Nephrology Diseases and Kidney Conditions

At PACE Hospitals, we diagnose and manage a wide range of nephrology conditions affecting the kidneys and related systems. To help patients easily understand their condition, our kidney diseases are categorised below based on different nephrology conditions and areas of renal care.

Glomerular Diseases 

These disorders affect the glomeruli, which filter blood to form urine.

Glomerulonephritis: Glomerulonephritis is a condition characterised by the inflammation and scarring of the glomerulus. The kidneys' capacity to filter waste products and extra fluid from the blood to produce urine gradually declines. Medicines (toxins), viral infections (HIV, hepatitis B& C), Lupus-related kidney inflammation, IgA nephropathy, and bacterial (strep or staph bacteria) infections are the causative factors for glomerulonephritis. An increase in blood pressure, fatigue, protein in urine, blood in urine, and low urine output are the symptoms of glomerulonephritis. This condition can be diagnosed by blood tests, kidney ultrasound, kidney biopsy and urinalysis.

• Glomerulosclerosis: Glomerulosclerosis is the scarring of tiny kidney blood vessels (glomeruli). It may develop in children and adults and can result from different types of kidney problems and diabetes. Protein in urine, swelling of ankles, puffy eyes, and fluid accumulation in the abdomen are the symptoms of this condition. Nearly 7 to 15% of people with proteinuria have glomerulosclerosis.
  
• Focal Segmental Glomerulosclerosis (FSGS): Focal segmental glomerulosclerosis is a rare disease that results in scarring of the glomerulus (the kidneys' filtering unit). It is caused by certain drugs, infection, obesity, inherited genetic problems, and sickle cell disease. This disease affects both adults and children but more common in men, it is characterized by symptoms of edema, proteinuria (protein in blood), weight gain and poor appetite. Managed by drugs that lowers high blood pressure, agents that get rid of excess body fluids and diet with low salt intake. If not treated properly this condition may lead to some complications such as nephrotic syndrome, infection, malnutrition, chronic kidney disease and end stage kidney disease.
• IgA Nephropathy: Immunoglobulin A (IgA) nephropathy is an autoimmune disease that causes inflammation and damage to the kidneys by accumulating or depositing clumps of antibodies. It is more common in men and individuals with a family history of IgA vasculitis, characterized by symptoms of hematuria (blood in urine), proteinuria (protein in urine), swelling of legs, ankles and other parts of the body due to accumulation of body fluids. It can be managed with angiotensin-converting enzyme (ACE) inhibitor or with angiotensin receptor blocker (ARB) to treat high blood pressure and with certain dietary modifications by limiting sodium intake. If left untreated this autoimmune disease may result in complications such as nephrotic syndrome, chronic kidney disease and kidney failure.
• Lupus Nephritis: Lupus nephritis is kidney inflammation caused by systemic lupus erythematosus; this disease is more common in women than men. It is characterized by symptoms of swelling of hands and feet (due to excess body fluid), weight gain or loss, fatigue, foamy urine due to protein, and high blood pressure. It can be managed with immunosuppressants and with the use of diuretics (that treat edema), calcium channel blockers and beta blockers (to treat high blood pressure). If it is not treated it may lead to complications such as diffuse proliferative nephritis and kidney failure.
• Nephrotic Syndrome: Nephrotic syndrome is a renal disorder where the kidney excretes an excessive amount of protein in the urine. The destruction of the small renal (kidney) blood vessels that aids in removing waste and extra water from the blood, resulting in nephrotic syndrome. In addition to increasing the risk of other health issues, the disorder produces swelling, especially around the eyes, ankles and feet, loss of hunger, fatigue, weight gain due to fluid retention, and foamy urine (due to excess protein in the urine). Diabetic kidney disease (diabetic nephropathy), minimal change disease, amyloidosis, focal segmental glomerulosclerosis, membranous nephropathy, and systemic lupus erythematosus are the primary possible causes of nephrotic syndrome.
• Diabetic Kidney Disease: It is a long-term kidney disease that affects people with diabetes. It occurs due to prolonged increased levels of glucose in the blood and damages the renal blood vessels because of insulin resistance or low/no insulin production. Smoking, age above 65 years, women's gender, obesity, increased blood pressure, and hyperlipidaemia are the risk factors for diabetic nephropathy. Changes in blood pressure, shortness of breath, fatigue, vomiting, metallic taste, blood in urine, swollen legs, hands and feet are the symptoms of diabetic nephropathy.

