Tag: Kidney

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Nephritis

Definition:
Nephritis is inflammationof the nephrons of one or both of the kidneys – the organs that filter the blood and get rid of excess fluid and unwanted chemicals.  The inflammation can affect the kidneys’ function, including their ability to filter waste and this can be caused by many different conditions.

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Symptoms may develop as the disease gets worse, but as nephritis resolves completely in about 60 per cent of adults and as many as 90 per cent of children, for many it comes and goes with little disruption to their life.

The downside is that for those in whom the disease doesn’t get better and instead progresses into a more severe condition, advanced kidney (renal) failure may have developed before they have had any reason to seek medical help.

Types:
*Glomerulonephritis is inflammation of the glomeruli. (When the term “nephritis” is used without qualification, this is often the condition meant.)...CLICK & SEE

*Interstitial nephritis or tubulo-interstitial nephritis is inflammation of the spaces between renal tubules……CLICK & SEE

*Pyelonephritis is inflammation that results from a urinary tract infection that reaches the pyelum (pelvis) of the kidney…….CLICK & SEE

*Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system....CLICK & SEE

Symptoms:
Symptoms of nephritis include:

•Swelling of the tissues (initially the face and around the eyes, later more prominent in the legs)
•Reduction in urine volume
•Dark urine (contains blood which may not be visible)
•Increase in blood pressure
•Headaches
•Drowsiness
•Visual disturbances
•Tiredness and general malaise (feeling ill)
•Nausea
•In rapidly progressive disease, loss of appetite, vomiting, abdominal pain and joint pain may occur
•Chronic nephritis may go unnoticed for years until symptoms of kidney failure appear: tiredness, itchy skin, nausea and vomiting, shortness of breath

About half of those who develop acute nephritis actually have no symptoms. If symptoms do develop, they point clearly to the problem. The inflammation causes blood and protein to leak into the urine. As protein levels in the blood fall, excess fluid accumulates in the body.

Tests show protein, blood cells, and kidney cells in the urine, while a high concentration of the body’s waste products of metabolism (such as urea and creatinine) may be found in the blood.

Swabs of the throat may show there’s been a streptococcal infection, while blood tests may be used to check for antibodies to streptococci or other infections, or signs of an abnormal immune response.

Sometimes a small biopsy or sample of tissue is taken from the kidney to examine in the laboratory.

Causes:
The causes of nephritis (or acute nephritic syndrome as the collection of symptoms is sometimes called) tend to be different in adults and children.

One of the commonest, especially in children, is after infection with the streptococcus bacteria, which leads to an immune reaction that damages the filtering units of the kidney known as the glomeruli. This condition is called post-streptococcal glomerulonephritis.

Other causes seen more frequently in children than adults include Henoch-Schönlein purpura (an inflammation of the blood vessels caused by an abnormal immune response) and haemolytic-uraemic syndrome (an abnormal immune reaction with triggers including gastrointestinal infection).

Risk Factors:
In adults, diseases that frequently underlie nephritis include vasculitis (inflammation of the blood vessels), pneumonia, abscesses, infections such as measles, mumps or glandular fever, hepatitis, and a range of different immune disorders that cause types of glomerulonephritis.

In more serious, rapidly progressive glomerulonephritis, about half of people remember having had a flu-like illness in the month before symptoms start.

Diagnosis:
Your doctor may suspect lupus nephritis if your urine is bloody or has a foamy appearance, if you have high blood pressure, or if you show signs of swelling in your hands or feet. Diagnostic tests for lupus nephritis  may include:

*Renal function testing.  Nephrologists may use a variety of tests, including blood tests and 24-hour urine collection, to accurately measure your kidney function. Iothalamate clearance testing, which uses a special contrast agent to track how well your kidneys are filtering, may be done if traditional tests don’t provide clear measurement of your kidney function.

*Kidney biopsy. Biopsy is the gold-standard test to confirm the diagnosis of many kidney diseases, including lupus nephritis. It can also help determine the severity of the disease. Because of the large number of people treated for kidney diseases.

Treatment :
The treatment of nephritis depends on the type and cause of the condition. The aim is to reduce inflammation, limit the damage to the kidneys and support the body until kidney function is back to normal.

Restriction of sodium (salt), potassium, protein and fluids in the diet may be necessary. Sometimes bed rest is advised. Steroids, or more powerful immunosuppressant drugs, may be given to reduce the inflammation.

Antibiotics may be needed too, although in many cases the infection that initially triggered the nephritis has long since gone. Medication may also be needed to control blood pressure.

In severe cases, renal dialysis may be necessary, although this may only be a temporary measure.

