Renal & Ureteral Disease

According to the Centers for Disease Control, 3.3 million adults are currently living with a diagnosis of renal disease, and millions more are living with silent and undiagnosed kidney and ureteral problems. The renal system is often taken for granted until disease begins to affect the many life-sustaining functions it performs.

Significance

• Renal or ureteral disease can be life threatening. The kidneys filter and remove waste and impurities from the blood, help to build red blood cells, balance electrolyte and acid levels in the body, and secrete hormones. The kidneys are most commonly known for sending waste (in the form of urine) down through the ureters to the bladder, then out of the body through the urethra. If this process is prevented or interrupted waste products build up in the body, red blood cells are depleted, and electrolyte and hormone levels become unbalanced.

Causes

• Kidney disease results anytime the kidneys are damaged and cannot function properly. The most common cause is chronic kidney disease (CKD), which usually happens as a result of other medical diagnosis like diabetes, heart disease, high blood pressure, infection or urinary blockage. Kidney disease can also be inherited and develop based on genetics alone. Polycystic kidney disease (PKD) is the most common genetic renal disease and involves cysts that grow and cause enlargement and decreased function of the kidneys.

Symptoms

• The most common symptoms of kidney or ureteral disease include changes in urine (frequency, color, amount, difficulty, blood), swelling due to retention of fluids, fatigue, shortness of breath, itching, rash, metallic taste in the mouth or "ammonia breath," nausea and vomiting, dizziness, trouble concentrating, feeling cold and leg or flank pain. Often by the time symptoms are noticed the kidneys are already severely damaged and in the advanced stages of disease.

Diagnosis

• A kidney failure diagnosis starts with a physical examination, family history and evaluation of current symptoms followed by measuring the blood pressure, running blood tests (BUN, creatinine) to check for the buildup of waste products in the bloodstream, and a urinalysis to measure electrolytes and to check for blood or protein in the urine (both not normal). Other tests that can be used to confirm a diagnosis include a CT scan, abdominal ultrasound and biopsy of the kidney tissue.

Treatment

• Treatments for kidney and ureteral disease depend on the underlying cause and are geared towards preventing further deterioration and maintaining what kidney function remains. Some cases can be managed with diet changes, medications and regular exercise to lower blood pressure, control sodium and protein intake, and keep blood sugar levels within normal limits. In cases of severe or total renal failure dialysis (the filtering of the blood via artificial means) or a complete kidney transplant might be indicated.