Tubular and Interstitial Diseases 

These conditions affect the kidney tubules and surrounding tissues that regulate fluid and electrolyte balance.

• Interstitial Nephritis: Interstitial nephritis is a kidney disorder which decreases the ability of kidneys to filter the blood, affecting older individuals, it is caused by allergic reactions to drugs, autoimmune disorders such as Kawasaki disease, excess calcium and low potassium in the blood. It is characterized by symptoms of fever, increased or decreased urination, nausea, vomiting and hematuria (blood in urine). These symptoms can be managed by avoiding the causative drug and by maintaining a balanced diet with low salt intake. If it is not treated this condition may cause complications such as metabolic acidosis, chronic kidney disease and end stage kidney disease. Describe the item or answer the question so that site visitors who are interested get more information. You can emphasize this text with bullets, italics or bold, and add links.
• Renal Tubular Acidosis: Renal tubular acidosis is a condition which occurs when the kidneys are not able to remove or excrete acids from blood into the urine. It is of three types: type 1 (distal renal tubular acidosis) is caused by an autoimmune disease known as Sjogren’s syndrome, type 2 (proximal renal tubular acidosis) is caused by Fanconi syndrome or caused by drugs to treat viral hepatitis, type 4 (hyperkalemic renal tubular acidosis) is caused due to rejection of kidney transplantation. It is characterized by symptoms of weakness, paralysis, irregular heartbeat, abdominal pain; can be treated by oral intake of alkali solution (solution that contains sodium carbonate or sodium citrate) that decreases the acid levels. Untreated type 1 and type 2 renal tubular acidosis causes complications like slow growth of children and rickets (bone disease). Type 4 renal tubular acidosis when left untreated causes muscle weakness and cardiac problems like irregular heartbeat and cardiac arrest.

Renal Vascular Diseases 

These disorders affect the arteries and veins supplying the kidneys.

• Renal Artery Stenosis: Renal artery stenosis, also known as renal artery disease, is a narrowing or constricting of renal (kidney) arteries which carry oxygenated blood from the heart to the kidneys. People with atherosclerosis (plaque or obstruction that builds up due to fat accumulation on artery walls) are at high risk of renal artery stenosis. In addition, high blood pressure, high cholesterol, obesity, diabetes, family history of cardiovascular disease, smoking, poor diet and older age are at-risk factors for renal artery stenosis. Difficulty in sleeping, fatigue, loss of hunger, muscle cramps, oedema, shortness of breath, dry/itchy skin, sudden weight loss, abnormal urination, headache, nausea and vomiting are the symptoms of renal artery stenosis.
• Renal Vein Thrombosis: Renal vein thrombosis is a condition in which a blood clot forms in the vein that carries blood away from the kidney. This reduces normal blood flow and can affect kidney function. It is more commonly seen in people with nephrotic syndrome, severe dehydration, clotting disorders, or certain infections. Symptoms generally include flank pain, blood in urine, and sudden worsening of kidney function, though some cases remain silent and are detected only on imaging studies.

Structural / Congenital Kidney Disorders

These involve abnormal kidney structure or development.

