Centre For Renal Sciences & Kidney Transplant

Kidneys are one of the most important organs of the body, which filter the blood and get rid of toxins. Acute kidney failure is the sudden failure of the kidneys. It happens within a few hours or days. The primary function of our kidneys is to filter the blood, get rid of toxins, and pass urine. Kidneys are located above the pelvic. When the kidneys stop working suddenly, the condition is known as acute kidney failure. Alternate Name of Acute Kidney Failure Acute kidney failure is also known as Acute Renal Failure. Acute Kidney Failure Causes There are many causes of acute kidney failure. These are: Blood Flow Stops in the Kidneys This may be because of multiple reasons such as infections, liver failure, side effects of some medicines, Heart Failure, dehydration, low blood pressure, serious burns, or rapid blood loss. Blocking of Urine Flow from the Kidney There are multiple reasons like prostate, Bladder Cancer, cervical, Kidney Stones, blood clots in the kidney; enlarged prostate, or nerve damage in the kidneys. Acute Kidney Failure Symptoms The symptoms of acute kidney failure are: Sharp pain in the lower back region Less urination than normal Swelling of ankle, feet, and joints of the body Drowsiness and tiredness Difficulty in breathing Nausea Loss of appetite Confusion in decision-making Chest pain and uneasiness Seizures and in severe cases, coma Acute Renal Failure Diagnosis The most common way to determine acute renal failure is through blood tests. Blood tests check for various parameters like the creatinine level in the blood, urea level, and potassium and sodium salt levels in the blood. The other common test for acute kidney failure is a urine test. The doctor will check for various protein and electrolytes levels in the urine sample and check the urine output per kg per hour. Acute Kidney Failure Treatment The majority of acute kidney failure cases can be healed by themselves. However, the doctor may prescribe a course of treatment for faster results. The possible treatment course for acute kidney failure is listed below: Kidney Dialysis In cases of severe kidney damage, the doctor may suggest kidney dialysis to filter the blood of toxins and other treatment courses till the kidneys heal by themselves. Diet: The doctor may suggest a diet plan which includes less potassium and sodium salts till the kidneys heal by themselves. Medications: The doctor may prescribe certain medicines to mitigate the effect of acute kidney failure. Acute Kidney Failure Preventions Primary Prevention for Acute Renal Failure By taking some preventive steps, you can avoid getting acute kidney failure: Maintain a healthy lifestyle: Eating healthy food, drinking lots of water, exercising daily, and refraining from alcohol may prevent acute kidney failure. By avoiding non-prescribed pain medications, you can reduce the likelihood of acute kidney failure. Secondary Prevention for Acute Renal Failure Follow your doctor’s advice: If you are suffering from high blood pressure or chronic kidney or liver ailment, you must strictly follow your doctor’s advice to avoid acute kidney failure. Risk Factors of Acute Kidney Failure Following are the factors which increase the chances of acute kidney failure: Diabetes: Diabetes increases the chances of you getting acute kidney failure Prolonged Hospitalization: If you are hospitalized, especially in ICU, for a prolonged period, the chances of acute kidney failure may increase Age: Older people are more prone to acute kidney failure Cardiac diseases Blood Pressure: High blood pressure increases the likelihood of acute kidney failure Chronic liver and kidney ailments Possible Complications of Acute Kidney Failure Many complications may arise due to acute kidney failure. These include chest pain due to the inflammation of the tissues of the chest lining; fluid builds up in the lungs; increased acidity of the blood that may lead to nausea, vomiting, and dizziness; permanent kidney damage which will lead to the patient becoming dependent on dialysis or Kidney Transplant; chronic muscle pain and weakness because of electrolyte imbalance in the body. Epidemiology of Acute Kidney Failure In the United States of America, approximately 1% of the people admitted to hospitals have Acute Kidney Failure at admission. Between 2-5% of people admitted to hospitals develop Acute Kidney Failure within 30 days in the USA. Nearly 50% of patients in the ICU develop acute kidney failure. The mortality rate for acute kidney failure in hospitals is around 40%-50%. Expected Prognosis of Acute Kidney Failure The prognosis of acute kidney failure