is too concentrated, so the salt and minerals crystallize.
Polycystic kidney disease. It is a hereditary disease in the form of cysts (fluid-filled pouches) clustered in the kidneys. Polycystic kidney disease is not malignant, but can lead to decreased renal function. In addition to occurring in the kidneys, cysts in the polycystic kidney can also appear in the liver or other parts of the body.
Acute renal failure. Acute renal failure is a condition in which the kidneys can not function normally suddenly. If not treated immediately, this condition can cause the accumulation of salt and other chemicals in the body and affect the function of other organs.
Chronic kidney disease. Chronic kidney disease or chronic renal failure is the decline in kidney function that persists for three months. This condition is characterized by several symptoms, such as shortness of breath, nausea, and fatigue. But this condition is not felt by the patient if it is still stage 1-3. Therefore, many people do not realize it is experiencing this condition until it reaches an advanced stage.
Symptoms of Kidney Disease
Symptoms of kidney disease depends on the type of illness and whether the disease results in decreased renal function. Some of the symptoms of kidney function decline and symptoms of kidney disease are specific, among others:
Swelling occurs in the ankle and around the eyes.
Nausea, vomiting, loss of appetite, and weight loss.
The urine volume and frequency of urination decreases.
Foamy urine.
Feeling tired and short of breath.
Dry and itchy skin.
Muscle cramps occur, especially in the legs.
Insomnia.
High blood pressure.
Heart rhythm disturbance.
Loss of consciousness.
In acute kidney failure can be seen signs of dehydration.
Lower back pain and urine mixed with blood can occur in patients with kidney stones, polycystic kidney disease, and kidney infections.
In patients with kidney and kidney stones may develop fever and chills complaints.
Children who experience kidney disease will be easily drowsy, not energetic, loss of appetite, and growth is inhibited.
Diagnosis of Kidney Disease
To detect any disorders of the kidneys, doctors can perform various investigations, namely:
Urine test. Performed to determine the level of albumin in the urine. Albumin is one type of protein that should be contained in the blood. If there is albumin in the urine, meaning the kidney does not work properly and indirectly albumin blood levels will decrease. Analysis and culture of germs from urine can also be done, to determine the presence of urinary tract infections and germs that cause the infection.
Blood test. Performed to examine the levels of creatinine, a substance derived from muscle tissue. If damaged, the kidneys can not remove creatinine from the blood. Through blood tests, the doctor will also know the patient's glomerular filtration rate (GFR). The results of the GFR examination will show the patient's renal function and condition. In addition to kidney function, blood tests can see that Hb decreases due to decreased red blood cell production.
Scanning. Kidney ultrasound and renal CT scan as well as urinary tract (urography) can see the possibility of kidney stones and polycystic kidney disease.
Treatment of Kidney Disease
Before determining the type of treatment for kidney disease, the doctor will confirm the cause first. Some types of treatment that can be done to overcome kidney disease are:
Drugs. In treating kidney disease, your doctor will give you one of the high blood drugs from the ACE inhibitors (eg ramipril, captopril) or ARBs (eg valsartan, irbesartan). In addition to controlling blood pressure, this group of drugs can also reduce the levels of protein in the urine. The erythropoietin hormone (EPO) may also be administered to patients with impaired renal function with anemia. For kidney infection the doctor will give antibiotics for one to two weeks.
Kidney stone therapy procedure. Kidney stones are small and with mild symptoms do not need special measures to overcome them. Patients will be advised to drink 2 to 3 L per day to rinse the urinary tract, given painkillers such as paracetamol or ibuprofen, and given medication to relax the urinary tract muscle (alpha blocker) so that the stone can come out quickly and painlessly. When the stone is large enough and is considered not able to go out alone, performed several procedures to remove stones from the kidneys, namely:
Extracorporeal shock wave lithotripsy (ESWL). The stone is crushed into smaller sizes so it can be disposed of with urine by using sound waves that generate vibrations from the ESWL machine.
Ureteroscopic Lithotripsy (URS). Through the URS method will be inserted a hose equipped with a camera into the urinary tract through the hole where the urine out. Then, the stone will be destroyed with a special tool so that it becomes smaller size, in order to be removed through the urinary tract.
Percutaneous Nephrolithotomy (PCNL). PCNL is done by taking a stone with a special tool inserted through the back to reach the kidneys. This action requires general anesthesia.
Diet. The kidneys function to filter out body waste substances, some minerals and liquids. If there is a decrease in kidney function, it is difficult for the kidneys to remove the waste substances. Therefore dietary patterns that should be lived by people with reduced kidney function are low-protein diet and some minerals such as sodium, potassium, and phosphate. In addition it is important to limit fluid intake, so the fluid does not accumulate in the body.
Kidney replacement therapy. If the kidneys are not working properly, there are three ways to replace the kidney task:
Wash blood or hemodialysis. Using a machine connected to a blood vessel to filter and remove substances that the body does not need in the blood. Required access in blood vessels to be connected into the machine. When needed for dialysis immediately, a catheter will be installed in the veins of the veins in the neck, the tube like the usual infusion placed in the hand, but mounted on a large blood vessel in the neck. If the dialysis is done in a planned and for a long time, will be installed access on the arm or leg by connecting arterial and venous blood vessels, this access is called cimino.
Continuous ambulatory peritoneal dialysis (CAPD). In contrast to dialysis, CAPD uses a membrane on the abdominal wall in order to wash the blood. As with dialysis, CAPD also requires permanent access such as a hose to be installed through the abdominal wall. The fluid used to wash the blood will be inserted into the tube and left for some time before being removed.
Kidney transplant or kidney transplant. Performed by removing one kidney from a suitable donor and implanted into the patient's body. Before the transplant, there will be several checks to determine whether the patient is a good candidate for kidney transplant. And after a graft, the patient will take some medication for the body to receive the donor organ. If the transplant is successful, the patient does not need to undergo another renal replacement therapy.
Prevention of Kidney Disease
Kidney disease can be caused by diabetes or hypertension. Therefore, one way that can be done to prevent kidney disease is to control both diseases. Because, if blood sugar and blood pressure levels are not controlled, then over time the kidneys will be damaged. If you experience symptoms of kidney disease or have a history of kidney disease in the family, patients are advised to undergo regular checkups.