Bladder infection occurs when bacteria cause inflammation in the bladder where is normally bacteria free.
Most common bacteria come from the gut, E. coli, although other gram negative or positive bacteria can cause infection.
Due the anatomical differences between men and women, women tend to get frequent UTIs when bacteria from gut reach urethra into the bladder. This can happen during sexual intercourse or poor hygiene.
During pregnancy, UTIs can occur due to large uterus pressing on bladder and inadequate emptying. UTIs are rare in men, but can occur when prostate hypertrophy is present preventing bladder emptying.
Stone can form in the kidneys. It can cause flank pain, blood in urine and kidney infections. Calcium Oxalate is the most common form of kidney stone. Uric acid or calcium phosphate stone can occur, as well.
Plenty of fluid intake to increase urine amount, adequate calcium intake, reduction of uric acid levels in the blood and alkalinization of urine can prevent kidney stones.
Acute Kidney Injury (AKI) occurs in many situations. AKI means acutely reduced kidney function due to acute injury, which results in accumulation of fluid, electrolytes and waste products. Urine output can be reduced and swelling can ensue. Body can become acidotic due to acid accumulation in the body.
Commonly used medications such as PPIs or NSAIDs can cause acute kidney inflammation. Depending upon the cause of AKI, treatment can be offered to ameliorate the degree of AKI.
Chronic Kidney Disease(CKD) can occur after many years of kidney injury. When kidney function drops below 15 % of normal, dialysis is required to maintain life. Most common cause of CKD and dialysis is Diabetes. When CKD reaches stage 5, water excretion and electrolyte control, acid base balance disorders ensue.
Kidney replacement therapy include hemodialysis, peritoneal dialysis and kidney transplantion. Depending upon patients’ clinical status, adequate therapy can be recommended.
Peritoneal dialysis or home hemodialysis can be performed at home after proper training. Kidney transplantation is the best modality for renal replacement therapy if donor can be arranged.
Kidney cystic diseases can be hereditary or acquired. Hereditaty form of renal cysts can cause CKD and end stage renal disease (ESRD). On the other hand, simple acquired cysts are usually benign and do not cause CKD.
With advance age, simple cysts can be seen in most of patients.
Pyelonephritis is an infection of kidneys. Untreated bladder infection can progress to pyelonephritis, which can present with life threatening infection especially in elderly. High fever and flank pain with hematuria, pyuria are typical symptoms of pyelonephritis.
Acute glomerulonephritis is inflammation of the kidneys. Contrasted with pyelonephritis that is caused by bacteria, glomerulonephritis is caused by abnormal immune system or non-bacterial damage to the kidneys.
Acute kidney injury with hematuria, proteinuria and edema can occur in a matter of weeks or months duration.
Various immunosuppressive medications are used to treat acute glomerulonephritis with variable success rates.
When acute glomerulonephritis is not treated within timely fashion, kidneys can suffer permanent injury that present with chronic glomerulonephritis.
Most of the case, chronic glomerulonephritis results in end stage renal disease(ESRD).
Diabetes is the number one cause of ESRD.
If diabetes is not controlled, diabetic kidney disease can begin after average 10 year of diabetes.
In addition to diabetes control, blood pressure control and ACE inhibitor treatment can prevent development of diabetic nephropathy.
Diabetic nephropathy starts with protein in urine, which progress with kidney dysfunction.
Although CKD patients have hypertension in 50-70%, hypertension itself can cause kidney injury when untreated for several years.
Hypertension with CKD is more difficult to treat requiring multiple medications.
Salt restriction, exercise, weight reduction along with medications are needed for adequate treatment.