depends on the underlying cause of Kidney Failure. If the acute kidney failure is not because of kidney tissue, the patient's recovery can be quick. However, if the cause of kidney failure is due to the kidney itself, full recovery may take some time. Only highly severe cases of acute kidney failure result in death. Natural Progression of Acute Kidney Failure If acute kidney failure is left untreated, it may lead to permanent kidney damage and the build-up of toxins in the body. The patient may need Dialysis for the rest of their life. Frequently Asked Questions 1. What is the role of dialysis in the treatment of acute kidney failure? Dialysis is a treatment option for acute kidney failure that helps remove waste products and excess fluid from the body when the kidneys are unable to perform their function adequately. It provides temporary support until kidney function improves. 2. Can acute kidney failure lead to chronic kidney disease? Yes, severe or recurrent episodes of acute kidney failure can increase the risk of developing chronic kidney disease. Regular follow-up and appropriate management are important to prevent the progression of kidney damage. 3. Is acute kidney failure a reversible condition? Acute kidney failure can be reversible if diagnosed and treated promptly. With appropriate management, addressing the underlying cause, and supportive care, kidney function can often recover, leading to improved health. 4. Are there specialized pediatric nephrology services available for children with acute kidney failure in Delhi? Yes, there are specialised pediatric nephrology services available in Delhi for the diagnosis and treatment of acute kidney failure in children. Pediatric nephrologists are trained to provide comprehensive care specifically tailored to the needs of pediatric patients. 5. How can I prevent the recurrence of acute kidney failure in Delhi? The prevention of recurrent acute kidney failure involves addressing and managing the underlying causes and risk factors. This may include controlling blood pressure, managing diabetes effectively, staying well-hydrated, avoiding nephrotoxic medications, maintaining a healthy lifestyle, and following any specific recommendations provided by the healthcare team. Related Blogs Dietary Changes You Can Make To Improve Your Kidney Health Common Causes Of Acute Liver Failure You Need To Know

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Bladder stones are hard calcified masses found in the urinary bladder. They are composed of solidified minerals found in the urine that gradually build up over time and form stones. They are painful and cause discomfort to the patient and also block urine outflow or bladder emptying. Associated Anatomy of Bladder Stones Urinary bladder, kidney, ureter Alternative Name of Bladder Stone Bladder Calculi Bladder Stones Causes It has several underlying causes, which include: Structure Urethra Benign hyperplasia of the prostate: This condition puts pressure on the urethra and causes incomplete emptying of the bladder. Nerve damage in the bladder or neurogenic bladder: It disrupts the functioning of the bladder. Post-bladder surgery: It causes injury to the bladder tissues. Bladder diverticula: Abnormal sac-like formations in the bladder cause the stoppage of urine outflow. Cystocele: The wall of the bladder pulls down in the vagina and creates pressure on the bladder. Bladder Stones Symptoms Most of the time, bladder stones remain asymptomatic and don't cause any discomfort to the patient. If the stones are tiny, they pass out through urine easily. However, large stones cause pain and discomfort to the person and if neglected can cause bladder tumour also. Some other bladder stone symptoms include: Pain: Severe (stabbing) pain occurs while urinating and pain in the abdominal region, including the genitals. Increased frequency of urination: It occurs because of incomplete emptying of the bladder. Urinary tract infections (UTIs): These occur because urine stays in the bladder for a long duration causing repeated infections. Presence of blood in the urine: It occurs because of a laceration of the bladder wall. Bladder Stones Diagnosis Doctors can diagnose bladder stones through various tests, which include: Urine examination It analyzes the presence of infections and minerals in the urine sample. Cystoscopy In this test, a small endoscope is inserted into the bladder to directly look at the stones in the bladder through a small camera. Intravenous pyelogram This test checks the presence of stones and other structures like kidneys, ureters, bladder. Typical Test to Diagnose Bladder Stones Lower abdominal imaging