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Nephrology – Overview

Nephrology is the branch of medicine that deals with the diagnosis and treatment of kidney diseases. The kidneys are 2 bean-shaped organs that filter the wastes and toxins out of the blood stream and eliminate them through the urine. The kidneys maintain the body’s electrolyte balance, fluid balance and acid-base regulation, playing an important role in maintaining the stability of the metabolic system. Diseases that fall under the scope of nephrology include kidney and bladder infections, renal stone disease, nephrotic syndrome, cancer, vascular diseases, acute kidney injury and chronic kidney disease (kidney failure), polycystic kidney disease and auto-immune kidney diseases.

Department of Nephrology

The Department of Nephrology at Global Gleneagles Health City specialises in the diagnosis and treatment of kidney injuries, diseases and defects. The team consists of doctors trained at some of the best medical colleges in the world. The department offers a broad range of treatment options to patients with varying needs. The hospital is equipped with advanced diagnostic tools and surgical equipment to enable the doctors to perform cutting-edge procedures like dialysis, continuous renal replacement therapy, to remove kidney stones or cysts, kidney transplants and treat kidney injuries. The doctors and surgeons in the department are supported by a skilled team of radiologists, anaesthesiologists, nurses and technicians. All our health-care providers are dedicated to caring for patients as best as they can and helping them heal.

Precautions to be taken for Healthy Kidneys

Tips for Kidney Health

  • Stay active – Keeping fit and active can lower your blood pressure and your risk of chronic kidney disease.
  • Eat healthy foods – A healthy diet can help maintain a healthy weight and avoid hypertension, high cholesterol and diabetes, which could trigger kidney disease.
  • Avoid excessive salt – Try to eliminate excessive amounts of salt and processed foods from your diet.
  • Control your blood sugar levels – High blood sugar can damage the capillaries of the kidneys and reduce function.
  • Drink plenty of fluids – Drink a minimum of two litres of water a day to stay hydrated and flush out your kidneys. Be careful not to overdo it though!
  • Don’t smoke – Smoking damages the blood vessels in the body, including the kidneys. This causes reduced blood flow to the kidneys and deteriorates function.
  • Avoid abusing over-the-counter pain medication – Ibuprofen and other nonsteroidal anti-inflammatory drugs can damage the kidneys if used frequently or in high doses.
  • Get regular screening – If you are at high risk of kidney disease, make sure to get tested regularly. This gives you the best shot at early detection and effective treatment.
  • Use supplements cautiously – Check the ingredients list of the supplements you take and ask your doctor about them.

Why Choose Us?

Experienced doctors

The doctors and surgeons who comprise our excellent medical team at GGHC have all been trained at some of the best medical colleges. They are highly experienced in tackling a wide range of diseases afflicting the kidneys and the urinary tract. The doctors of the nephrology department collaborate with doctors from oncology, cardiology, radiology and plastic surgery as needed, to ensure patients get a holistic treatment plan.

Patient Experience

How does the patient feel when they walk into our hospital and when they walk out? Have we put a smile on their face and a little more spring in their step? These are the questions we constantly ask ourselves as an organisation to improve our patient care. We focus on everything the patient experiences from the minute they walk inside. With streamlined, simplified administrative procedures and a modern and aesthetic premises, we provide our patients with the healing environment they deserve.

Latest Technologies

The department of nephrology is constantly updating its diagnostic and surgical technologies. We stay abreast of the latest medical research and incorporate what we deem appropriate into our treatment protocols. The pathological laboratories, dialysis centre and critical care unit are equipped with state-of-the-art instrumentation to allow our doctors to continue saving lives. At GGHC, you will experience the future of medical care today.

Providing Quality Care

The doctors, surgeons, radiologists, nursing and assistive staff are sensitive to patient needs and make it their priority. Through careful diagnosis, compassionate care and patience, our health-care providers achieve a high level of successful patient outcomes. Our emphasis is on providing quality care to all our patients, giving them their best chances at recovery.

