Understanding GFR

Understanding GFR
GFR stands for glomerular (glow-MAIR-you-lure) filtration rate. A blood test checks your GFR, which tells how well your kidneys are filtering.
It's important to know your GFR if you are at risk for kidney disease. A urine test will also be used to check your kidneys.
GFR is reported as a number.
· A GFR of 60 or higher is in the normal range.
· A GFR below 60 may mean you have kidney disease.
· A GFR of 15 or lower may mean kidney failure.
You can't raise your GFR, but you can try to keep it from going lower. Learn more about what you can do to keep your kidneys healthy.
The graphic below can help you understand the meaning of your GFR result. Please remember that this information should not take the place of talking with your health care provider.
If you have a:
GFR of 60 or higher*: Your kidney function is in the normal range. Ask your provider when your GFR should be checked again. You still need to get your urine checked for kidney damage.
* If your lab report shows an actual number that is higher than 60, such as 75, 90, 100, consider your result as "60 or higher" and in the normal range.
GFR below 60: This may mean kidney disease. Talk to your provider about treatment to keep your kidney health at this level. Ask about:
· medicines you should take,
· medicines to stay away from,
· changes to your diet,
· other lifestyle changes,
· whether your kidney disease is likely to get worse,
· ways to treat kidney failure, and
· if you should begin preparing for dialysis.​
GFR of 15 or lower: This is usually referred to as kidney failure. Most people at this point may need dialysis or a kidney transplant. Talk to your provider about your treatment options.

How is pyelonephritis diagnosed?

How is pyelonephritis diagnosed?
Pyelonephritis is a type of urinary tract infection (UTI) that affects one or both kidneys.
Pyelonephritis is caused by a bacterium or virus infecting the kidneys. Though many bacteria and viruses can cause pyelonephritis, the bacterium Escherichia coli is often the cause. Bacteria and viruses can move to the kidneys from the bladder or can be carried through the bloodstream from other parts of the body. A UTI in the bladder that does not move to the kidneys is called cystitis.
Symptoms of pyelonephritis can vary depending on a person’s age and may include the following:
· fever
· vomiting
· back, side, and groin pain
· chills
· nausea
· frequent, painful urination
Children younger than 2 years old may only have a high fever without symptoms related to the urinary tract. Older people may not have any symptoms related to the urinary tract either; instead, they may exhibit confusion, disordered speech, or hallucinations.
The tests used to diagnose pyelonephritis depend on the patient’s age, gender, and response to treatment and include the following:
· Urinalysis. Urinalysis is testing of a urine sample. The urine sample is collected in a special container in a health care provider’s office or commercial facility and can be tested in the same location or sent to a lab for analysis. The presence of white blood cells and bacteria in the urine indicate infection.
· Urine culture. A urine culture is performed by placing part of a urine sample in a tube or dish with a substance that encourages any bacteria present to grow. The urine sample is collected in a special container in a health care provider’s office or commercial facility and sent to a lab for culture. Once the bacteria have multiplied, which usually takes 1 to 3 days, they can be identified. The health care provider can then determine the best treatment.
· Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care provider’s office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist—a doctor who specializes in medical imaging; anesthesia is not needed. The images can show obstructions in the urinary tract. Ultrasound is often used for people who do not respond to treatment within 72 hours.
· Computerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create three-dimensional (3-D) images. A CT scan may include the injection of a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. The procedure is performed in an outpatient center or hospital by an x-ray technician, and the images are interpreted by a radiologist. Anesthesia is not needed. CT scans can show obstructions in the urinary tract. The test is often used for people who do not respond to treatment within 72 hours.
· Voiding cystourethrogram (VCUG). A VCUG is an x-ray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. The procedure is performed in an outpatient center or hospital by an x-ray technician supervised by a radiologist, who then interprets the images. Anesthesia is not needed, but sedation may be used for some people. The bladder and urethra are filled with contrast medium to make the structures clearly visible on the x-ray images. The x-ray machine captures images of the contrast medium while the bladder is full and when the person urinates. This test can show abnormalities of the inside of the urethra and bladder and is usually used to detect VUR in children.
· Digital rectal examination (DRE). A DRE is a physical exam of the prostate that is performed in the health care provider’s office. Anesthesia is not needed. To perform the exam, the health care provider asks the person to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies in front of the rectum. Men with suspected pyelonephritis may have a DRE to determine whether a swollen prostate may be obstructing the neck of the bladder.
· Dimercaptosuccinic acid (DMSA) scintigraphy. DMSA scintigraphy is an imaging technique that relies on the detection of small amounts of radiation after injection of radioactive material. Because the dose of radioactive material is small, the risk of causing damage to cells is low. The procedure is performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologist. Anesthesia is not needed. Radioactive material is injected into a vein in the person’s arm and travels through the body to the kidneys. Special cameras and computers are used to create images of the radioactive material as it passes through the kidneys. The radioactive material makes the parts of the kidney that are infected or scarred stand out on the image. DMSA scintigraphy is used to show the severity of kidney infection or kidney damage, such as scarring.