like X-rays, CT scans, flexible cystoscopy and ultrasound evaluate the presence, size, and exact location of the bladder stones. Differential Diagnosis of Bladder Stones Bladder stone pain can resemble a lot with other similar conditions like: Urinary tract infection Kidney stones Urothelial carcinoma Prostate enlargement Bladder Stones Treatment If bladder stones are tiny, drinking plenty of water is recommended to pass them through urination. Taking alkalizers with water also dissolutes uric acid stones to some extent. However, the overuse of alkalizers can be harmful and can further lead to the formation of calcium phosphate stones in the bladder. With large stones, cystolitholapaxy is one of the common procedures for removing bladder stones. It removes the stones by breaking them into smaller fragments using laser or ultrasonic methods. In the case of very large stones keyhole surgery of the bladder is done to remove the stones. Risk Factors of Bladder Stones Gender: Males are more prone to bladder stones than females. Age: Chances of bladder stones increase after 50 years. Benign hyperplasia of prostate (BHP): A condition occurring in elderly men that causes the enlargement of the prostate gland. Bladder surgery: Any surgical procedure done to treat urinary incontinence increases the risk of bladder cancer. Possible Complications of Bladder Stones Urinary tract infections (UTI): Increased frequency of UTIs in the cases of bladder stones, if not treated on time. Urethritis and bladder cysts Bladder cancer Bladder Stone Prevention Primary Prevention for Bladder Stone There is no way to prevent the occurrence of bladder stones. If you have issues associated with the prostate, like delayed emptying of the bladder after urination, you can consult your kidney transplant surgeon's doctor so that you don’t develop bladder stones. For people with UTIs, it is always recommended to double void your bladder so that there is no urine left in the bladder after urination. Secondary Prevention for Bladder Stones Drinking a lot of water can help prevent the formation of stones by making the urine less concentrated in people who are at risk of developing bladder stones. Epidemiology of Bladder Stones The incidence of bladder stones is increasing in developing countries because of dietary changes and dehydration. Deficiency of vitamins and the intake of fatty diets are associated with the risk of developing bladder stones. In India, 1-19% of the population has bladder stones. It is more common in men over the age of 50 years. Prognosis of Bladder Stones With treatment advancement, bladder stones are treated effectively with minimally invasive surgical procedures. Moreover, the treatment of enlarged prostate is recommended in patients having a history of urinary bladder stones to prevent a recurrence. Natural Progression of Bladder Stones If left untreated, bladder stones grow in size and create issues like urinary tract infections, pain, bleeding, and discomfort during urination. They also lead to chronic damage to the bladder muscles, thus making them weak. Bladder Stones Pathophysiology Bladder stones, just like kidney stones, form because of excess calcium oxalate, calcium phosphates, and uric acid in your urine. This build-up of crystals further speeds up if you have some issues in bladder emptying. 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The prostate is an organ in the body that helps to produce some of the liquid during ejaculation. The prostate gland surrounds the urethra, which is the passageway by which urine leaves the body. Enlargement of the prostate is an indication that the gland has grown in size. Almost all men experience prostate enlargement as they age. The condition is often referred to as BPH (benign prostatic hyperplasia). The condition is not cancerous. Associated Anatomy of Enlarged Prostate Prostate Glands Enlarged Prostate Causes It is unclear what causes prostate enlargement. With age, the probability of acquiring an enlarged prostate increases. Many males over the age of 40 have some degree of prostate enlargement. But usually develop symptoms after the age of 50. More than 90% of males over the age of 80 have the disorder. Enlarged Prostate Symptoms These are the most common symptoms of enlarged prostates: Weak urine flow and the feeling your bladder has not been emptied completely. Starting to urinate is difficult Dribbling of urine after urination. More frequent urination, especially at night Frequent urge to pee It is possible to experience none of these symptoms, even if your prostate is enlarged. Other factors, such as cold weather, anxiety, other health