Nephrology Treatments & Procedures

Nephrology Treatments

AKI (Acute Kidney Injury)

Acute kidney injury occurs quickly and without warning. It is a serious medical condition and requires prompt treatment. In majority of cases, the condition can be reversed, with quick treatment avoiding permanent kidney damage. Treatment involves rectifying the cause, intravenous fluid for rehydration and administering vasopressor support to help raise blood pressure. The patient may also be recommended Haemodialysis – when the patient has severe acidosis, volume overload, hyperkalemia, etc. Haemodialysis is a procedure to filter the toxins and waste products out of the blood.

CKD (Chronic kidney disease)

Chronic kidney disease is a clinical condition in which there is gradual loss of kidney function, causing a build-up of fluids, toxins and wastes in the patient’s blood stream. Chronic kidney disease is typically treated with dietary changes and oral medication to treat the symptoms. This includes medication to treat high blood pressure, lower cholesterol levels, treat anaemia, relieve swelling and protect the bones. The patient will be recommended a low protein diet to minimise the build-up of wastes in the blood stream. Advanced stage chronic kidney disease is known as end-stage kidney failure. At this stage, the kidneys no longer function, and the patient requires regular dialysis or kidney transplant surgery.

Intensive Nephrology Care

Conditions such as electrolyte disorders, fluid imbalances and acute renal failure can cause the sudden onset of symptoms and require immediate medical treatment to limit permanent functional deficiencies. Nephrologists and Critical care experts specialise in the latest cutting-edge techniques to treat these conditions. The Nephrology ICU is equipped with state-of-the-art medical equipment, including dialysis machines, to provide life-saving care to critical patients. Patients are treated with the aim of preserving maximum kidney function and restoring good health as quickly as possible.

Renal Stone Disease

Kidney stones, also known as renal calculi, nephrolithiasis, or urolithiasis, are hard deposits of crystallised minerals in the urinary tract. Kidney stone can affect any part of the urinary tract – the kidney, ureters, bladder or urethra. Most kidney stones cause pain once they become dislodged, as they travel through the urinary tract. Small kidney stones may pass out naturally in the urine. The doctor may provide the patient with a urinary seize to catch the kidney stone for laboratory analysis. Some kidney stones may require medication to break them up so they can pass naturally, with less pain.

Large kidney stones may be broken up using extracorporeal shock wave lithotripsy. They may also be extracted surgically. Surgical removal of kidney stones is performed by urologists with minimally invasive techniques to reduce recovery time and minimise scarring. The doctor may perform a ureteroscopy procedure or a percutaneous nephrolithotomy.

Polycystic Kidney Disease

Polycystic kidney disease is a genetic disorder that results in the formation of multiple fluid-filled sacs on the kidney. The kidneys become enlarged and may lose function over time. Polycystic kidney disease can also cause cysts to develop on the liver. Treatment in the early stages of the disease can help slow the progression and delay end-stage kidney failure. If the cysts are large and close to rupturing or at risk of infection, the doctor may elect to have it removed. Kidney cysts can be removed laparoscopically.

Haemodialysis

Hemodialysis is a therapeutic procedure to remove wastes and toxins from the blood, in patients whose kidneys have lost function completely. The dialysis machine has a mechanical filter that does the job of the compromised kidney. Blood is pumped out of the patient’s body and into the dialysis machine through special tubes. The blood passes through the filters and the waste and toxins are removed. The purified blood is pumped back into a vein in the patient’s arm. Dialysis sessions typically last 3-4 hours and are recommended 3-4 times a week for patients with completely compromised kidneys.

Peritoneal Dialysis

Peritoneal dialysis performs the same function as haemodialysis, but in a different way. During peritoneal dialysis, a catheter carrying a cleansing fluid is inserted into the abdomen. The lining of the abdomen, called the peritoneum, acts as a filter, and removes waste from the blood stream. After a fixed amount of time, the cleansing fluid and wastes are drained out of the abdomen. Peritoneal dialysis is simpler to perform and can be done at home, once the patient is given the proper education and training by a health-care professional. Peritoneal dialysis is usually a daily procedure.

CRRT

Continuous Renal Replacement Therapy (CRRT) Continuous renal replacement therapy is provided to critically ill patients with acute kidney failure, especially those with an unstable heart rate and blood pressure. During continuous renal replacement therapy, the patient’s blood is passed through an external filter that mechanically purifies the blood, before it is returned to the body. Continuous renal replacement therapy works on the same principle as dialysis, but the pace is much slower. CRRT is done over a 24-hour period, as compared to dialysis which takes about 4 hours. The slow rate allows patients with unstable blood pressure to stabilize and respond better to the treatment.