• Ectopic Kidney: An ectopic kidney is a condition where the kidney is not located in its usual position or present on the opposite side above or below the kidney's normal position. The two kidneys are usually positioned just below the rib cage (on either side of the spinal cord), near the middle of the back. The exact cause of this condition is idiopathic; however, researchers estimate that an ectopic kidney may result from a weakly developed kidney bud, the presence of a genetic disorder, a problem in the kidney tissue, and the presence of any disease or infection during foetal growth. An ectopic kidney is usually asymptomatic (doesn't cause any symptoms or health problems), and it is usually found during a foetal ultrasound or during regular screening tests done to check for urinary tract infection (UTI) or to find the cause of abdominal pain.
• Horseshoe Kidney: A Horseshoe kidney, also known as renal fusion, is where two kidneys are fused together and form a horseshoe-shaped kidney that might be located at different positions compared to typical kidneys. In general, during the stage of foetal development, the kidney first forms in the lower belly and moves up toward the back of the pelvic area. In the case of the horseshoe kidney, the kidneys attached to the lower end fuse and form a "U shape". Horseshoe kidney affects about one in every 500 people (especially in men) and are asymptomatic. The exact causes of horseshoe kidney disease are idiopathic (unknown); however, it could be related to the genes that form the kidneys and exposure to environmental factors and toxins before birth.
• Medullary Sponge Kidney: Medullary sponge disease or Cacchi–Ricchi disease is a birth defect that results in changes in tubules and tiny tubes of a fetus's kidney. The cause of this disease is unknown, and it occurs more often in women than men in individuals with a risk of calcium-based kidney stones. It is characterized by symptoms of painful or burning urination, cloudy or dark-coloured urine, fever, and smelling urine. This condition is not reversable, and treatment usually focuses on managing existing urinary tract infection and removing kidney stones. Complications like hematuria (blood in urine) and kidney stones occur when it is left untreated.
• Polycystic Kidney Disease: Polycystic kidney disease (PKD) is a genetic condition that results in the growth of many fluid-filled cysts in the kidneys. In contrast to ordinary kidney cysts, PKD cysts can change the shape of the kidneys, resulting in an increase in their size. Kidney failure may result from PKD, a type of chronic kidney disease (CKD) that impairs kidney function. Autosomal dominant PKD and autosomal recessive PKD are the two types of polycystic kidney disease. An increase in blood pressure, chest pain, backside pain, blood in urine, and an increase in abdominal size are the symptoms of PKD.
• Acquired Cystic Kidney Disease: Acquired cystic kidney disease is a medical condition in which the kidneys develop cysts (fluid-filled sacks), different from polycystic kidney disease. This condition can occur in children and adults suffering from chronic kidney disease or end-stage renal failure. The exact aetiology of this condition is idiopathic (unknown); however, the cyst mostly develops in people who are on dialysis (kidney failure). This condition is often asymptomatic; nevertheless, the complications of acquired cystic kidney disease show signs and symptoms such as fever, back pain, and haematuria (blood in urine).

Obstructive Kidney Disorders (Urine Flow Problems)

These conditions occur when urine flow is blocked, causing pressure and kidney damage.

• Hydronephrosis: Hydronephrosis is defined as kidney swelling that occurs due to urine backup or backflow. It is caused by bladder blockage, birth defects of the urinary system, kidney stones, and cancer or tumours that develop in the ureter, bladder, or pelvic region. It can occur in one or both kidneys, when it occurs in both kidneys it is termed bilateral hydronephrosis. It is characterized by symptoms of flank pain, nausea, vomiting, fever, painful urination, urinary urgency and increased urinary frequency. Hydronephrosis is managed by removing kidney stones, antibiotics to treat infection and with placement of stent through bladder and ureter to allow passage of urine from kidneys to bladder. The affected kidney gets damaged permanently if it is left untreated.
• Kidney Stones (Nephrolithiasis): Kidney stones are strong, hard objects composed of chemicals in urine. Calcium oxalate, struvite, uric acid and cystine are the four types of kidney stones. The common symptoms include pain, blood in urine, nausea, vomiting, fever and chills. The most common causes (etiology) of kidney stones are drinking less water than the daily requirement, low exercise, weight loss surgery, obesity, consuming food with too much salt or sugar, family history, and infections. In addition to these, consuming excess fructose can increase the risk of kidney stones. This can be disguised by a CT scan and KUB x-ray.

Infectious / Inflammatory Kidney Disorders

These involve infection or inflammatory processes within kidney tissue.