issues, and certain medications, can also cause these symptoms. Blood in the urine can be a sign of an enlarged prostate. This is not common and is typically caused by something else. Enlarged Prostate Diagnosis Overactive bladder (OAB), Bladder Cancer, foreign things in the bladder (stones or stents), Prostate Cancer and urethral stricture due to trauma or a sexually transmitted illness are some of the differential diagnoses for an enlarged prostate. Typical Test for Enlarged Prostate Your doctor will ask you questions about your medical history. A digital rectal exam will be performed to feel the prostate gland. The following tests may also be performed: Urine flow rate A residual urine test: It measures how much urine is left in your bladder after you urinate. Pressure-flow investigations are used to determine the pressure in your bladder when you pee. Urinalysis Urine culture: To detect if there is any infection Prostate-specific antigen (PSA) blood test: To screen for Prostate Cancer Cystoscopy in the certain specific conditions Creatinine and blood urea nitrogen (BUN) testing Enlarged Prostate Treatment The following are the three primary forms of therapy for an enlarged prostate: Modifications in Lifestyle There are several basic changes you may make to your lifestyle that may help your symptoms. Reduce your intake of alcohol, caffeine, artificial sweeteners, and fizzy drinks. Before leaving the house, make sure your bladder is empty. Consume more fruits and vegetables. Maintain a healthy weight Stop smoking Regular exercise is essential. Medicines The use of medications may be an option if lifestyle changes do not alleviate your symptoms. The most commonly prescribed medications are: Alpha-blockers Inhibitors of 5-alpha-reductase Surgery Surgery may be an option if your symptoms don't improve with lifestyle changes or medications. The most common types of surgery are: Prostate transurethral resection Prostate transurethral vaporization Laser surgery Urethral prostatic lift Open simple prostatectomy Risk Factors of Enlarged Prostate You are more likely to develop an enlarged prostate if you have the following risk factors: Age: An enlarged prostate is more likely to occur as you grow older. Hormone Levels: The hormones (estrogen and testosterone) in your body change as you age. It may cause the prostate to enlarge. Other Risk Factors: Obesity and Diabetes are known to be associated with a high risk of enlarged prostate. Patients with a family history are also more likely to develop the condition. Possible Complications of Enlarged Prostate When a man has an enlarged prostate and whose symptoms have gradually worsened over a long period of time, he may develop the following complications: Infections of the urinary tract (UTIs): The inability to completely empty the bladder might raise the risk of urinary tract infection. Stones in the bladder: In most cases, this is caused by an inability to empty the bladder. Bladder Stones can result in infection, bladder discomfort, blood in the urine, and urinary flow restriction. Damage to the bladder: A bladder that hasn't been fully emptied might expand and weaken over time. Kidney failure: Urinary retention can cause bladder pressure, which can directly harm the kidneys or allow bladder infections to reach the kidneys. Enlarged Prostate Prevention Primary Prevention of Enlarged Prostate The experts say there is no way to prevent benign prostatic hyperplasia. Men who are at risk of enlarged prostate should consult their doctor if they experience any lower urinary tract symptoms and whether they should undergo frequent prostate exams. Patients with a family history of Prostate cancer should come early for screening to mitigate the risk. Secondary Prevention of Enlarged Prostate The following steps can help in the secondary prevention of mild symptoms: Pee as soon as you feel the desire. Also, use the restroom whenever possible, even if you don't feel the urge to urinate. Avoid drinking and using caffeine, especially after dinner. Drinking a lot of fluid all at once is not a good idea. Distribute fluids throughout the day. Avoid consuming fluids within two hours of going to bed. Avoid using over-the-counter cold and sinus drugs containing decongestants or antihistamines. These drugs have the potential to exacerbate enlarged prostate symptoms. Maintain a healthy level of fitness by staying warm and exercising on a regular basis. The combination of cold weather and a lack of physical activity may aggravate symptoms. Pelvic strengthening exercises should be learned and practised. Reduce your tension. Increased urination can be caused by nervousness and