Adults are slower to recover than children and more likely to develop complications or progress into chronic nephritis. Acute nephritic syndrome is unlikely to recur, but if it does there’s at least a one in three chance that an adult will develop what is known as ‘end-stage kidney disease’, leaving them in need of permanent dialysis or a kidney transplant.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Nephritis
http://www.bbc.co.uk/health/physical_health/conditions/nephritis1.shtml
http://www.mayoclinic.org/lupus-nephritis/diagnosis.html
http://commons.wikimedia.org/wiki/File:Diffuse_proliferative_lupus_nephritis.jpg

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Kidney transplant

Introduction:
A kidney transplant is an operation that places a healthy kidney in your body. The transplanted kidney takes over the work of the two kidneys that failed, and you no longer need dialysis.

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During a transplant, the surgeon places the new kidney in your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Often, the new kidney will start making urine as soon as your blood starts flowing through it. But sometimes it takes a few weeks to start working.

If you have advanced and permanent kidney failure, kidney transplantation may be the treatment option that allows you to live much like you lived before your kidneys failed. Since the 1950s, when the first kidney transplants were performed, much has been learned about how to prevent rejection and minimize the side effects of medicines.

But transplantation is not a cure; it’s an ongoing treatment that requires you to take medicines for the rest of your life. And the wait for a donated kidney can be years long.

Many transplanted kidneys come from donors who have died. Some come from a living family member. The wait for a new kidney can be long. People who have transplants must take drugs to keep their body from rejecting the new kidney for the rest of their lives.

A successful transplant takes a coordinated effort from your whole health care team, including your nephrologist, transplant surgeon, transplant coordinator, pharmacist, dietitian, and social worker. But the most important members of your health care team are you and your family. By learning about your treatment, you can work with your health care team to give yourself the best possible results, and you can lead a full, active life.

Around 40 per cent of patients with end-stage renal failure (ESRF) need a transplant which frees people from the need for dialysis treatments.

A successful kidney transplant has ten times the function of dialysis (for example ten times the ability to remove toxins and extra water from the blood). It means that transplant patients have a better quality of life, with more energy than they did on dialysis.

How transplants work:-
An assessment is necessary to determine whether your body will accept an available kidney. This may require several visits over four to six months, and all potential recipients must be healthy enough for surgery.

Although there is no age limit, few units will transplant patients over 70 years – unless very fit.

If a family member, partner or friend wants to donate a kidney, they will need to be evaluated for general health too.

If there is no potential living donor, you will need to register with hospital and be put on a national waiting list to receive a kidney from a deceased donor. but this varies considerably around the country. Kidneys can also be donated by strangers.

If there is a suitable living donor, the operation can be scheduled in advance, when it suits both sides. If you’re on a waiting list for a deceased donor kidney, as soon as it becomes available, you must go to the hospital quickly – where a test is carried out to check the kidney won’t be rejected. If it’s suitable, the transplant can proceed. The operation usually takes three to four hours.

A surgeon places the new kidney inside your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Your blood flows through the new kidney, which makes urine, just like your own kidneys did when they were healthy. Unless they are causing infection or high blood pressure, your own kidneys are left in place.

During the operation, the transplant kidney is inserted into the lower abdomen and connected to an artery and vein (to the leg). The blood flows through the new kidney, which makes urine, just like the old kidneys did when they were healthy. The old kidneys are usually left in place.

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Often the new kidney will start making urine as soon as blood starts flowing through it, but about one third of patients will require dialysis for around a week. Most patients leave hospital two weeks after the operation.

To prevent the immune system from seeing the new kidney as foreign and rejecting it, you’ll have to take drugs that turn off (or suppress) your immune response (immunosupressants). It’s important to understand the instructions for taking these medicines before leaving hospital, as missing the tablets for just 24 hours can cause rejection and the loss of the kidney.

Recovery From Surgery:-
As after any major surgery, you’ll probably feel sore and groggy when you wake up. However, many transplant recipients report feeling much better immediately after surgery. Even if you wake up feeling great, you’ll need to stay in the hospital for about a week to recover from surgery, and longer if you have any complications.

Posttransplant Care:-
Your body’s immune system is designed to keep you healthy by sensing “foreign invaders,” such as bacteria, and rejecting them. But your immune system will also sense that your new kidney is foreign. To keep your body from rejecting it, you’ll have to take drugs that turn off, or suppress, your immune response. You may have to take two or more of these immunosuppressant medicines, as well as medications to treat other health problems. Your health care team will help you learn what each pill is for and when to take it. Be sure that you understand the instructions for taking your medicines before you leave the hospital.

If you’ve been on hemodialysis, you’ll find that your posttransplant diet is much less restrictive. You can drink more fluids and eat many of the fruits and vegetables you were previously told to avoid. You may even need to gain a little weight, but be careful not to gain weight too quickly and avoid salty foods that can lead to high blood pressure

Rejection:-
You can help prevent rejection by taking your medicines and following your diet, but watching for signs of rejection—like fever or soreness in the area of the new kidney or a change in the amount of urine you make—is important. Report any such changes to your health care team.

Even if you do everything you’re supposed to do, your body may still reject the new kidney and you may need to go back on dialysis. Unless your health care team determines that you’re no longer a good candidate for transplantation, you can go back on the waiting list for another kidney.

