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Stone Disease of the Kidneys
Stone Disease of the Kidneys
Stone formation in the kidneys is a common disease. About 1 in 8 men and 1 in 20 women suffer from the symptomatic stone disease. Stone formation without symptoms is even more common.
About ¾ of the stones contain calcium and 10% have uric acid. Rest are due to combinations and rare diseases.
These contain calcium oxalate or calcium phosphate. Former is more common.
The risk factors for stone formation are
Low volume, High calcium in urine, High acid concentration and Low citrate levels.
Water and fluid intake is low, fruits are seldom eaten, food has high oxalate level or if calcium content of the diet is on the lower side.
Other diseases with high risk for stone formation are overweight, gout, diabetes, recurrent urinary tract infection etc. Bariatric surgery is a very significant risk factor.
If kidneys have certain diseases like the inability to excrete acid, a stone formation may occur.
Symptoms: Stones if they are on the urinary path (ureters or urethra) pain colicky in nature often radiating from back to lower abdomen or upto urine passage opening (urethra) may occur. This pain is at times very severe necessitating urgent consultation.
Urine may be passed in drops and is often red in colour due to blood.
If the passage of urine is blocked due to stone at any site, high pressure develops upstream of the blockage. If not treated early this may permanently damage the kidney.
In India, an untreated stone disease is a common cause of permanent renal failure.
Stone analysis, various urine tests aid in finding the underlying cause of stone formation. A cause is found in about ½ of the cases.
Stone disease can usually be prevented by adequate water intake, fruits or fruit product ingestion, enough calcium and lower salt in the diet and early complete treatment of urinary tract infection.
Eating lower oxalates in the diet is of questionable value.
Small stones pass spontaneously with more fluid ingestion and alpha blockers. Large stones need to be removed by surgery.
For patients suffering from type II /adult onset diabetes :In type II diabetes, diagnosis is often late (after the disease has already been present for some time). In early days T2DM (short for the adult type of diabetes) are often without symptoms. Hence the delay in diagnosis. This means complications will be seen early after diagnosis. Foot Care :
Foot disease in diabetes may lead to difficulty in walking, pain and may lead to infections. If neglected amputation may be required.
Inspect feet with a mirror before going to sleep every night.
Use well fitting shoewear.
Do not walk bare feet even in the house.
Socks should be clean and correct size.
In case of deformities of feet, special shoes can be worn. Eye Care :
It is nowadays the commonest cause of blindness throughout the world. Continue Reading ~ Second Medical Opinion / Advice
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In the urine, the protein excretion is > 3.5 gm/day or in children, it is >50mg/kg of body weight. In most cases, the serum albumin is <3gm/dl (normal>4), and passage of lipids in the urine. The lipids in the blood increase and swelling of face and feet also occur. Causes of Nephrotic Syndrome:
In children, most cases are due to Minimal Change Disease, FSGS, MPGN etc. In adults, most cases are due to primary illness while upto 30% may be due to secondary illness. Clinical Features:
Apart from Edema, ther…
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Symptoms of asthma are shortness of breath, difficulty in breathing, cough and whistling sounds during breathing. These symptoms may also be seen in a no of heart, lung or infective conditions. Hence the diagnosis is usually made by experienced doctors after a few episodes have occurred!
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