strain. Enlarged Prostate Epidemiology According to the findings of an age-related study, the prevalence of enlarged prostate increased with age from 14% in those aged 50-59 years to 30% among those aged 60-69 years and 44% among those aged 70-79 years. The risk of BPH is 41% higher in Black and Hispanic men compared to white men. Enlarged Prostate Expected Prognosis The early recognition of bladder symptoms and the identification of enlarged prostate gives men the opportunity to receive early treatment and limit its consequences. Enlarged Prostate Pathophysiology A prostate enlargement results from an increase in the size of the prostate. It is called as Benign Prostate Enlargement (BPE) on clinical examination and benign prostate hyperplasia (BPH) after histopathological confirmation. It is either due to an increase in the size of the prostate or an increase smooth muscle tone of the Prostate. Frequently Asked Questions 1. What are the surgical options for an enlarged prostate? Surgical options for an enlarged prostate include: Transurethral Resection of the Prostate (TURP) GreenLight Laser Therapy Holmium Laser Enucleation of the Prostate (HoLEP) Open Prostatectomy The choice of surgery depends on the severity of the symptoms and the patient's overall health. 2. Is there a risk of erectile dysfunction after prostate surgery? Erectile dysfunction is a potential risk after prostate surgery. However, the risk varies depending on the surgical technique used and individual factors. Discussing potential risks with the surgeon beforehand and exploring post-operative management options can help minimize the risk. 3. Can lifestyle changes help manage symptoms of an enlarged prostate? Yes, lifestyle changes can help manage symptoms of an enlarged prostate. These may include limiting fluid intake before bedtime, avoiding caffeine and alcohol, regular exercise, and practicing pelvic floor exercises. However, it is important to consult with a healthcare professional for personalized guidance and recommendations. 4. What are the risks and benefits of different treatment options for an enlarged prostate in Delhi? Different treatment options for an enlarged prostate in Delhi carry their own risks and benefits. It is important to discuss these with your doctor to understand the potential complications, success rates, and long-term outcomes associated with each treatment modality. 5. How much does enlarged prostate treatment cost in Delhi? The cost of enlarged prostate treatment in Delhi can vary depending on the chosen treatment approach, hospital, and individual patient factors. It is advisable to consult with hospitals or healthcare providers directly to obtain accurate cost estimates. Related Blogs Things To Know About Prostate Cancer Common Urologic Conditions and Their Surgical Treatment Options

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Gallbladder stones, technically known as Cholelithiasis, are solidified by-products of bile juice deposited in the gallbladder. The gallbladder is a pouch-like organ located under the upper right side of the liver. Gallbladder stores bile, a digestive juice, before releasing it into the small intestine. Bile juice helps in digesting fats. However, bile also excretes cholesterol and bilirubin, produced by the breakdown of blood cells in the liver. When these products solidify, they form stones in the gallbladder. The size of gallstones ranges from very minute multiple stones called sludge to as big as golf balls. Types of GallStones (Gallbladder Stones) 1. Cholesterol Gallstones 80% of gallstones are made up of cholesterol and are greenish-yellow in colour. 2. Bilirubin or pigmented Gallstones Constitutes the rest of 20%. They are made up of bilirubin, a yellow pigment formed after the breakdown of red blood cells (RBCs). Gallbladder Stones Causes There is no specific reason for gallbladder stone formation. However, some factors which can give rise to gallstone formation are High Cholesterol in the Bile Bile juice formed in the liver breaks down cholesterol from time to time. However, if an excessive amount of cholesterol is excreted in bile juice, more than it can clear, gallstones start forming in the gallbladder. Too much Bilirubin Excretion in Bile Juice Certain conditions push the liver to produce too much bilirubin, like certain blood disorders like hemolytic anaemia, liver infections, and liver cirrhosis. This excess bilirubin gets collected in the gallbladder, eventually forming stones. Hypomotility of Gallbladder Impairment of the gallbladder to empty the contents of bile properly leads to a concentration of bile contents which causes stone formation