Kidney Transplant

A kidney transplant is a surgical procedure to graft a healthy kidney from a living or deceased donor, to a patient with compromised kidney function. When the kidneys lose function, they stop filtering toxins and wastes out of the blood stream. This is dangerous and other organs in the body may be poisoned. Dialysis is also an option for patients who have lost kidney function, but transplant is considered a more permanent solution with lower long-term costs and better quality of life. It is important to choose a matching donor kidney to minimise the chances of rejection by the patient’s immune system. The surgical transplantation is performed under general anaesthesia. It is a surgical procedure, and hence does have certain risks – The patient may develop postoperative complications such as blood clots, infection or stroke.

Nephrology Procedures

Kidney Biopsy

A kidney biopsy is a minimally-invasive procedure performed to remove a small portion of the kidney tissue for laboratory testing. A kidney biopsy may be done to assess the extent of damage caused by kidney diseases. A kidney biopsy may be recommended by the doctor if there is blood in the urine, excessive protein in the urine and other signs of deteriorating kidney function. Kidney biopsies are usually performed as an outpatient procedure, meaning an overnight hospital stay will not be required. The patient is usually given an intravenous drip, with optional sedatives. The doctor uses an ultrasound to visualise the exact location of the biopsy. The location is marked and a local anaesthetic is applied. A micro-incision is made at the site of the biopsy and the needle is guided through the incision into the kidney. Once the tissue sample is collected, it is sent to pathology for analysis.

Kidney Transplantation

A kidney transplant is a surgical procedure to graft a healthy donor kidney into a patient with compromised kidney function. The donor organ may be retrieved from a deceased (brain-dead) donor or from a live donor. If the patient chooses to go with a live donor, the donor must be in good health, have two viable kidneys (one for donation and one for the donor’s continued use), be a good match for the patient and be able to withstand the stress of a surgery without any foreseeable complications. The transplant surgery is performed in two parts – retrieval and transplant. During the retrieval, the surgeon carefully harvests one kidney from the donor. The blood vessels to the kidney are then expertly grafted and blood flow is restored.

PERMCATH (permanent dialysis catheter insertion)

A PermCath is a long-flexible tube inserted permanently into a vein in the neck or the groin, to facilitate easy dialysis treatment. The tube is left in place permanently, as the patient likely requires dialysis treatment 3-4 times a week. The tube tunnels beneath the skin and is exposed at the site of attachment to the dialysis machine. PermCaths are inserted when the patient requires multiple dialysis sessions over a period of more than 2 weeks. The PermCath has lower chances of becoming infected with long-term repeated usage, when compared to a temporary dialysis catheter.

Diseases and Treatments

Acute Kidney Injury

Acute Kidney Injury Overview

Acute kidney injury also known as acute kidney failure, is a sudden onset of kidney failure that occurs over a period of a few hours to days. Acute kidney injury causes a dangerous build-up of waste in the blood stream that the kidney cannot filter out. Acute kidney failure is common in patients who are already hospitalised or bed-ridden. The condition can be fatal and requires immediate medical attention.

Signs and symptoms of Acute Kidney Injury

Symptoms of acute kidney injury may include reduced urine output, fluid retention or swelling, shortness of breath, fatigue, nausea, weakness, chest pains or seizures. In severe cases, the patient may fall into a coma. Sometimes acute kidney failure doesn’t cause any symptoms, but is accidentally detected on medical tests done for other reasons.

Causes and Risk Factors of Acute Kidney Injury

Acute kidney failure could be caused by conditions that reduce blood flow to the kidneys, including hypertension, dehydration, heart attack, organ failure, burns, injury or major surgery. Over-use of non-steroidal anti-inflammatory drugs can also reduce blood flow to the kidneys and cause acute kidney failure. Sepsis, multiple myeloma, vasculitis, interstitial nephritis or scleroderma could also trigger acute kidney failure. Blockages of the urinary tract caused by cancer, enlarged prostate or kidney stones can also result in acute kidney failure. The condition tends to occur more often in patients with pre-existing conditions like diabetes, high blood pressure, heart failure, peripheral artery disease and liver disease. Older geriatric patients have a higher risk of experiencing acute kidney failure.

