Thursday, June 6, 2024

Urinary Tract Infection And Chronic Kidney Disease

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Imaging Tests For Kidney Disease

Warning signs of kidney disease and UTI (based on NKTI)

Tests that create various pictures or images may include:

  • x-rays to check the size of the kidneys and look for kidney stones
  • cystogram a bladder x-ray
  • voiding cystourethrogram where the bladder is x-rayed before and after urination
  • ultrasound sound waves are bounced off the kidneys to create a picture. Ultrasound may be used to check the size of the kidneys. Kidney stones and blood vessel blockages may be visible on ultrasound
  • computed tomography x-rays and digital computer technology are used to create an image of the urinary tract, including the kidneys
  • magnetic resonance imaging a strong magnetic field and radio waves are used to create a three-dimensional image of the urinary tract, including the kidneys.
  • radionuclide scan.

What If The Infection Does Not Clear Up With Treatment

Most infections clear up with treatment. However, if an infection does not clear up, or if you have repeated infections, you may be given some special tests such as:

  • a type of x-ray called an intravenous pyleogram , which involves injecting a dye into a vein and taking pictures of your kidney and bladder

  • an ultrasound exam, which gives a picture of your kidneys and bladder using sound waves

  • a cytoscopic exam, which uses a hollow tube with special lenses to look inside the bladder.

When Will I Begin To Feel Better

Once you start treatment, you should start to feel better in a few days.

Can I have sex while being treated for a kidney infection?After you have started treatment and your symptoms have gone away, it is usually safe to have sex. Remember to urinate after sex to avoid getting more bacteria in your urinary tract.

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Are There Risk Factors For Pyelonephritis

There are several developmental conditions that increase the risk for pyelonephritis.

  • Ectopic ureters describe a condition in which the ureters do not attach to the bladder properly or may attach to reproductive organs instead of the bladder.
  • Vesicoureteral reflux describes backflow of urine from the bladder back into the ureters.
  • Renal dysplasia describes abnormal development of the kidneys from birth.

There are several medical and procedural conditions that increase the likelihood of urinary tract infection including:

  • Diabetes mellitus, causing glucose in the urine, making the urine very attractive to bacteria.
  • Cushingâs disease , or overactive adrenal glands, causing increased levels of steroids in the body and decreasing the bodyâs resistance to infection.
  • Administration of medications containing steroids.
  • Kidney failure.

Interventions To Delay Ckd

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During the past 20 years, human and animal research has developed our understanding of CKD and led to preventive measures. The notion of renoprotection has resulted in a dual approach to renal diseases based on effective and sustained pharmacological control of blood pressure and reduction of proteinuria. Lowering blood lipids, stopping smoking, and maintaining tight glucose control for diabetes form part of the multimodal protocol for managing renal patients monitored by specific biological markers .

Abnormal urinary excretion of protein is strongly associated with the progression of CKD in both diabetic and nondiabetic renal diseases. Clinical studies have established that a reduction in proteinuria is associated with a decreased rate of kidney function loss. A specific category of drugs that lower blood pressure, the angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, appear to be more effective than other antihypertensive drugs in slowing the progression of both diabetic and nondiabetic CKDs . The administration of an ACE inhibitor is an important treatment for controlling blood pressure and slowing the rate of progression of chronic kidney failure. Other drugs to lower blood pressure are added as necessary to achieve current targets of 120/80 to 130/80 millimeters of mercury. Concurrent diuretic therapy is often necessary in patients with renal insufficiency, because fluid overload is an important determinant of in such cases.

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Diagnosis Of Kidney Disease

If kidney disease is suspected, you will have some kidney function tests to measure how well your kidneys are working and help plan your treatment. This includes:

  • Tests for albumin and/or blood in your urine.
  • A blood test to find out the level of waste products in the blood and calculate your glomerular filtration rate
  • A blood pressure test. Kidney disease causes high blood pressure, which can damage the small blood vessels in the kidneys. High blood pressure can also cause kidney disease.