in the gallbladder. Gallbladder Stone Symptoms In most people, gallbladder stones remain asymptomatic and cause no harm as such. The problem arises when these stones start impinging on bile ducts, causing cholecystitis or inflammation of the gallbladder. The pain occurs in an episodic manner and continues for 3-4 hours. Sometimes this pain can happen late at night. Pain in the upper right side of the abdomen, under the ribs moving towards the back, especially after having fatty foods Vomiting and nausea Paleness of the skin and eyes Loss of appetite Flatulence and bloating Restlessness and confusion Sweating and sometimes a low-grade fever with pain over the gallbladder area. Gallbladder Stones (Gallstones) Diagnosis When a patient presents with a history of episodic pain in the upper right abdominal area, various tests are done for diagnosing gallstones that include Abdominal ultrasound: This provides a clear image of the stone in the gallbladder. The stone's size, shape, and location can be seen clearly on an ultrasound. Endoscopic ultrasound is used to identify tiny gallstones, commonly known as sludge. An endoscope is passed through the mouth inside the gallbladder to detect gallbladder stones. Computed tomography (CT scans) Magnetic resonance imaging (MRI) Hepatobiliary iminodiacetic acid scan (HIDA scan) or cholescintigraphy Blood tests to check for possible infections like jaundice, pancreatitis, and other complications Tissue biopsy to detect malignancy, if any. Differential Diagnosis of Gallbladder Stones The pain in gallstones is very similar to following conditions like Gastroesophageal reflux disease (GERD) Peptic ulcer Acute pancreatitis Jaundice. Gallbladder Stone (Gallstones) Treatment Gallbladder Stone treatment is determined by the size of the gallstones Surgical treatment to remove Gallbladder Stone(Cholecystectomy) If the gallstone isn’t causing pain, then no treatment is required. However, gallbladder stones surgery is the only option if it is symptomatic and causing trouble. This procedure is known as cholecystectomy. The whole gallbladder is removed through laparoscopic technique or conventional cholecystectomy in this treatment. Laparoscopy Treatment to remove Gallbladder Stone It is a treatment of choice in gallbladder stone removal these days as it is minimally invasive with the least postoperative complications. Full Recovery with a laparoscopic procedure takes around two weeks, and you are discharged after 24 hours post-surgery. Medications to dissolve Gallbladder Stone Some medications like ursodeoxycholic acid help disintegrate the gallstone over time, but it takes a very long time with a definite possibility of recurrence. Alternative treatments like lithotripsy use ultrasonic shock waves to disintegrate the gallstones. However, it is rarely used in the case of tiny stones. Surgical removal of the gallbladder is the only treatment with a 99.9% success rate as it completely removes the gallbladder, which can harbour bile juice. Risk Factors of GallStones (Gallbladder Stones) Age: Age over 40 years predisposes anyone to gallstone formation. Gender: Female predominance than males Family history: Having a family history of gallbladder stones also increases the chances of having gallstones. Diet: A high-cholesterol diet with no fibres Lifestyle: Sedentary lifestyle with no exercise Certain medications: Medications like hormonal therapy in women for menopause. Estrogen hormone has been linked to the formation of gallstones. Ethnicity: More common in native American and Hispanic people than the Asian population Liver diseases like cirrhosis Blood disorders like hemolytic anaemia Rapid weight loss Pregnancy Diabetes Complications of Gallbladder Stones Pancreatic duct blockage leading to pancreatitis, if left untreated. Biliary colic due to gallstone hampering the gallbladder contraction causing severe pain. Infections due to blockage of the bile duct which releases bile causing symptoms of jaundice known as acute cholangitis. After gallbladder stone surgery, people complain about indigestion after a heavy meal. Frequent stools than before occur because of bile juice directly flowing into the small intestines. However, Gallbladder cancer is very rare. Gallbladder Stone Prevention Prevention of gallstones involves leading a healthy lifestyle with a minimal-fat diet and exercise, especially if you have a family history of gallstones and obesity. Eating vegetables, whole grains, and a dairy-free diet can help prevent gallstones. Avoiding foods rich in cholesterol and fats Exercising and maintaining a healthy lifestyle. Epidemiology of Gallstones The prevalence of gallstones