Complications of Acute Kidney Injury

Acute kidney failure could cause other complications in the body such as fluid build-up, chest pain, permanent kidney damage and possibly even death.

Diagnosis of Acute Kidney Injury

The diagnosis for acute kidney failure begins with a physical exam and patient medical history. Based on the suspected cause of the kidney failure, the doctor may perform different tests for identification. This could include a urine output test, urinalysis, blood tests to determine the levels of creatinine, urea, nitrogen phosphorous and potassium, glomerular filtration test, ultrasound scans and a kidney biopsy.

Treatment of Acute Kidney Injury

Acute kidney injury is a potentially fatal condition, typically requiring a hospital stay until the cause is identified and treated. The duration of treatment depends on the cause of the acute kidney injury and how quickly the patient’s body responds. The patient is given intravenous fluids or diuretics to balance the fluids in the body. They may also be given medication to control blood potassium and calcium levels. In more serious cases, dialysis treatment may be required at periodic intervals, to remove accumulated toxins from the blood.

Prevention of Acute Kidney Injury

It is difficult to predict when acute kidney injury may occur. If you have pre-existing kidney conditions, you can consult with your doctor to work out a lifestyle program to keep your risk low.

Glomerulonephritis

Glomerulonephritis Overview

Glomeruli are tiny spherical structures in the kidneys, made of capillaries, where the blood is filtered to produce urine. Glomerulonephritis occurs when the glomeruli become inflamed and are unable to function normally. Acute glomerulonephritis can develop suddenly. Chronic glomerulonephritis may set in over a period of time. Glomerulonephritis can occur on its own or in connection with diabetes or lupus. Severe or prolonged glomerulonephritis could cause permanent loss of function in the kidneys.

Signs and symptoms of Glomerulonephritis

Acute glomerulonephritis could occur following a throat or skin infection. Early symptoms include blood in the urine or brown urine, low urine output high blood pressure and puffiness in the morning. The patient may also experience a shortness of breath or chest pain due to excess fluid in the lungs. Chronic glomerulonephritis may develop without showing any symptoms for years. The symptoms for chronic glomerulonephritis, if the patient has, would be the same as acute glomerulonephritis.

Causes and Risk Factors of Glomerulonephritis

Acute glomerulonephritis could be caused by an infection such as streptococcal throat infection, Goodpasture’s syndrome, lupus, small vessel vasculitis. Chronic glomerulonephritis like Alports syndrome may run in the family. The disease commonly shows up in young men with hearing or vision loss. Some forms of chronic glomerulonephritis are auto-immune in nature, and in many cases, the cause remains unidentified.

Complications of Glomerulonephritis

Acute glomerulonephritis could lead to complications like acute kidney failure, high blood pressure and chronic kidney disease.

Diagnosis of Glomerulonephritis

The diagnosis for glomerulonephritis is based on a patient physical exam, medical history, blood tests and urinalysis. The presence of proteins and blood cells in the urine is a good indicator of glomerulonephritis. A kidney ultra sound scan may also be required. The doctor may also need to perform a needle biopsy to retrieve a tissue sample from the kidney for testing.

Treatment of Glomerulonephritis

The treatment program for glomerulonephritis is dependent on whether it is acute or chronic, its underlying cause and the severity of the patient’s symptoms and potential complications. The acute form sometimes resolves on its own. The patient may be given medication to remove excess fluid build-up in the body and prevent high blood pressure and kidney failure. In some cases, the patient may be treated with dialysis to remove accumulated wastes from the blood stream.

Prevention of Glomerulonephritis

It is not entirely possible to prevent glomerulonephritis, but the risk can be minimised by seeking immediate treatment for infections, and keeping blood pressure and blood sugar within healthy levels.

Hyperoxaluria and Oxalosis

Hyperoxaluria and Oxalosis Overview

Hyperoxaluria occurs when there is a build-up of oxalate compounds in the urine. Oxalate compounds are naturally-occurring and found in foods like rhubarb. Excess oxalate in the urine can combine with calcium and form kidney stones. Recurrent kidney stones can cause scarring and loss of kidney function. With loss of kidney function, excessive oxalate will begin to build up in other organs as well, such as the bones, heart, skin and eyes. This is called systemic oxalosis.