An ultrasound or Computed Tomography scan to take a picture of your kidneys and urinary tract. These tests show the size of your kidneys, locate kidney stones or tumours and find any problems in the structure of your kidneys and urinary tract.

You may also visit a kidney specialist to help manage your care and decide if a kidney biopsy is needed. During a kidney biopsy a small piece of kidney tissue is removed and looked at under a microscope to find out the type of kidney disease and check if your kidneys are damaged.

Complications Of A Kidney Infection

If it isnt treated promptly, a kidney infection can lead to a number of potentially serious complications.

Youre more likely to develop a complication from a kidney infection if you have:

  • Prior kidney disease
  • A history of kidney infections
  • A structural abnormality in your urinary tract

The following complications can result from a kidney infection:

High Blood Pressure Your blood pressure can rise to unhealthy levels as your immune system tries to fight your infection.

Kidney Failure If its serious enough, an infection can stop your kidneys from effectively removing waste products from your blood.

Scarring If you develop scars in your kidneys from an infection, your kidneys may not be able to function properly, potentially leading to chronic kidney disease.

Blood Infection One of the main jobs of your kidneys is to filter waste products out of your blood. A kidney infection can spread to your entire bloodstream in this process.

A bloodstream infection can, in turn, lead to sepsis, which is a severe inflammatory reaction to bacteria. Sepsis can be life-threatening.

Renal or Perinephric Abscess If the infection in your kidney is not treated promptly, the bacteria may create an abscess, or pocket of pus, inside or next to your kidney.

Pregnancy Complications A kidney infection during pregnancy raises the risk of low birth weight in your baby.

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Keeping Your Kidneys Healthy

There are a number of things you can do to keep your kidneys healthy, including:

  • If you have diabetes, make sure that your blood sugar control is excellent. Follow your doctors advice about insulin injections, medicines, diet, physical activity and monitoring your blood sugar.
  • Control high blood pressure. Have your blood pressure checked regularly. Medications used to lower blood pressure , such as ACE inhibitors or angiotensin blockers, can slow the development of kidney disease.
  • If you have one of the risk factors for kidney disease, have a kidney health check at least every two years .
  • Treat urinary tract infections immediately.
  • Control blood cholesterol levels with diet and medications if necessary.
  • Drink plenty of water and choose foods that are low in sugar, fat and salt, but high in fibre. Stick to moderate serving sizes.
  • Drink alcohol in moderation only.
  • Stay at a healthy weight for your height and age.
  • Try to exercise moderately for at least 30 minutes a day.

What Are The Signs & Symptoms Of Utis

Acute pyelonephritis (urinary tract infection) – causes, symptoms & pathology

Symptoms of a UTI can include:

  • pain when peeing
  • changes in how often a child needs to pee
  • changes in the look or smell of pee
  • lower belly pain
  • lower back pain or discomfort

UTIs also can cause kids to wet their pants or the bed, even if they haven’t had these problems before. Infants and very young children may only show nonspecific signs, such as fever, vomiting, or decreased appetite or activity.

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What Are The Symptoms Of A Kidney Infection

First, kidney infection starts with symptoms of lower urinary tract infection such as discomfort with urination and frequent urination. However, once the infection has travelled up to the kidneys, you will start to experience more severe symptoms such as:

  • Fever and chills

You can do some things at home to feel better while you have an infection:

  • Drink plenty of fluids to flush out germs.
  • Get extra rest.
  • When you go to the bathroom, sit on the toilet instead of squatting over it, which can keep your bladder from completely emptying.
  • Take a pain reliever with acetaminophen. Donât use aspirin, ibuprofen, or naproxen because these can raise your risk of kidney problems.
  • Use a heating pad on your belly, back, or side.

How Do You Know You Have It

If symptoms occur, they might be those of kidney infection , or chronic kidney disease .

Other symptoms include:

  • Pain in your side, back or abdomen
  • Needing to urinate at night
  • Repeated urinary tract infections in early childhood
  • Single urinary tract infection in a male

Note: sometimes the disorder may not cause symptoms. It is picked up by routine blood tests, or when a patient is investigated for high blood.