• Kidney Abscess: A kidney abscess is a pus formation in a hollow area of the kidney. Patients with renal abscesses might have symptoms that include an increase in body temperature(fever), chills, pain in the abdomen, loss of body weight, pain while passing urine, and blood in urine. Kidney abscesses can be caused by bacteria that spread to the kidney from the blood or from urine that backs up into the kidney, thereby spreading the infection. Kidney abscesses can also occur because of kidney stone disease, kidney inflammation, and urine backward flow from the bladder into the kidney. Complicated urinary tract infections such as pregnancy, diabetes mellitus, and neurogenic bladder can increase the risk of kidney abscess.
• Pyelonephritis: Pyelonephritis is a kidney infection that usually starts in the bladder and spreads upward to the kidneys. It is mainly caused by bacteria like Escherichia coli. This condition is more common in women and people with weak immunity or urinary problems. Common symptoms include fever, chills, back or side pain, nausea, vomiting, and burning or frequent urination. The urine may look cloudy or smell bad. It is diagnosed by urine and blood tests.

Kidney Function Failure Disorders

These conditions involve partial or complete loss of kidney function.

• Acute Kidney Injury (AKI): Acute kidney damage is characterized by a rapid loss in renal function over days to weeks, resulting in the accumulation of nitrogenous products in the blood (azotemia) and no drop in urine production. It is mainly caused by insufficient renal perfusion as a result of severe trauma, illness, or surgery, but it can also be caused by a rapidly progressive, intrinsic renal disease. Symptoms may include anorexia, nausea, and vomiting. If neglected, it can lead to seizures and coma. Fluid, electrolyte, and acid-base problems develop rapidly. Treatment focuses on the underlying cause but may also require hydration, electrolyte control, and dialysis.
• Chronic Kidney Disease (CKD): Chronic kidney disease, or CKD, is a disorder in which the kidneys gradually lose the ability to function normally over time. In the early stages, symptoms might not be noticeable, but as the disease progresses, people may experience problems like loss of appetite (anorexia), nausea, vomiting, mouth sores, bad taste, frequent urination at night (nocturia), fatigue, itching, muscle cramps, fluid buildup, poor nutrition, and nerve issues. In severe cases, it can affect mental clarity and lead to seizures. Treatment focuses on managing the causes, including fluid and electrolyte management, blood pressure control, anaemia treatment, several types of dialysis, and kidney transplantation.
• End-stage Renal Disease (ESRD): End-stage renal disease (ESRD), also known as end-stage renal failure, is the last irreversible stage of chronic kidney disease. It occurs when kidney function has decreased to the point where the kidneys can no longer function independently. Dialysis or a kidney transplant are the only ways an end-stage renal failure patient can live more than a few weeks. Patients with ESRD might experience various symptoms that include drowsiness, difficulty urinating, skin itchiness, headache, nausea, bone pain, loss of weight, dry skin, etc. It can be diagnosed by urine tests, renal ultrasound, kidney biopsy, CT scan, and blood tests. Hypertension, diabetes, heart problems, and drug abuse are some of the risk factors for End Stage Renal Disease.
• Kidney Failure: It is the condition where the kidneys no longer function on their own, resulting in itchy skin, loss of hunger, hand-face or ankle swelling, nausea, vomiting, difficulty concentrating, muscle cramps, and fatigue. The most common causes of kidney failure are unmanaged high blood sugar levels and high blood pressure (hypertension). People with diabetes, abnormal kidney structure, high blood pressure, heart disease, a family history of kidney disease, age over 60, and intake of pain relievers are at high risk of developing kidney failure and chronic kidney disease (CKD). Polycystic kidney disease, Lupus and Glomerular diseases are the major causes of CKD leading to kidney failure.

Systemic or Secondary Kidney Disorders

These occur when other diseases affect the kidneys.

