Q.9 What do you know about Kidney disorders?
Answer:
There are many different kidney disorders:
(i) Kidney stones
When urine becomes concentrated, crystals of many salts e.g. calcium oxalate, calcium and ammonium phosphate, uric acid etc are formed in it. Such large crystals cannot pass in urine and form hard deposits called kidney stones. Most stones start in kidneys, some may travel to ureter or urinary bladder.
Causes of Kidney stones
Major causes of kidney stones are:
1. Age
2. Diet (containing more green vegetables, salts, vitamins C and D)
3. Recurring urinary tract infections
4. Less intake of water
5. Alcohol consumption
Symptoms of kidney stones
Following are the symptoms of kidney stones:
1. Severe pain in kidney or in lower abdomen
2. Vomiting
3. Frequent urination
4. Foul-smelling urine with blood and pus
Treatment of kidney stones
(i) Drinking plenty of water
About 90% of kidney stones can pass through the urinary system by drinking plenty of water.
(ii) Surgical treatment
In surgical treatment, the affected area is opened and stone (s) are removed
(iii) Lithotripsy
Lithotripsy is another method for the removal of kidney stones. In this method, non-electrical shock waves from outside are bombarded on the stones in the urinary system. Waves hit the dense stones and break them. Stones become sand-like and are passed through urine.
(ii) Kidney (Renal) Failure
Kidney failure means a complete or partial failure of kidneys to function.
Causes of kidney failure
Following are causes of kidney failure:
i. Diabetes mellitus
ii. Hypertension
iii. Sudden interruption in the blood supply to kidneys
iv. Drug overdoses
Symptoms of kidney failure
Main symptoms include:
i. High level of urea and other wastes in blood
ii. Vomiting
iii. Nausea
iv. Weight loss
v. Frequent urination
vi. Blood in urine
vii. Excess fluids in body may causes swelling of legs, feet and face
viii. Shortness of breath
Treatment of kidney Failure
Kidney failure is treated with:
i. Dialysis
ii. Kidney transplant
1. Dialysis
Dialysis means the cleaning of blood by artificial ways. There are two methods of dialysis:
(1) Peritoneal Dialysis
(2) Haemodialysis
(1)Peritoneal Dialysis
In this type of dialysis, the dialysis fluid is pumped for a time into the peritoneal cavity which is the space around gut. This cavity is lined by peritoneum. Peritoneum contains blood vessels. When we place dialysis fluid in peritoneal cavity, waste materials from peritoneal blood vessels diffuse into the dialysis fluid, which is then drained out. This type of dialysis can be performed at home, but must be done every day.

(2)Haemodialysis
In haemodialysis, patient’s blood is pumped through an apparatus called dialyzer. The dialyzer contains long tubes, the walls of which act as semi-permeable membranes. Blood flows through the tubes while the dialysis fluid flows around the tubes. Extra water and wastes move from blood into the dialysis fluid. The cleansed blood is then returned back to body. The haemodialysis treatments are typically given in dialysis centres three times per week.

ii) Kidney Transplant
Introduction
Dialysis needs to be repeated after every few days and is unpleasant for patients and attendants. Another treatment for the end-stage kidney failure is kidney transplantation. It is the replacement of patient’s damaged kidney with a donor healthy kidney. .
Conditions for Transplant
(1) Kidney may be donated by a deceased-donor or living donor.
(2) The donor may or may not be a relative of the patient.
(3) Before transplant, the tissue proteins of donor and patient are matched.
(4) The donor’s kidney is transplanted in patient’s body and is connected to the patient’s blood and urinary system.
(5)The average lifetime for a donated kidney is 10 to 15 years.
(6) When transplant fails, the patient may be given a second kidney transplant. In this situation, the patient is treated through dialysis for some intermediary time.
Problems after transplant.
Problems after a transplant may include transplant rejection, infections, imbalances in body salts which can lead to bone problems and ulcers.