Signs and symptoms of Hyperoxaluria and Oxalosis

The first symptom of hyperoxaluria is usually a kidney stone. The patient will most likely experience pain in the lower back and sides, vomiting, pain while urinating, cloudy urine and fever. While kidney stones could be caused by a variety of lifestyle factors in older adults, in children and young adults, it often indicates an underlying disorder like hyperoxaluria.

Causes and Risk Factors of Hyperoxaluria and Oxalosis

Primary hyperoxaluria is a rare genetic disorder wherein the liver cannot produce the enzymes that regulate oxalate production in the body. Patients with primary hyperoxaluria usually develop kidney stones in early childhood. Enteric hyperoxaluria is caused by an underlying case of Crohn’s disease or Short Bowel Syndrome, increasing the absorption of oxalate into the body. Hyperoxaluria could also be caused by consuming a diet that is high in oxalates.

Complications of Hyperoxaluria and Oxalosis

Untreated hyperoxaluria can create complications such as kidney failure and systemic oxalosis. The systemic oxalosis, in return, can cause heart, eye and bone problems.

Diagnosis of Hyperoxaluria and Oxalosis

The doctor will start with patient medical history and description of their diet. They will also need a panel of blood tests, urine tests and ultrasound or CT scans to check for kidney stones. If the initial tests point towards hyperoxaluria, the doctor may require additional tests including an echocardiogram to check for oxalate deposits in the heart, eye tests, a bone marrow biopsy and genetic tests to check for hereditary hyperoxaluria.

Treatment of Hyperoxaluria and Oxalosis

The treatment protocol depends on the type of hyperoxaluria, whether it has progressed to systemic oxaluria and the patient’s age and general health. The doctor may recommend medication, high fluid intake and some dietary changes to reduce the oxalate build-up in the body. If the patient has developed kidney stones, they may be removed surgically or be allowed to pass naturally. Severe hyperoxaluria can cause loss of kidney function requiring dialysis treatment or a kidney transplant surgery. Patients with primary hyperoxaluria may need combined Liver kidney transplant.

Prevention of Hyperoxaluria and Oxalosis

Patients who are at risk of hyperoxaluria should be screened regularly.

Kidney Cysts

Kidney Cysts Overview

Kidney cysts are fluid-filled sacs that form on the kidneys. Some patients present with a singular cyst and some have multiple cysts on both kidneys. Individual cysts have thin walls, a watery fluid within and typically do not cause much damage to the kidneys. Poly-cystic kidney disease is a genetic condition that causes multiple cysts to form which could damage the kidneys as they grow.

Signs and symptoms of Kidney Cysts

Individual cysts may cause symptoms such as fever, pain between the ribs and pelvis, abdominal swelling, frequent urination and blood in the urine. Individual cysts typically only cause symptoms if they become very large or infected. Poly-cystic kidney disease causes symptoms such as high blood pressure, back pain, headaches, urinary tract infections, blood in the urine and kidney stones.

Causes and Risk Factors of Kidney Cysts

The cause of kidney cysts is still uncertain. Poly-cystic kidney disease is caused by gene mutations and is hereditary. Men appear to have a higher risk of developing kidney cysts. Many people over the age of 50 have an asymptomatic individual kidney cyst that may never be discovered unless the patient has another medical condition requiring a kidney ultrasound or CT scan.

Complications of Kidney Cysts

Kidney cysts can rupture or become infected. If a kidney cyst grows very large, it could block the urinary tract and cause difficulty in urinating.

Diagnosis of Kidney Cysts

The doctor will require a physical exam and a host of medical tests to diagnose kidney cysts. The tests required will include blood tests, kidney function tests and imaging tests such as CT or MRI scans to visualise the kidney cysts.

Treatment of Kidney Cysts

Individual kidney cysts may not require any treatment unless they are very large and painful. The doctor may recommend simply monitoring the cyst through regular ultrasound scans. If the cyst is large and painful, surgically draining the cyst may be recommended. Sclerotherapy is a minimally invasive technique, wherein a medical solution is injected into the cyst with a needle and syringe to shrink it, after it has been drained. Surgical removal of large or multiple kidney cysts is performed laparoscopically, through multiple small incisions in the skin. Specialised endoscopic cameras and surgical tools are manoeuvred through these incisions to remove the cysts with minimal damage to surrounding tissues.