Side Effects of Immunosuppressants:
Immunosuppressants can weaken your immune system, which can lead to infections. Some drugs may also change your appearance. Your face may get fuller; you may gain weight or develop acne or facial hair. Not all patients have these problems, though, and diet and makeup can help.

Immunosuppressants work by diminishing the ability of immune cells to function. In some patients, over long periods of time, this diminished immunity can increase the risk of developing cancer. Some immunosuppressants cause cataracts, diabetes, extra stomach acid, high blood pressure, and bone disease. When used over time, these drugs may also cause liver or kidney damage in a few patients.

Hope through Research:-
The NIDDK, through its Division of Kidney, Urologic, and Hematologic Diseases, supports several programs and studies devoted to improving treatment for patients with progressive kidney disease and permanent kidney failure, including patients who receive a transplanted kidney.

•The End-Stage Renal Disease Program promotes research to reduce medical problems from bone, blood, nervous system, metabolic, gastrointestinal, cardiovascular, and endocrine abnormalities in kidney failure and to improve the effectiveness of dialysis and transplantation. The program seeks to increase kidney graft and patient survival and to maximize quality of life.

•The NIH Organ/Tissue Transplant Center, located at the NIH Clinical Center in Bethesda, MD, is a collaborative project of NIH, the Walter Reed Army Medical Center, the Naval Medical Research Center, and the Diabetes Research Institute at the University of Miami. The site includes a state-of-the-art clinical transplant ward, operating facility, and outpatient clinic designed for the study of new drugs or techniques that may improve the success of organ and tissue transplants.

•The U.S. Renal Data System (USRDS) collects, analyzes, and distributes information about the use of dialysis and transplantation to treat kidney failure in the United States. The USRDS is funded directly by NIDDK in conjunction with the Centers for Medicare & Medicaid Services. The USRDS publishes an Annual Data Report, which characterizes the total population of people being treated for kidney failure; reports on incidence, prevalence, mortality rates, and trends over time; and develops data on the effects of various treatment modalities. The report also helps identify problems and opportunities for more focused special studies of renal research issues.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.topnews.in/health/kidney-transplant-patients-low-physical-activity-likely-die-early-211177
http://www.nlm.nih.gov/medlineplus/kidneytransplantation.html
http://www.kidney.niddk.nih.gov/kudiseases/pubs/transplant/
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/kidneys/kidneys_transplant.shtml

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Kidney dialysis

Introduction:
In order for blood to perform its essential functions of bringing nutrients and oxygen to the cells of the body, and carrying waste materials away from those cells, the chemical composition of the blood must be carefully controlled. Blood contains particles of many different sizes and types, including cells, proteins, dissolved ions, and organic waste products. Some of these particles, such as proteins like hemoglobin, are essential for the body. Others, such as urea (a waste product from protein metabolism), must be removed from the blood or they will accumulate and interfere with normal metabolic processes. Still other particles, including many of the simple ions dissolved in the blood, are required by the body in certain concentrations that must be tightly regulated, especially when the intake of these chemicals varies. The body has many different means of controlling the chemical composition of the blood. For instance, you learned in the “Iron Use and Storage in the Body: Ferritin and Molecular Representations” tutorial that the ferritin protein can help to control the amount of free iron in the blood. As you will discover in the tutorial entitled, “Blood, Sweat, and Buffers: pH Regulation During Exercise”, buffers dissolved in the blood can help regulate the blood’s pH. But the largest responsibility for maintaining the chemistry of the blood falls to the kidneys, a pair of organs located just behind the lining of the abdominal cavity. It is the job of the kidneys to remove the harmful particles from the blood and to regulate the blood’s ionic concentrations, while keeping the essential particles in the blood

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Healthy kidneys clean the blood by removing excess fluid, salt and wastes. When they fail, harmful wastes build up, blood pressure may rise, and the body may retain excess fluid. When this happens, treatment – dialysis or a kidney transplant – is needed to replace the work of the failed kidneys, which is known as end-stage renal failure (ESRF).

There are three primary and two secondary types of dialysis: hemodialysis (primary), peritoneal dialysis (primary), hemofiltration (primary), hemodiafiltration (secondary), and intestinal dialysis (secondary).

Hemodialysis:
Haemodialysis (HD) is the most common method used to treat ESRF and has been available since the 1960s. Despite some advances in dialysis machines in recent years, HD is still a complicated and inconvenient therapy requiring a coordinated effort from a large healthcare team, including:

•GP
•Nephrologist (kidney doctor)
•Dialysis nurse
•Dialysis technician
•Dietitian
•Social worker
One important step before starting HD is a small operation to prepare a site on the body. One of the arteries in your arm is re-routed to join a vein, forming a fistula. Blood is removed from the fistula, cleaned and returned to it, allowing dialysis process to take place.