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How Is Chronic Kidney Disease Diagnosed

If your doctor suspects you have kidney disease, they will talk to you about your health and the health of your family, and run some tests.

Tests that help to diagnose kidney disease include:

  • an Estimated Glomerular Filtration Rate test

If these tests show you have kidney damage, you may be referred to a specialist kidney doctor, called a nephrologist. They will try to work out the cause of your chronic kidney disease.

Dietary Changes During Kidney Treatment#

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In the course of kidney treatment, diet plays an important role. Some dietary changes your child might need to make in the diet are :

Reduce the protein intake because the kidneys may not efficiently eliminate the excess protein.

Limit food containing potassium because the excess potassium may accumulate in the blood , which can be life-threatening .

Avoid phosphorus-containing foods because extra phosphorus can cause calcium to leave the bones.

A low-sodium diet helps reduce fluid retention in the body.

Congenital Diseases of the Kidney | Riley Childrens Health

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Data Extraction And Quality Assessment

Data were extracted from relevant studies using a prespecified collection form. Study characteristics extracted included study design, data source, any participant exclusion criteria, number of participants, age, gender, baseline renal function, definition of renal impairment and definition of the outcome infection. An estimate of relative risk with any measures taken to address confounding was extracted from each eligible independent analysis in each study. Studies with no CIs and for which the SE was not calculable from the data presented were included in the review but not considered for meta-analysis.

When multiple estimates were available from a study but were not independent, a single estimate was identified for potential meta-analysis by selecting the estimate best adjusted for confounding, using the most recent data, comparing the level of CKD most common in the general population with no CKD.

Study quality was assessed using a prespecified tool adapted from Higgins et al for observational studies. Studies were assigned a high, low or uncertain risk of each of the following: selection bias, non-differential measurement error for exposure and outcome, information bias in exposure and outcome, confounding and reverse causation. The minimum requirement for a low risk of bias from confounding was appropriate management of confounding by age, sex and diabetes. The specific criteria used are detailed in online supplementary table S5.

What Causes A Kidney Infection

The bacteria or viruses that cause kidney infections usually come from another part of your urinary tract, such as your bladder, ureters or urethra and spread to your kidneys. Less commonly, the bacteria or viruses come from an infection elsewhere in your body.

Kidney infection can also happen if the flow of urine through your urinary tract is blocked. This can happen due to:

  • An enlarged prostate
  • A problem with the shape of your urinary tract that makes it harder for urine to pass through

A kidney infection is not contagiousyou cannot catch one from another person or spread a kidney infection if you have one.

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Musculoskeletal: Very Rare: Myalgia

Mode of Action: Essential for nervous, muscular, and skeletal systems. Maintain cellmembrane and capillary permeability. Act as an activator in the transmission of nerveimpulses and contraction of cardiac, skeletal and smooth muscles. It is essential forbone formation and blood coagulation. It is also used a replacement of calcium indeficiency states. It controls of hyperphosphatemia in end-stage renal disease withoutpromoting aluminum absorption.

Interactions: Hypercalcemia increases the risk of digoxin toxicity. Chronic use withantacids in renal insufficiency may lead to milk-alkali syndrome. Ingestion by mouth maydecrease the absorption of orally administered tetracyclines, fluoroquinolones,phenytoin, and iron salts. Excessive amounts may decrease the effects of calciumchannel blockers, atenolol. Concurrent use with diuretics may result in hypercalcemia.Side Effects: CV: cardiac arrest, arrythmias, bradycardia GI: constipation, nausea, vomting

Increase risk of hypokalemia with thiazide and loop diuretics, or amphotericin B. May increase requirement for insulin or oral hypoglycemic agents. Pheytoin, Phenobarbital, and rifampin increase metabolism may decrease effectiveness. At chronic cases, may decrease antibody response to and increase risk of adverse reactions from live-virus vaccines. Antacids decrease absorption of it. Increase risk of GI ulceration with NSAIDs.