Prevention of Kidney Cysts

As the cause is uncertain, kidney cysts cannot be prevented.

Kidney Infection

Kidney Infection Overview

Kidney infection (also known as pyelonephritis) is a type of urinary tract infection that begins in the urethra and bladder and spreads to the ureters and the kidneys. Kidney infections require prompt attention as they can spread to the blood stream. A kidney infection could be life-threatening if left untreated.

Signs and symptoms of Kidney Infection

A patient with a kidney infection may experience fever, blood or pus in their urine, loss of appetite, upset stomach, vomiting, fatigue and lower back or groin pain. In addition to this, the patient may also be experiencing a bladder infection, with symptoms such as lower stomach pain, a burning sensation during urination, frequent urination and great difficulty emptying the bladder.

Causes and Risk Factors of Kidney Infection

Kidney infections usually begin as bladder infections that spread. Blockages in the urinary tract, pregnancy, type 2 diabetes, a weakened immune system, repeated use of a urinary catheter and nerve damage in the bladder will increase a patient’s risk of developing a kidney infection. The shorter length of the ureter in women results in them being more likely to develop bladder infections and kidney infections compared to men.

Complications of Kidney Infection

Kidney infections can cause serious complications including kidney failure – chronic kidney disease. In pregnant women, a kidney infection increases the chances of an early birth or a low birth weight.

Diagnosis of Kidney Infection

The doctor will start with patient medical history and a physical exam. Diagnostic tests including a urinalysis, urine culture, ultrasound scans and CT scans may be required. The doctor may also require a voiding cystourethrogram, to check for disease in the urethra and bladder. Male patients may also require a digital rectal exam to check for a swollen prostate.

Treatment of Kidney Infection

Kidney infections are treated with oral or intravenous antibiotics. The patient will also be advised to rest and consume plenty of fluids. If the patient is in pain, they may also be prescribed a painkiller and advised to apply a heating pad to the painful area.

Prevention of Kidney Infection

To prevent kidney infections, drink plenty of water and don’t hold it in when you need to urinate. Avoid using perfumed personal-hygiene products around the genitals.

Kidney Stones

Kidney Stones Overview

Kidney stones are hard, calcified, mineral deposits that form in the kidneys. It c`ould be caused by a variety of factors including a high salt intake, obesity and consumption of certain medications or supplements. The stones typically form in places where un-expelled urine stagnates and causes a mineral build-up over time. It can occur in the kidneys, ureters or bladder. Passing a kidney stone can be a very painful process. However, they don’t usually cause any permanent damage if they are discovered in time. If the kidney stone becomes large and forms a urinary obstruction, it may require surgical removal.

Signs and symptoms of Kidney Stones

Kidney stones don’t usually cause any symptoms until they get dislodged and begin to move around in the urinary tract. Patients may experience sharp shooting pains in the abdomen or lower back. The pain typically comes in waves and intensifies while urinating. The patient may also have other symptoms such as pink, red or brown-coloured urine, frequent urination, feeling the need to urinate while the bladder is empty, nausea and vomiting. If the kidney stone has caused an infection, the patient may have fever and chills as well.

Causes and Risk Factors of Kidney Stones

Kidney stones are caused by the crystallisation of urine in the urinary tract. Not drinking enough water, consuming excessive mineral salts and certain medications can cause kidney stones to form. Certain pre-existing medical conditions such as type 2 diabetes, gout, hyperparathyroidism and renal tubular acidosis can also lead to the formation of kidney stones. Kidney stones are mainly classified into four types based on the minerals it contains – calcium stones, struvite stones, uric acid stones and cystine stones. Chronic dehydration, obesity and a highly-processed food rich diet can increase your risk of kidney stones. Family history of the condition also increases a person’s risk of developing kidney stones.

Complications of Kidney Stones

When the kidney stones become dislodged and travel down the urinary tract, they cause a host of complications such as irritation of the ureters, urinary obstruction and kidney infections, leading to permanent kidney damage.