Needles are inserted into a fistula (the point of access to the bloodstream) at the start of HD. You may find this one of the hardest parts, although most people report getting used to them after a few sessions. If it’s painful, an anesthetic cream or spray can be applied to the skin.

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In HD, blood is allowed to flow, a small amount at a time, through a special filter (the ‘dialyser’ or ‘artificial kidney’) that removes wastes and extra fluids. The clean blood is then returned to your body via the fistula. This helps to keep the correct amount of water in the body, control blood pressure – and keep the proper balance of chemicals such as potassium, sodium and acid.

Most people have HD three times a week for three to five hours, with a morning, afternoon or evening ‘slot’; depending on availability and capacity at a dialysis unit, usually in a large hospital. Some receive it at a smaller satellite unit nearer home, and a few have HD in their own homes.

By learning about the treatment, and working with your healthcare team, it’s possible to have a full, active life

Peritoneal dialysis:
Peritoneal dialysis (PD) became an alternative to HD in the 1980s, with many preferring the independence it brings them.

It means you don’t have to have dialysis sessions at a unit, but can give treatments at home, at work or on holiday. Like HD, by learning about the treatment, and working with the medical team, it’s possible to have a full and active life.

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In PD, a soft tube called a catheter is used to fill the abdomen with a cleansing liquid called dialysis solution. The abdominal cavity is lined with a layer called the peritoneum. Waste products and extra fluid (and salt) then pass through the peritoneum from the blood into the dialysis solution. They then leave the body when the dialysis solution is drained. This used solution is then thrown away.

The process of draining and filling is called an ‘exchange’ and takes about 30 to 40 minutes. The period the dialysis solution is in the abdomen is called the ‘dwell time’. A typical schedule is four exchanges a day, each with a dwell time of four to eight hours.

There are many forms of PD. One doesn’t even require a machine and it’s possible to walk around with the dialysis solution in your abdomen. Talk to your specialist about what’s best for your particular situation.

Whatever form is chosen, an operation is needed to have the soft catheter placed in the abdomen, which will carry the dialysis solution in and out of the abdomen. It’s usually inserted two weeks before dialysis proceeds, to allow scar tissue to build up that will hold it in place.

Hemofiltration:
Hemofiltration is a similar treatment to hemodialysis, but it makes use of a different principle. The blood is pumped through a dialyzer or “hemofilter” as in dialysis, but no dialysate is used. A pressure gradient is applied; as a result, water moves across the very permeable membrane rapidly, “dragging” along with it many dissolved substances, importantly ones with large molecular weights, which are cleared less well by hemodialysis. Salts and water lost from the blood during this process are replaced with a “substitution fluid” that is infused into the extracorporeal circuit during the treatment. Hemodiafiltration is a term used to describe several methods of combining hemodialysis and hemofiltration in one process.

Hemodiafiltration:
Hemodialfiltration is a combination of hemodialysis and hemofiltration. In theory, this technique offers the advantages of both hemodialysis and hemofiltration.

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Intestinal dialysis:
In intestinal dialysis, the diet is supplemented with soluble fibres such as acacia fibre, which is digested by bacteria in the colon. This bacterial growth increases the amount of nitrogen that is eliminated in fecal waste.  An alternative approach utilizes the ingestion of 1 to 1.5 liters of non-absorbable solutions of polyethylene glycol or mannitol every fourth hour.

Which is better?
Neither technique ‘cures’ ESRF, as they only provide about five per cent of normal kidney function. In other words, they control kidney failure to an extent. It’s hard to state which technique is ‘better’ for which patient, as both have pros and cons. Many patients will have both in their continuing treatment.

Living with dialysis
Adjusting to the effects of ESRF and the time spent on dialysis can be difficult. Aside from the ‘lost time’ (dialysis can take six to eight hours a day) most patients feel they have less energy. Many need to make changes in their work or home life, and can feel depressed when starting the process, or after several months of treatment. It’s good to talk with a social worker, nurse or doctor as this is a common problem that can often be treated effectively.

If you’re feeling well, your kidney specialist should measure the effectiveness of the dialysis with blood tests at least once a month in HD, and once every three months in PD.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose
Resources:
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/kidneys/kidneys_dialysis.shtml
http://en.wikipedia.org/wiki/Dialysis
http://www.chemistry.wustl.edu/~edudev/LabTutorials/Dialysis/Kidneys.html

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Kidney Cancer

Definition:–
Kidney cancer is usually defined as a cancer that originates in the kidney.

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The two most common types of kidney cancer, reflecting their location within the kidney, are renal cell carcinoma (RCC) and urothelial cell carcinoma (UCC) of the renal pelvis.
The distinction between these two types (RCC and UCC) is important because their prognosis, staging, and management, i.e. treatment (e.g. surgery, chemotherapy etc.), are different.

Renal cell carcinoma (RCC) is the most common type in adults, responsible for approximately 80 per cent of cases.