How Is A Kidney Infection Treated

Urinary Tract Infection – Overview (signs and symptoms, pathophysiology, causes and treatment)

Antibiotics are the main kidney infection treatment because most cases are due to a bacterial infection. The antibiotic course will last at least a week and usually longer. Its important to finish the entire course, even when you start to feel better. Most people will notice improvement after a few days. But your body needs the entire course to fully kill the infection. Skipping doses or stopping before the course is complete increases the risk of recurrence and resistance. If this happens, the infection can be harder to treat.

While you are treating a kidney infection, you should follow the same steps that can help prevent a urinary tract infection. In particular, you should make an effort to drink plenty of water. This helps flush out the bacteria from your system. Avoid beverages with caffeine or alcohol, which can be irritating to the urinary tract. These drinks can also contribute to dehydration.

In severe cases, a kidney infection may require hospitalization for IV antibiotics and fluids. If kidney infections are the result of blockages or structural problems, surgery may be necessary to treat recurrent or chronic infections. If surgery cant fix the problem, long-term antibiotics or kidney transplantation are potential treatment options.

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How Is Kidney Infection Diagnosed

A kidney infection is usually diagnosed based on your symptoms, a physical exam, and the results of urine tests, indicating bacteria in your urinary tract.

Your doctor will likely ask about your health history and any conditions that might place you at higher risk of a kidney infection, such as having an enlarged prostate gland or a medical condition that can cause urinary retention, such as multiple sclerosis.

Sometimes a doctor will order imaging tests, such as an ultrasound or computerized tomography scan, to look for signs of swelling or other abnormalities in your kidneys or bladder.

When Should I Call The Doctor

As soon as you think that your child has a UTI, call your doctor. The doctor may recommend another urine test after treatment to be sure that the infection has cleared.

If your child has from recurrent UTIs, consult a pediatric urologist, who can do a thorough evaluation and order tests for urinary system abnormalities. In the meantime, follow your doctorâs instructions for treating a UTI.

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Disorders Of The Kidneys

play such vital roles in eliminating wastes and toxins and in maintaining body-wide homeostasis that disorders of the kidneys may be life threatening. Gradual loss of normal kidney function commonly occurs with a number of disorders, including diabetes mellitus and high blood pressure. Other disorders of the kidneys are caused by faulty inherited genes. Loss of kidney function may eventually progress to kidney failure.

Alternative And Complementary Therapies

Pathophysiology of an UTI

There are no effective alternative or complementary methods or therapies for curing a kidney infection.

But there may be ways you can increase your comfort while being treated with antibiotics, such as placing a heating pad on your abdomen, back, or side to ease any pain in those areas.

Drinking plenty of fluids can also help flush the bacteria causing the infection from your system.

And getting plenty of rest will help in your recovery from the infection.

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What Is The Urinary Tract

The urinary tract includes the organ system primarily responsible for cleaning and filtering excess fluid and waste material from the blood. The urinary system is made up of the following:

The kidneys also function as glands that produce hormones necessary for building red blood cells and regulating blood pressure.

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How Is Pyelonephritis Treated

Dogs with pyelonephritis are usually treated as outpatients unless they have bacteria circulating in their blood causing , or they have clinical signs of kidney failure. The specific treatment of pyelonephritis depends on the underlying cause. If dogs with pyelonephritis also have kidney disease, part of their treatment will include a kidney support nutritional profile .

Ectopic ureters are repositioned surgically to properly drain urine into the bladder. Blockage of the upper urinary tract by a urinary tract stone in a dog with bacterial infection/inflammation of the kidneys may rapidly progress to generalized disease and septicemia. This is a medical emergency and is most often treated with surgery.

Antibiotics to treat pyelonephritis are chosen based on testing the urine for bacteria and antibiotic sensitivity. The chosen antibiotic should kill bacteria, be present at appropriate levels in the blood and in the urine, and should not be toxic to the kidneys. Antibiotics are generally given for 4-6 weeks to treat pyelonephritis.

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