Diagnosis of Kidney Stones

The diagnosis begins with patient medical history and a physical exam. If kidney stones are suspected, the doctor will require diagnostic tests, including blood tests, urine tests and a CT scan or X-ray to visualise the size and location of the kidney stone.

Treatment of Kidney Stones

Treatment for kidney stones is customised to the individual case. Small kidney stones may require minimal intervention – These can be passed naturally by drinking plenty of water and taking oral medications. The oral medications help break up the kidney stones so they can pass through the urinary tract more easily and relieve pain. The doctor may give the patient a medical strainer to collect the kidney stones that have passed for laboratory analysis. Large kidney stones may be treated with extracorporeal shock wave lithotripsy (ESWL), using shockwaves to break up the kidney stones so they can pass naturally. The doctor may also recommend surgical removal of the kidney stone. Depending on the case, the surgeon may opt to perform a percutaneous nephrolithotomy or an ureteroscopy.

Prevention of Kidney Stones

Proper hydration and emptying the bladder completely each time you urinate are the keys to preventing kidney stones.

Diabetic Nephropathy

Diabetic Nephropathy Overview

Diabetic nephropathy is a serious complication of type 1 & 2 diabetes. Diabetic nephropathy affects the kidneys’ ability to filter waste from the blood stream. About 25% of patients with diabetes develop diabetic nephropathy. Diabetic nephropathy could progress to kidney failure or end-stage disease.

Signs and symptoms of Diabetic Nephropathy

Symptoms of diabetic nephropathy include high levels of protein in the urine, swelling of the hands, feet and ankles, frequent urination, difficulty concentrating, shortness of breath, loss of appetite, nausea and vomiting.

Causes and Risk Factors of Diabetic Nephropathy

Diabetic nephropathy occurs when the tissues of the kidneys are damaged by diabetes. This is usually due to high sugars and high blood pressure which damages the delicate capillaries in the kidneys where filtration of the blood occurs. Patients with type 1 and type 2 diabetes, hypertension and high blood cholesterol have a higher risk of diabetic nephropathy. Smoking also increases the risk of diabetic nephropathy.

Complications of Diabetic Nephropathy

Diabetic nephropathy could cause numerous complications that develop slowly over time. The potential complications include fluid retention that could lead to a dangerous build-up of fluid in the lungs, anaemia, foot sores, erectile dysfunction, cardiovascular diseases like stroke and diabetic retinopathy.

Diagnosis of Diabetic Nephropathy

If you have been diagnosed with diabetes, the doctor will likely recommend regular urine and blood tests to screen for kidney damage. This includes a microalbuminuria urine test, BUN blood test and serum creatinine blood tests. If these tests provide evidence of kidney damage, the doctor may also need to perform a kidney biopsy.

Treatment of Diabetic Nephropathy

Diabetic nephropathy has no cure, but medication and lifestyle changes can help delay the progression of the disease. If caught early, oral medications to control high blood pressure, fluid retention and high blood sugar may be sufficient. If the condition has progressed to end-stage kidney disease, the patient will require regular dialysis treatment or a kidney transplant surgery.

Prevention of Diabetic Nephropathy

To prevent diabetic nephropathy, take steps to keep your blood pressure and blood sugar levels within the normal range.

Electrolyte disorders

Electrolyte disorders Overview

An electrolyte disorder occurs when the levels of various minerals in the body are out of balance. These electrolytes are maintained at certain levels for optimal bodily functions. Severe electrolyte imbalances can cause cardiac arrest, coma or seizures.

Signs and symptoms of Electrolyte disorders

Patients with electrolyte disorder may experience irregular heartbeat, fatigue, racing heart rate, nausea, muscle cramping, confusion, headache and numbness. Mild cases of electrolyte imbalance may only experience a few of these symptoms.

Causes and Risk Factors of Electrolyte disorders

An electrolyte disorder is caused if a person is dehydrated or has too much water in their body. Vomiting, diarrhoea, not drinking enough fluids, excessive sweating, eating disorders, alcoholism, cancer treatments and congestive heart failure may cause an electrolyte disorder. The condition can occur in patients of all ages and genders.