is more among the western population than in Asians and Africans. In addition, women are more susceptible than men, which may be due to the estrogen hormone in females, which increases the cholesterol secretion in bile. Other modifiable factors attributing to gallstones are increased obesity rates, a sedentary lifestyle, metabolic disorders, and a diet rich in heavy and fried foods. Prognosis of GallStones Most people having gallbladder stones remain asymptomatic throughout their life. In 80% of people, gallstones remain silent throughout life. If there are no symptoms, no treatment is done in such cases. But in case it is symptomatic, surgery should be done. The success rate of gallbladder removal surgery is good, and the patient leads a normal life after the surgical removal without any side effects. Related Blogs Busting Myths About Gall Bladder Stones What is Jaundice? Symptoms, Causes, Diagnosis, Treatment & Prevention Chest Pain: Its Major Reasons & Preventive Lifestyle Changes Understanding The Pancreas And Its Diseases: Acute Pancreatitis What Are The Different Types, Procedures And Risks Of Bariatric Surgery? How are Laparoscopic Procedures Helpful in Gastric Bypass Surgery? 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Glomerulonephritis refers to inflammatory kidney problems of the tiny capillary in the kidneys, called glomeruli. The glomeruli remove excess fluids and wastes from the bloodstream so that they exit the body in the form of urine. The condition can develop suddenly (acutely) or gradually (chronically). This condition impacts 10% of the population around the world. Associated Anatomy of Glomerulonephritis Glomerulus (filtering part of the kidneys) Alternate Name of Glomerulonephritis Nephritis and nephrotic syndrome, RPGN, CKD. Types of Glomerulonephritis There are two types of Glomerulonephritis, which are: 1. Acute Glomerulonephritis Acute glomerulonephritis is defined as swelling and subsequent damage of the glomeruli leading to hematuria (presence of blood in urine), proteinuria (enhanced levels of protein in urine), and azotemia (increased level of Blood Urea Nitrogen or Serum Creatinine); it may be triggered by primary kidney illness or systemic problems. 2. Chronic Glomerulonephritis It is a group of kidney diseases defined by long-term damage and scarring of the glomeruli (tiny functioning factors in the kidney that filter blood and produce urine). This form of kidney illness is typically created gradually (over the years) and may not have signs and symptoms at the outset. Glomerulonephritis Causes The reason Glomerulonephritis appears is often unknown. However, causes might include: Genetics Anti-GBM condition (previously Goodpasture syndrome), which is a severe autoimmune disease. Endocarditis - an infection due to inflammation of the heart chambers and valves. Various other viral infections, such as strep throat, HIV, or liver diseases like Hepatitis C. Issues with the immune system assaulting healthy body parts, such as lupus. Unusual illnesses that irritate blood vessels like granulomatosis with polyangiitis (previously Wegener's disease), microscopic polyangiitis, or eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss Syndrome). Glomerulonephritis Symptoms Glomerulonephritis may appear suddenly, but some of the symptoms that may occur are: Puffiness of the face on waking up Reduced urination Inability to complete family Bone pains/aches Often urinating throughout the evening Shortness of breath due to fluid-filled lungs High blood pressure Blood or protein in the urine Swollen ankle joints or face due to water retention Bubbles or foam in the urine due to excess protein in the urine. Stages of Glomerulonephritis It may have three stages, which include: 1. The latent stage It occurs when Glomerulonephritis results from a post-infectious disease like a streptococcal infection. From the onset of the infection until it develops into Glomerulonephritis, it lasts seven to twenty-one days. 2. The acute stage The acute stage starts after the development of Glomerulonephritis. At this stage, it may cause severe harm to your kidneys unless treated appropriately in time. 3. The recovery stage In this stage, the treatment and dietary precautions help in the patient's recovery. Glomerulonephritis Diagnosis To see if you have Glomerulonephritis, your nephrologist will begin by examining your blood or urine to see if your kidneys are functioning well or not. After that, your doctor might ask you to have more tests. Some Imaging tests for your kidneys are: 1. X-ray X-rays are a type of high-energy electromagnetic radiation that penetrates deep into the body. 2. Ultrasound A medical procedure in which high-frequency sound waves are used to see inside the body. It is a non-invasive, harmless and early available test which should be done as soon as possible. 