Disorders of Kidney

There are many different kidney disorders:

1. 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 kidney. Some may travel to ureter or urinary bladder.

The major causes of kidney stones are age, diet (containing more green vegetables, salts, vitamins C and D), recurring urinary tract infections, less intake of water, and alcohol consumption. The symptoms of kidney stones include severe pain in kidney or in lower abdomen, vomiting, frequent urination and foul-smelling urine with blood and pus.

About 90% of all kidney stones can pass through the urinary system by drinking plenty of water. In surgical treatment, the affected area is opened and stone(s) are: removed.

What is 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.

Abu Nasr al-Farabi (872-951) was a prominent scientist who wrote many books that contained information about kidney diseases. The genius Abu al-Qasim Al Zahrawi (known as Albucasis: 936-1013), is considered to be Islam’s greatest surgeon who invented many surgical procedures including the surgical removal of stones from the urinary bladder. His encyclopedia, Al-Tasrif (“The Method”). contained over 200 surgical medical instruments he personally designed.

2. Kidney (Renal) failure

Kidney failure means a complete or partial failure of kidneys to function. Diabetes mellitus and hypertension are the leading causes of kidney failure. In certain cases, sudden interruption in the blood supply to kidney and drug overdoses may also result in kidney failure.

The main symptom of kidney failure is the high level of urea and other wastes in blood, which can result in vomiting, nausea, weight loss, frequent urination and blood in urine. Excess fluids in body may also cause swelling of legs, feet and face and shortness of breath.

The kidney failure is treated with dialysis and kidney transplant.

a. Dialysis

Dialysis means the cleaning of blood by artificial ways. There are two methods of dialysis.

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 (Fig. 11.11). 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.

Peritioneal dialysis
Peritoneal dialysis

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 (Fig. 11.12). 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.


b. Kidney Transplant

We know that 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. Kidney may be donated by a deceased-donor or living donor. The donor may or may not be a relative of the patient. Before transplant, the tissue proteins of donor and patient are matched.

The donor’s kidney is transplanted in patient’s body and is connected to the patient’s blood and urinary system. The average lifetime for a donated kidney is ten to fifteen years. When a 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 a transplant may include transplant rejection, infections, imbalances in body salts which can lead to bone problems and ulcers.

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