Complications of Electrolyte disorders

Electrolyte disorder can lead to low blood pressure, tachycardia or rapid heartbeat and loss of consciousness. Some patients may also experience serious cognitive impairment or hallucinations.

Diagnosis of Electrolyte disorders

A simple blood test can measure electrolyte levels in the blood and give the doctors information about the nature of the imbalance. The doctor may check for dehydration by performing the “pinch test” and checking if the skin stays pinched. The doctor may also check the patient’s neural reflexes and perform an ECG.

Treatment of Electrolyte disorders

Mild electrolyte disorders may be treated with oral fluids and supplements. Severe electrolyte disorders are treated in hospital with intravenous fluids and medication.

Prevention of Electrolyte disorders

To prevent an electrolyte disorder, stay hydrated, especially if you are experiencing vomiting, diarrhoea or excessive sweating.

Hyponatremia

Hyponatremia Overview

Hyponatremia is a specific type of electrolyte disorder, in which sodium levels in the blood are low. It is usually discovered on blood tests. With low sodium levels, the cells of the body begin to swell with water. The swelling can cause a range of health problems, including swelling of the brain, seizures and coma.

Signs and symptoms of Hyponatremia

Hyponatremia can cause confusion, disorientation, muscle cramps, vomiting, lethargy, headache, changes in mental state and weakness. In severe cases, the patient may experience seizures or a coma.

Causes and Risk Factors of Hyponatremia

Sodium in the body helps maintain normal blood pressure, function of the nerves and muscles and fluid balance. Drinking too much water, consuming certain medications, chronic vomiting or diarrhoea, and adrenal gland insufficiency could cause hyponatremia. Geriatric adults and premenopausal women have a high risk of hyponatremia.

Complications of Hyponatremia

Hyponatremia can cause seizures and coma. This usually results in brain damage or even death.

Diagnosis of Hyponatremia

The diagnosis typically begins with a patient’s medical history and a physical exam. Hyponatremia is diagnosed on the basis of a blood test measuring electrolyte levels in the blood. The doctor may require additional tests to assess the extent of complications caused by the hyponatremia.

Treatment of Hyponatremia

Treatment for hyponatremia aims to restore sodium balance and treat any complications. The patient may be given oral or intravenous medication to reduce symptoms. A diuretic will also be recommended to reduce swelling and fluid retention if present.

Prevention of Hyponatremia

To prevent hyponatremia, treat any underlying conditions you may have, and stay properly hydrated while engaging in strenuous physical activity.

Hypokalemia

Hypokalemia Overview

Hypokalemia is an electrolyte disorder characterised by low potassium. Potassium is an important mineral needed for normal muscle, heart and nerve function. Without it, the patient may experience arrhythmias, abnormal heartbeat and muscle weakness. These symptoms are usually reversed once the imbalance is corrected.

Signs and symptoms of Hypokalemia

Mild hypokalemia does not produce any noticeable symptoms. Symptoms such as muscle weakness, heart palpitations, muscle cramping, constipation, vomiting, loss of appetite and arrhythmias occur when the potassium level in the body drops very low.

Causes and Risk Factors of Hypokalemia

Hypokalemia usually occurs when the patient has lost too much potassium due to diarrhoea, adrenal gland issues, nutritional deficiencies, long term use of laxatives, use of certain medications, barium poisoning or familial hypokalemia. People with prolonged illnesses that cause vomiting and diarrhoea have a high risk of developing hypokalemia.

Complications of Hypokalemia

People with pre-existing heart conditions have a high risk of developing cardiac complications due to hypokalemia. This includes arrhythmias, congestive heart failure and cardiac arrest. Patients may also suffer paralysis.

Diagnosis of Hypokalemia

Hypokalemia is diagnosed on the basis of a blood test that measures blood potassium concentration. The normal range for blood potassium is typically 3.6 to 5.2 millimoles per litre. If your potassium levels are low, the doctor may also recommend an ECG to check heart function.

Treatment of Hypokalemia

Treatment for the condition aims to restore potassium levels in the body and address the underlying cause of the potassium imbalance if possible. The patient will be given oral or intravenous fluids and potassium supplements.

Prevention of Hypokalemia

Hypokalemia can be prevented by consuming a diet rich in potassium.

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