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Kidney disease has been known as the silent killers. Often they do not give specific symptoms initially, which is why they are diagnosed at an advanced stage of development. The high heterogeneity of this group of diseases makes it difficult to identify one form of treatment. Some require pharmacological intervention, others require dialysis, and some require transplantation.
What are the functions of the kidneys?
The kidneys are an organ that we often overlook in preventive examinations. And wrongly, because their functions are no less important than that of the heart or the liver. The kidneys are essential for life because they allow the body to remove harmful waste products, including toxins and drug metabolites. Thanks to this, it is possible to maintain the water and electrolyte balance, as well as the correct blood pressure. Disruption of the physiological functioning of the kidneys causes the accumulation of undesirable substances that negatively affect many organs of the human body, including the central nervous system and the heart.
Kidney dysfunction may be asymptomatic for many years. However, the changes develop gradually and very insidiously, often leading to the complete destruction of this organ. According to statistics, around 4,2 million adult Poles suffer from kidney disease. Alarmingly, as many as 90% do not know about it. It is worth noting that quick diagnosis means immediate implementation of appropriate treatment, which translates directly into recovery and a better quality of life.
The most serious kidney diseases
Acute renal failure
It is one of the more serious kidney problems. It occurs with a frequency of 200/100 cases per year. The causes of this failure are seen, among others, in in damage to the parenchyma of the kidneys and reduced blood flow, which may develop in the case of, for example, long-term use of certain medications, mainly antibiotics, anti-inflammatory drugs, analgesics and anti-cancer drugs. Patient mortality is very high and amounts to approx. 000%.
Symptoms: heart and liver failure, decreased urine volume, dehydration, vomiting, diarrhea, sepsis, burns, haemorrhage.
Diagnosis: medical history, increase in serum creatinine, ultrasound, in some cases kidney biopsy.
Treatment: pharmacology and constant renal replacement therapy – dialysis and live kidney transplantation.
Kidney cancer
It is a group of malignant cancers, the most common of which is renal cell carcinoma. This disease occurs after the age of 40, more often in men than in women, although the average age of diagnosis is 60 years. It develops dormant and shows symptoms very late. That is why the diagnosis is often issued accidentally, e.g. during preventive examinations. Factors increasing the risk of kidney cancer development are arterial hypertension, a less active lifestyle, chronic use of certain types of drugs, and exposure to heavy metals.
Symptoms: pain in the lumbar region, general weakness, weight loss, fever with night sweats.
Diagnosis: medical history, general urine and blood tests, ultrasound, determination of C-reactive protein (CRP) concentration, X-ray, computed tomography, magnetic resonance imaging.
Treatment: tumor resection, chemotherapy, immunotherapy.
Lupus nephritis
It is a severe kidney disease with a frequency of 5 / 10 people. Lupus nephritis is diagnosed primarily in women between the ages of 000 and 20. Inflammation develops in the glomeruli, the urethra, and the parenchymal tissue of the kidneys.
Symptoms: joint pain and swelling, problems urinating, reddening of the skin on the cheeks and nose, cough, chest pain.
Diagnosis: medical history, kidney biopsy, general urine and blood tests.
Treatment: immunosuppressants, dialysis, kidney transplantation.
Polycystic kidney disease
It is a genetically inherited disease (autosomal dominant and recessive) that affects both kidneys. In its course, numerous cysts are observed in the core of the organ cortex. It is already present in infants and occurs with a frequency of 1/20 births.
Symptoms: pain in the lumbar region, kidney stones, hematuria, urinary tract infections, hypertension, abdominal hernia, liver and pancreatic cysts.
Diagnosis: medical history (family history of the disease), ultrasound.
Treatment: painkillers, renal replacement therapy, kidney transplantation.
Renal amyloidosis
Another name is amyloidosis. It is a serious systemic disease caused by an excessive build-up of amyloid in the internal organs. The abnormal protein accumulates in the glomeruli and tubules, damaging the structure and function of the kidneys. There are several types, including primary (AL) and secondary (AA) amyloidosis.
Symptoms: proteinuria, heart failure, nerve damage, enlargement of the liver and spleen, body edema, increased blood cholesterol, diarrhea, loss of appetite, vomiting.
Diagnosis: medical history, kidney biopsy, presence of amyloid deposits, blood and urine tests.
Treatment: dialysis. In most cases, the patient cannot be classified for transplant.
What are the treatments for kidney disease?
The choice of treatment depends on the type of disease, its stage, the patient’s age and the presence of comorbidities. If the source of the disease is known, the objective is to remove the obstacle, including, for example, removing stone deposits during surgery. The standard procedure for bacterial infections is the use of antibiotics. Management of kidney diseases also includes the use of anti-inflammatory, antispasmodic and analgesic drugs, as well as immunotherapy.
The treatment of kidney diseases looks slightly different in the presence of other diseases, e.g. diabetes. Then the doctor must take into account a number of additional factors, which may make the entire procedure more complicated.
Dialysis is a life-saving treatment. Its purpose is to remove harmful waste products, including toxins, which are excreted in the urine in the case of healthy kidneys. There are two types of dialysis: hemodialysis and peritoneal dialysis. However, they are extremely uncomfortable for the patient as they require frequent visits to dialysis centers. One visit takes 3 to 5 hours a day every other day, which is about 15 hours a week. In addition, the patient often feels a marked weakness after the procedure.
Kidney transplantation is the most beneficial form of treatment for patients. In Poland, the number of transplants is still not sufficient, and about 900-1100 kidney transplants are carried out annually – compared to other European countries, we perform poorly in this respect. The best situation for a sick person is to donate an organ from a living donor. After surgery, the kidney may continue to function properly for another 15 years. It is also possible to collect an organ from a deceased donor. In this case, however, the kidney functions slightly shorter after transplantation – from 9 to 12 years.
The organ may come from a donor who is related to the patient or has a close relationship with him. Before collecting a kidney, the donor must undergo a series of very detailed laboratory and diagnostic tests. This is not only to assess the health of the whole organism, but also to exclude contraindications and reduce the risk of transplant rejection.
Most importantly, kidney transplantation doubles the life of patients compared to dialysis and significantly improves their quality of life. The average waiting time for an organ in Poland is approx. 11 months.