• Pregnancy-Related Kidney Disease: Pregnancy-related kidney disease refers to kidney problems that develop or worsen during pregnancy. These may include preeclampsia-related kidney damage, acute kidney injury, or flare-ups of pre-existing kidney disease. Hormonal changes, increased blood volume, and high blood pressure can strain kidney function. The warning signs are swelling, raised blood pressure, protein in urine, reduced urine output, and abnormal kidney test results, which require careful monitoring for maternal and fetal safety.
• Hemolytic Uremic Syndrome (HUS): Hemolytic uremic syndrome is a serious condition characterised by the destruction of red blood cells, low platelet count, and acute kidney injury. It commonly occurs after certain gastrointestinal infections, especially those causing severe diarrhea in children, but can also affect adults. Damage to small blood vessels leads to reduced kidney blood flow. Symptoms include pallor, fatigue, reduced urination, swelling, high blood pressure, and neurological changes in severe cases.
• Hypertensive Nephropathy: Hypertensive nephropathy (HTN) or hypertensive nephrosclerosis is a kidney disease caused by chronic high blood pressure and is the second most common cause of end-stage renal disease (ESRD). Symptoms include nausea, vomiting, loss of appetite, itching, sleepiness, weight loss, and an unpleasant taste in the mouth. Risk factors include older age, poorly controlled high blood pressure, and other kidney disorders, including diabetic nephropathy. Treatment focuses on strict blood pressure control with a combination of drugs, including an angiotensin II receptor blocker (ARB), an angiotensin-converting enzyme (ACE) inhibitor, calcium channel blockers, thiazide diuretics and beta-blockers. Lifestyle changes like weight loss, exercise, and salt and water restriction also help control blood pressure and sometimes dialysis.

Complications of Kidney Disease

• Proteinuria: Proteinuria, also known as albuminuria, is a condition in which urine contains an abnormally high protein called albumin, the main protein in the bloodstream. In the early stage, Proteinuria has no signs or symptoms, but high protein levels in urine may cause it to appear frothy in the toilet. This leads to no longer absorbing enough fluid, resulting in swelling in the hands, feet, abdomen, or face. These signs of large protein loss indicate that kidney disease has progressed. People with diabetes, hypertension, or certain family history are at risk for Proteinuria. Treatment mainly involves angiotensin-converting enzyme (ACE), angiotensin receptor blockers (ARBs), and diuretics, and it follows a healthy diet plan. 
• Hematuria: Hematuria indicates the presence of blood in urine. It is classified into gross hematuria, which can see blood in urine, and microscopic hematuria, which cannot see blood in urine but can be observed under a microscope or by a urine test known as a urinalysis. Gross hematuria is less prevalent than microscopic hematuria. Gross hematuria changes urine colour to pink, red, or brown. It does not produce discomfort or other symptoms, although it may induce bladder or back pain if blood clots are in the urine. Microscopic hematuria, on the other hand, does not change the colour of the urine and usually does not cause symptoms. This is caused by infection or inflammation of the bladder, urinary tract stones or a recent urinary tract procedure, BPH (Benign prostatic hyperplasia), prostate, kidney and urethra trauma, prolonged sexual activity, and endometriosis Health care practitioners treat hematuria by addressing its underlying cause.
• Anaemia of Kidney Disease: This is a common complication of kidney disease in which the body produces fewer red blood cells. This occurs because injured kidneys generate less erythropoietin, a hormone that stimulates red blood cell synthesis in the bone marrow. As a result, patients experience symptoms like fatigue, weakness, shortness of breath, and pale skin. 
• Bone and mineral disorders in chronic kidney disease: This occurs because damaged kidneys cannot properly balance calcium, phosphorus, and vitamin D in the body. Normally, kidneys help activate vitamin D and remove excess phosphorus, but in CKD, phosphorus builds up, and calcium levels decrease. This imbalance leads to increased secretion of parathyroid hormone, this removes calcium from bones, making them weak and brittle. As a result, patients may develop bone pain, fractures, and skeletal deformities. This condition is called renal bone disease.
  
• Electrolyte imbalance: This happens because the kidneys are unable to maintain normal levels of important minerals in the blood. Common imbalances include high potassium, low or high sodium levels, increased phosphorus, and decreased calcium. These changes can affect many body functions, especially the heart and muscles.
  

Make informed decisions with a free second opinion on nephrology diseases and kidney conditions.

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