Types:
In addition to renal cell carcinoma and renal pelvis carcinoma, other, less common types of kidney cancer include:

*Squamous cell carcinoma
*Juxtaglomerular cell tumor (reninoma)
*Angiomyolipoma
*Renal oncocytoma
*Bellini duct carcinoma
*Clear-cell sarcoma of the kidney
*Mesoblastic nephroma
*Wilms’ tumor, usually is reported in children under the age of 5.
*Mixed epithelial stromal tumor

Rarely, some other types of cancer and potentially cancerous tumors that more usually originate elsewhere can originate in the kidneys. These include:

*Clear cell adenocarcinoma
*Transitional cell carcinoma
*Inverted papilloma
*Renal lymphoma
*Teratoma
*Carcinosarcoma
*Carcinoid tumor of the renal pelvis

Cancer in the kidney may also be secondary, the result of metastasis from a primary cancer elsewhere in the body.

Around 208,500 new cases of kidney cancer are diagnosed in the world each year, accounting for just under 2% of all cancers. The highest rates are recorded in Northern America and the lowest rates in Asian and African regions.

In the United States in 2008, these two types together are estimated to cause 54,390 new cases and 13,010 deaths.

2005. The most recent estimates of incidence of kidney cancer suggest that there are 63,300 new cases annually in the EU25. In Europe, kidney cancer accounts for nearly 3% of all cancer cases.

In the UK kidney cancer is the eighth most common cancer in men, with 4,622 new cases diagnosed in 2005. This compares to 2,758 new cases of kidney cancer in women, giving a male:female ratio of 1.5:1. In women it is the fourteenth most common cancer. Male kidney cancer incidence rates increased by more than 85% from 7.1 per 100,000 in 1975 to 13.4 per 100,000 in 2005. In women the rates have more than doubled over the same period from 3.2 to 6.6 per 100,000. Most of the increase has occurred in older men and women, with rates more than doubling between 1975 and 2005 for men in their 70s and early 80 and women aged 65 and over. The incidence of the disease in Britain has an aspect ratio of 50.6% of the final exitus( quote by Welsh Cancer Intelligence, 2005 ).

The incidence of kidney cancer is increasing also in the United States, and this increase is thought to be real, at least in part, not due only to changes in diagnostic practices.

Some types of kidney cancer have a known hereditary or familial risk, and to date five hereditary syndromes have been associated with renal cell carcinoma

Symptoms:–
Many people with kidney cancer have no symptoms at first, especially when the cancer is small. The affected kidney will become larger and in time, the tumour may grow through the wall of the kidney and invade nearby tissues and organs, such as the muscles around the spine, liver and nearby large blood vessels.

As the cancer develops, the following may occur:

•Blood in the urine, which is usually painless and may ‘come and go’ as the tumour bleeds (the first symptom in 60 per cent of cases)
•Pain in the back or side
•Swelling in the abdomen
•High blood pressure
•Feeling generally unwell or tired
•Loss of appetite
•Polycythaemia (too much blood in body) or anaemia (too little)
•Varicocele (tangled network of veins in the scrotum)
•Hip fracture, owing to spread of the cancer to bone
•Excessive hair growth in females
•Feeling thirsty
•Night sweats
•Severe weight loss

Causes:–
Kidney cancer develops most often in people over 40, but no one knows the exact causes of this disease. Doctors can seldom explain why one person develops kidney cancer and another does not. However, it is clear that kidney cancer is not contagious. No one can “catch” the disease from another person.

Research has shown that people with certain risk factors are more likely than others to develop kidney cancer. A risk factor is anything that increases a person’s chance of developing a disease.

Studies have found the following risk factors for kidney cancer:

•Smoking: Cigarette smoking is a major risk factor. Cigarette smokers are twice as likely as nonsmokers to develop kidney cancer. Cigar smoking also may increase the risk of this disease.
•Obesity: People who are obese have an increased risk of kidney cancer.
•High blood pressure: High blood pressure increases the risk of kidney cancer.
•Long-term dialysis: Dialysis is a treatment for people whose kidneys do not work well. It removes wastes from the blood. Being on dialysis for many years is a risk factor for kidney cancer.
•Von Hippel-Lindau (VHL) syndrome: VHL is a rare disease that runs in some families. It is caused by changes in the VHL gene. An abnormal VHL gene increases the risk of kidney cancer. It also can cause cysts or tumors in the eyes, brain, and other parts of the body. Family members of those with this syndrome can have a test to check for the abnormal VHL gene. For people with the abnormal VHL gene, doctors may suggest ways to improve the detection of kidney cancer and other diseases before symptoms develop.
•Occupation: Some people have a higher risk of getting kidney cancer because they come in contact with certain chemicals or substances in their workplace. Coke oven workers in the iron and steel industry are at risk. Workers exposed to asbestos or cadmium also may be at risk.