The diet and fitness of diabetic nephropathy

The diet and fitness of diabetic nephropathy
Carbohydrate
Carbohydrate is the main energy source in body, but it is also the nutrient that has the greatest effect on blood sugar levels. Therefore, it is important for the patients to cut down carbohydrate in diet. Breads and grains, fruits, milk, starchy vegetables and sweets are the main sources of carbohydrate.
Calorie
If the patients with diabetes and kidney disease should cut down protein consumption in their diet duet to protein in urine, inadequate intake of protein is very likely to cause malnutrition. To maintain a healthy body weight, the patients should increase the consumption of calorie in their diet.
Salt
Salt can increase blood pressure, which in return causes damage to kidneys and increases risk of heart disease and stroke. The patients with diabetes kidney disease are recommended to limit sodium intake to 1,500 mg daily. The patients should limit or avoid canned, processed foods and choose fresh fruits and vegetables.
Protein
The patients even with early diabetes kidney disease are recommended to limit protein intake and the daily protein should be reduced to 0.8g/d. If the patients have renal insufficiency and swelling, the protein should be reduced to 0.6g/d.
Exercise for people with diabetes kidney disease
Proper exercise has many heath benefits for people with diabetes kidney disease:
*Enhance immunity
*Better control of high blood pressure
*Benefit control of blood sugar level
*Reduce incidence of bone disease
*Delay renal function decline
The patients should choose continuous activity such as walking, swimming, bicycling, aerobic dancing, etc. Low-level strengthening exercise may also be beneficial as part of your program. Exercise should be done at least three days a week. If you experience the following discomforts, you should stop exercising.
*Very tired
*Shortness of breath
*Chest pain
* Leg cramp
*Dizziness

Moreover, the patients with diabetes kidney disease are very likely to develop low blood sugar during exercise. If the patients experience the signs of low blood sugar, they should take measures to correct it at once.

Primary causes of Nephrotic Syndrome

Primary causes of Nephrotic Syndrome
Nephrotic Syndrome is usually caused by damage to the filters (glomeruli) in your kidneys. In normal case, the glomeruli in your kidneys are filtering blood as it flows through your kidneys and they can separate the useful things from wastes. Healthy glomeruli can keep proteins in blood to maintain the right amount of fluid in your body. However, once your glomeruli are damaged, they will allow too much blood proteins leak into urine thus resulting in Nephrotic Syndrome. The common causes of Nephrotic Syndrome could be listed as the following:
Minimal kidney disease: It is the most common cause of Nephrotic Syndrome in children. This disorder can result in abnormal renal function. However, the result of microscope test usually does not show abnormality.
Focal segemental glomerulosclerosis: A part of glomeruli in kidneys are scarred or sclerotic. It may result from another disease or a genetic defect or occur for no reason.
Membranous nephropathy: It refers to the thickening of glomerular membrane. Secondary causes of Nephrotic Syndrome
Diabetes Mellitus: Long-term high blood glucose can damage the filters in kidneys thus resulting in Nephrotic Syndrome.
Systemic lupus erythematosus( SLE): It is a autoimmune disorder than can involve multiple organs including kidneys. It can cause inflammation of glomeruli.
Amyloidosis: It is attributed to the proteins building up in blood and it can affect multiple organs including kidneys. It can damage the filters in kidneys thus resulting in Nephrotic Syndrome.
Viral infection: The common viral infections mainly include hepatitis B, hepatitis C etc.