Diagnosis:-

If a patient has symptoms that suggest kidney cancer, the doctor may perform one or more of the following procedures:

•Physical exam: The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
•Urine tests: Urine is checked for blood and other signs of disease.
•Blood tests: The lab checks the blood to see how well the kidneys are working. The lab may check the level of several substances, such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
•Intravenous pyelogram (IVP): The doctor injects dye into a vein in the arm. The dye travels through the body and collects in the kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.
•CT scan (CAT scan): An x-ray machine linked to a computer takes a series of detailed pictures of the kidneys. The patient may receive an injection of dye so the kidneys show up clearly in the pictures. A CT scan can show a kidney tumor.
•Ultrasound test: The ultrasound device uses sound waves that people cannot hear. The waves bounce off the kidneys, and a computer uses the echoes to create a picture called a sonogram. A solid tumor or cyst shows up on a sonogram.
•Biopsy: In some cases, the doctor may do a biopsy. A biopsy is the removal of tissue to look for cancer cells. The doctor inserts a thin needle through the skin into the kidney to remove a small amount of tissue. The doctor may use ultrasound or x-rays to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.
•Surgery: In most cases, based on the results of the CT scan, ultrasound, and x-rays, the doctor has enough information to recommend surgery to remove part or all of the kidney. A pathologist makes the final diagnosis by examining the tissue under a microscope.

Treatment:–
Treatment options which may be considered include:

•Surgery to remove all (or part) of the affected kidney. This is the most common treatment and can be done as a keyhole operation in some cases. If the cancer is at an early stage and hasn’t spread, surgery alone may be enough. If the cancer has spread, surgery to remove the affected kidney may still be advised, often in addition to further surgery to remove a secondary kidney tumour (one which has spread to another part of the body).
•Radiotherapy may be advised to kill any cancerous cells left behind following an operation.
•Arterial embolisation may be used instead of surgery, where the artery to the kidney tumour is blocked. The blood supply to the tumour is then cut off, and the tumour dies.
•Medications such as sunitinib, temsirolimus, bevacizumab, interferon-alpha have improved the outlook for kidney cancer patients. Speak to your specialist about what may be best for you.
Chemotherapy doesn’t work as well as it does for other types of cancer. The type of treatment depends on the type and how large the cancer is, whether it has spread and general health.

If a cure is not realistic, in some cases treatment aims to control the cancer, limiting the growth or spread so it progresses less rapidly. This may limit the amount of symptoms for some time.

If the cancer is confined to the kidney without spreading, and the patient is in otherwise good general health, the outlook is good, with around 95 per cent of patients surviving five years after diagnosis (if the tumour is less than 4 cm). Surgical removal of an affected kidney in this situation gives a good chance of cure.

However, many people with kidney cancer are diagnosed when the cancer has already spread, so a cure is less likely. However, treatment can often slow down the progression of the cancer.

Follow-up care:-

Follow-up care after treatment for kidney cancer is important. Even when the cancer seems to have been completely removed or destroyed, the disease sometimes returns because cancer cells can remain in the body after treatment. The doctor monitors the recovery of the person treated for kidney cancer and checks for recurrence of cancer. Checkups help ensure that any changes in health are noted. The patient may have lab tests, chest x-rays, CT scans, or other tests.

Support for people with kidney cancer

Living with a serious disease such as kidney cancer is not easy. People with kidney cancer may worry about caring for their families, keeping their jobs, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful to those who want to talk about their feelings or discuss their concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support.

Support groups also can help. In these groups, patients or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment. Groups may offer support in person, over the telephone, or on the Internet. Patients may want to talk with a member of their health care team about finding a support group.

The Cancer Information Service at 1-800-4-CANCER begin_of_the_skype_highlighting 1-800-4-CANCER end_of_the_skype_highlighting can provide information to help patients and their families locate programs, services, and publications.

The promise of cancer research:

Doctors all over the country are conducting many types of clinical trials. These are research studies in which people volunteer to take part. In clinical trials, doctors are testing new ways to treat kidney cancer. Research has already led to advances, and researchers continue to search for more effective approaches.

Patients who join these studies have the first chance to benefit from treatments that have shown promise in earlier research. They also make an important contribution to medical science by helping doctors learn more about the disease. Although clinical trials may pose some risks, researchers do all they can to protect their patients.

Researchers are studying surgery, biological therapy, chemotherapy, and combinations of these types of treatment. They also are combining chemotherapy with new treatments, like stem cell transplantation. A stem cell transplant allows a patient to be treated with high doses of drugs. The high doses destroy both cancer cells and normal blood cells in the bone marrow. Later, the patient receives healthy stem cells from a donor. New blood cells develop from the transplanted stem cells.

Other approaches also are under study. For example, researchers are studying cancer vaccines that help the immune system to find and attack kidney cancer cells.

Patients who are interested in being part of a clinical trial should talk with their doctor.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/cancer/typescancer_kidney.shtml
http://en.wikipedia.org/wiki/Kidney_cancer
http://www.medicinenet.com/kidney_cancer/page7.htm

Kidney Cancer – Causes, Symptoms Diagnosis And Treatment

http://www-cancer.us/320/kidney-cancer-treatment/

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Ailmemts & Remedies

Henoch-Schonlein purpura

Definition:
There are many health problems that arise from the fact that the body’s immune system can turn on itself itself and attack its own tissues. These are called autoimmune reactions, and they can happen without warning. Henoch-Schonlein purpura (HSP) is one such reaction.

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In HSP, the immune system is triggered to produce a type of antibody known as IgA which targets and attacks the blood vessels. This causes the blood vessels to become inflamed, a condition called vasculitis.

Although Henoch-Schonlein purpura can affect anyone, it’s most common in children and young adults. Henoch-Schonlein purpura usually improves on its own, but if the kidneys are affected, medical care is generally needed, as well as long-term follow-up to prevent more-serious problems.

Symptoms:
HSP often affects various parts of the body. Most patients are mildly unwell, with a low grade fever. A triad of more specific symptoms usually occurs:

•a characteristic symmetrical skin rash on the lower extremities
•abdominal pain or kidney problems
•arthritis
The characteristic rash of HSP appears as purple spots on the skin, known as purpura which may rapidly merge together to look like bruises. These are usually found over the lower extremities – in particular, the buttocks and lower legs. However, the rash can also appear on the face, trunk and upper extremities – especially the outer side of the arms. It tends to be more prominent in areas where pressure on the skin occurs, from socks or waistbands for example.

When the joints are affected, they may become red, swollen and tender. This is most common in the ankles and knees, but the feet, hands and elbows may also be involved. Fortunately, this is only temporary and permanent deformity doesn’t occur.

Cramping abdominal pain, sometimes with diarrhoea and vomiting, and the passing of blood raises the alarm that the gut has become involved. In up to three percent of cases the bowel may become blocked by a condition called intussusception. Traces of blood or protein found in the urine indicates the kidneys are inflamed (called glomerulonephritis) – this affects up to 50 per cent of older children.

Causes:
In Henoch-Schonlein purpura, some of the body’s small blood vessels become inflamed, which can cause bleeding in the skin, joints, abdomen and kidneys. Why this initial inflammation develops isn’t clear, although it may be the result of an overzealous immune system responding inappropriately to certain triggers.The exact cause for this disorder is unknown.

Some of these triggers may include:

*Viral and bacterial infections, such as strep throat and parvovirus infection — nearly half the children with Henoch-Schonlein purpura develop the disease after an upper respiratory infection

*Certain medicines, including some types of antibiotics and antihistamines

*Insect bites

*Some vaccinations, including those for measles, typhoid, yellow fever and cholera

*Cold weather

*Certain chemicals

* Food allergens.

It’s thought that HSP may be triggered by a viral infection, as up to two-thirds of children will have had a respiratory tract infection (a cough or cold) one to three weeks before HSP appears.

Risk Factors:
*Age. The disease affects primarily children and young adults, with the majority of cases occurring in children between 4 and 6 years of age.

*Sex. Henoch-Schonlein purpura is slightly more common in boys than girls

*Race. White and Asian children are more likely to develop Henoch-Schonlein purpura than black children are.It’s between one and a half and two times more likey to affect boys than girls.

*Illness. Having an upper respiratory infection or other bacterial or viral illness increases a child’s risk.

*Season. Henoch-Schonlein purpura strikes mainly in autumn, winter and spring, and rarely in summer.Every year in the UK about one person in every 5,000 develops HSP

Complications:-
For most people, symptoms of Henoch-Schonlein purpura improve in a few weeks, leaving no lasting problems. Recurrences are fairly common, however. Children who have severe symptoms appear more likely to have a recurrence, but repeat bouts are usually milder than the initial episode.

Kidney damage
The most serious complication of Henoch-Schonlein purpura is kidney damage, which can cause blood in the urine, swelling and high blood pressure. Most children with kidney problems recover fully, but in a very small percentage of cases, Henoch-Schonlein purpura leads to end-stage kidney disease. In that case, dialysis or a kidney transplant may be needed. Adults are at greater risk than children of developing end-stage kidney disease.

The long-term outcome for people with Henoch-Schonlein purpura appears to depend on whether they develop kidney problems and how severe those problems are.

Bowel obstruction
In rare cases, Henoch-Schonlein purpura can cause a kind of bowel obstruction (intussusception) that reduces blood flow to the intestinal tract and leads to inflammation of other organs, including the pancreas.

Future pregnancies
Women who’ve had Henoch-Schonlein purpura during childhood may be at increased risk of high blood pressure during pregnancy. If you’re pregnant and have a history of Henoch-Schonlein purpura, be sure to tell your doctor about it so that you can be monitored appropriately.