Prevention of kidney stones

Prevention of kidney stones
For precaution of kidney stone, the best way is drinking a lot of water and do some exercise. Of course, there are many specific way to prevent kidney stone, as follow:
The diet of kidney stone precaution ‘four little and one many’
One many: drinking more water and don’t hold urine. The water intake is 3000-3500ml per day, which is divided into several times during the day.
One little: drink little beer, because beer involves calcium, oxalic acid and purine nucleotides etc., they interact, which can make the urine acid of body increase, then become the key inducement forming kidney stone.
Two little: eat little meat and animal viscera. Because the metabolism of meat will produce uric acid, animal viscera involve high purine, after catabolism, also will produce high serum uric acid, and then uric acid is the main ingredient of kidney stone.
Three little: little salt intake, salty food will aggravate the kidney burden, then salt and calcium have synergetic function in the body, and disturb the metabolism of medicine of treating kidney stone. So the salt intake should be less 5g.
Four little: little sugar intake, the calcium ion in urine, oxalic acid and acidity of the urine all will increase after taking sugar. Acidity of the urine increase, which will make the calcium urate and calcium oxalate precipitate easily, promote kidney stone formation.
Stone is related to the metabolic balance directly. When nutrition metabolic disorder, stone will appear in different parts of urinary tract. So we have to drink more water and do some exercise to prevent the stone formation.
What can the kidney stone patient eat?
1. black fungus
2. the food rich in vitamin A.

The basics of diabetic nephrothy

The basics of diabetic nephrothy
What is diabetes kidney disease?
Diabetes kidney disease is damage to your kidneys caused by diabetes. In severe case it can lead to kidney failure. But not all patients with Diabetes will develop kidney damage.
What causes diabetes kidney disease?
The kidneys have many tiny blood vessels which are responsible for filtering wastes from your blood. High blood sugar can cause extra workload on these blood vessels and over time can make the blood vessels worn out. When the kidneys fail to work well, high levels of wastes will build up in body and proteins will leak into urine. Approximately 40 percent of diabetes patients will get diabetes kidney disease.
In addition, certain conditions can make the patients with diabetes are prone to diabetes kidney disease like high blood pressure and high cholesterol.
What are the symptoms of diabetes kidney disease?
In early stages, the patients experience no symptoms. Therefore, it is important to have regular urine tests to find kidney damage early. Sometimes early kidney damage can be reversed.
Microalbuminuria refers to a small amount of protein in urine and it is the first sign of kidney disease in diabetes. As kidney function worsens, blood pressure will increase. If the kidneys fail to remove fluid from body, retention of fluid in body will result in edema in feet and legs.
How is diabetes kidney disease diagnosed?
Microalbuminuria test is a test used to check for a protein called albumin in the urine. This sign occurs as your kidneys are not able to filter it out the way they should.
As early kidney damage can be reversed, it is important for the patients to find diabetes kidney disease early. It is important for the patients with diabetes to take the following tests.
*If you have type 1 diabetes, you should have a urine test yearly after you have had diabetes for 5 years.

*If you are a type 2 diabetes sufferer, start yearly testing at the time you are diagnosed with diabetes.
http://www.kidneyhospital.org/

What is kidney transplant?

What is kidney transplant?
Kidney transplant refers to a procedure that places a healthy kidney to replace the diseased kidney to work. If it is done successfully, there is a great chance to get rid of dialysis. In this condition, a matched kidney is necessary, generally, the kidney may come from:
1.Cadaveric donor kidney- a person who has recently died.
2.Living-related donor- your parents, brothers and sisters or children.
3.Living-unrelated donor- your spouse or friends.
When kidney transplant is needed?
Generally speaking, kidney transplant is needed when the condition progresses into kidney failure or ESRD. By doing so, this surgery can help expend patients’ life expectancy.In addition to this treatment, a well-balanced diet, usage of drugs, etc are also needed to treat kidney failure well.
How long will kidney transplant take?
In general, this procedure takes for 3-6 hours. And patients may stay in hospital within 15 days. If other discomforts occurs, you should stay in hospital for a longer time. When you leave the hospital, it is also necessary to do some tests to monitor how your kidneys work.
What are the contraindications of kidney transplant?
Absolute contraindications:
1. Ages The shorter life expectancy is, the stronger the allograft rejection.
2.Primary disorders
3.Unhealed malignant tumors
4.Active hepatitis
5.Myocardial infarction or active tuberculosis
6.AIDs or peptic ulcer
Relative contraindications: These contraindications usually include obesity, mental disorder, urinary tract infection, primary glomerulonephritis, uncontrolled high blood sugar level.
http://www.kidneyhospital.org/