Diagnosis:
The diagnosis is based on the combination of the symptoms, as very few other diseases cause the same symptoms together. Blood tests may show elevated creatinine and urea levels (in kidney involvement), raised IgA levels (in about 50%), and raised CRP or erythrocyte sedimentation rate (ESR) results; none are specific for Henoch–Schönlein purpura. The platelet count may be raised, and distinguishes it from diseases where low platelets are the cause of the purpura, such as idiopathic thrombocytopenic purpura and thrombotic thrombocytopenic purpura.

If there is doubt about the cause of the skin lesions, a biopsy of the skin may be performed to distinguish the purpura from other diseases that cause it, such as vasculitis due to cryoglobulinemia; on microscopy the appearances are of a hypersensitivity vasculitis, and immunofluorescence demonstrates IgA and C3 (a protein of the complement system) in the blood vessel wall.[2] However, overall serum complement levels are normal.

On the basis of symptoms, it is possible to distinguish HSP from hypersensitivity vasculitis (HV). In a series comparing 85 HSP patients with 93 HV patients, five symptoms were found to be indicative of HSP: palpable purpura, abdominal angina, digestive tract hemorrhage (not due to intussussception), hematuria and age less than 20. The presence of three or more of these indicators has an 87% sensitivity for predicting HSP.

Biopsy of the kidney may be performed both to establish the diagnosis or to assess the severity of already suspected kidney disease. The main findings on kidney biopsy are increased cells and Ig deposition in the mesangium (part of the glomerulus, where blood is filtered), white blood cells, and the development of crescents. The changes are indistinguishable from those observed in IgA nephropathy.

Microphotograph of a histological section of human skin prepared for direct immunofluorescence using an anti-IgA antibody, the skin is a biopsy of a patient with Henoch-Schönlein purpura. IgA deposits are found in the walls of small superficial capillaries (yellow arrows). The pale wavy green area on top is the epidermis, the bottom fibrous area is the dermis.HSP can develop after infections with streptococci (?-haemolytic, Lancefield group A), hepatitis B, herpes simplex virus, parvovirus B19, Coxsackievirus, adenovirus, Helicobacter pylori,[5] measles, mumps, rubella, Mycoplasma and numerous others.  Drugs linked to HSP, usually as an idiosyncratic reaction, include the antibiotics vancomycin and cefuroxime, ACE inhibitors enalapril and captopril, anti-inflammatory agent diclofenac, as well as ranitidine and streptokinase. Several diseases have been reported to be associated with HSP, often without a causative link. Only in about 35% of cases can HSP be traced to any of these causes.

The exact cause of HSP is unknown, but most of its features are due to the deposition of abnormal antibodies in the wall of blood vessels, leading to vasculitis. These antibodies are of the subclass IgA1 in polymers; it is uncertain whether the main cause is overproduction (in the digestive tract or the bone marrow) or decreased removal of abnormal IgA from the circulation. It is suspected that abnormalities in the IgA1 molecule may provide an explanation for its abnormal behaviour in both HSP and the related condition IgA nephropathy. One of the characteristics of IgA1 (and IgD) is the presence of an 18 amino acid-long “hinge region” between complement-fixating regions 1 and 2. Of the amino acids, half is proline, while the others are mainly serine and threonine. The majority of the serines and the threonines have elaborate sugar chains, connected through oxygen atoms (O-glycosylation). This process is thought to stabilise the IgA molecule and make it less prone to proteolysis. The first sugar is always N-acetyl-galactosamine (GalNAc), followed by other galactoses and sialic acid. In HSP and IgAN, these sugar chains appear to be deficient. The exact reason for these abnormalities is not known

Treatment:
The condition usually settles down within six weeks, although it can go on for several months. It can recur, sometimes more than once, in as many as one in three people. There is no treatment which has been shown to shorten the duration of the disease or reduce the risk of complications, so no specific treatment is required. However, treatment can be used to relieve the symptoms. Paracetamol or non-steroidal anti-inflammatory medication (such as ibuprofen) may be prescribed to relieve any joint pain. If symptoms persist, corticosteroid therapy may be recommended.

The most serious possible consequence of Henoch-Schonlein purpura is kidney damage. Up to five percent of cases develop progressive kidney disease and ultimately kidney failure (this is more likely in older children and adults). For this reason, regular urine tests to monitor kidney function are important, even once someone has recovered from the acute illness.

Prognosis:
Overall prognosis is good in most patients, with one study showing recovery occurring in 94% and 89% of children and adults, respectively (some having needed treatment).

In children under ten, the condition recurs in about a third of all cases and usually within the first four months after the initial attack.Recurrence is more common in older children and adults.

In general, however, the majority of people who develop HSP make a full recovery without any further problems.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.mayoclinic.com/health/henoch-schonlein-purpura/DS00838
http://en.wikipedia.org/wiki/Henoch%E2%80%93Sch%C3%B6nlein_purpura
http://www.bbc.co.uk/health/physical_health/conditions/henochschonleinpurpura1.shtml

http://www.nlm.nih.gov/medlineplus/ency/imagepages/19831.htm

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