3. CT scan CT scans are medical imaging techniques used to obtain detailed images of the inside of a person's body with unmount contrast dyes. Kidney biopsy Biopsy is a medical procedure in which a tiny piece of your kidney is taken out under ultrasound guidance and local anaesthesia. It is the most diagnostic test and should be done as the earliest, if indicated to prevent irreversible injury to kidneys. Differential Diagnosis of Glomerulonephritis Usual differential medical diagnoses of Glomerulonephritis consist of minimal change nephropathy, FSGS, hypertensive nephropathy, diabetic nephropathy, IgA nephropathy, fibrillary glomerulopathies (illnesses may cause amyloidosis), lupus nephritis, and multiple myeloma, cardio-renal syndrome, pulmonary-renal and hepato-renal syndromes, where two way organs are covered. Glomerulonephritis Treatment Glomerulonephritis Treatment depends on the problem's root cause and signs. In mild cases, treatment is not necessary and disease remits with a timely case. Immunosuppressants Severe Glomerulonephritis, brought on by problems with the immune system, is treated with immunosuppressants. These medications blunts the injury caused by a misguided immune system. Steroids Steroids are used to minimize swelling and also suppress your immune system. In Glomerulonephritis, your doctor may recommend you to take steroids for a period of time. Various other medications If your problem is believed to be linked to a viral infection, it may be treated with an antiviral drug. Treating hypertension Glomerulonephritis usually brings about hypertension, which can cause more kidney damage and various other wellness problems. You may need to take medicines that decrease blood pressure and help reduce the quantity of protein that leaks into your urine. In difficult situations that can not be improved with various other treatments, you might need: Kidney dialysis Kidney dialysis is a treatment that takes control of the kidney's work components and gets rid of waste products from your body. Kidney transplant Kidney transplant is a procedure where a healthy kidney from a contributor is operatively implanted to replace one’s own damaged kidneys. Possible Complication of Glomerulonephritis Possible problems of Glomerulonephritis include: Hypertension Damage to the glomeruli from swelling or scarring can enhance blood pressure. Acute kidney injury Acute kidney failure is the sudden, rapid reduction in kidney function, usually connected with a transmittable root cause of Glomerulonephritis. The accumulation of waste and liquids can be lethal if not dealt with immediately with a synthetic filtering system device (dialysis). The kidneys frequently resume standard features after recuperation. Chronic kidney disease Persistent inflammation causes long-term damage and decreases the function of the kidneys. Chronic kidney disease may advance to end-stage kidney illness, which requires dialysis or a kidney transplant. Nephrotic disorder It is a condition in which too much blood protein is excreted in urine as waste, and hence there is insufficient protein amount in the bloodstream. A decrease in blood proteins leads to high cholesterol, hypertension, and swelling (oedema) of the face, hands, feet, and abdomen. In rare instances, nephrotic syndrome may create an embolism in a kidney blood vessel. Risk Factor of Glomerulonephritis Some factors that may elevate the glomerulonephritis risk are: Having a family history of kidney illness Past or present kidney troubles Having health problems such as hypertension, or high blood sugar levels Direct exposure to toxic substances, drugs and gym products. Glomerulonephritis Preventions Primary Prevention of Glomerulonephritis Eat healthy, balanced and unadulterated food. Take care of high BP with a low salt diet, regular medications, physical activity and regular follow-up. Additionally, avoid using needles for controlled substances and tattoos. See a healthcare provider whenever you have an infection like sore throat, blood in urine, foam, or bubbles in urine. Secondary Prevention of Glomerulonephritis Prevent infections by practising good health with a healthy diet. Have safe sex practice by using protection to prevent infections. Control your blood sugar level to prevent diabetic nephropathy. Intravenous drug abuse should be avoided to prevent infections that can cause Glomerulonephritis, such as HIV and liver disease. Epidemiology of Glomerulonephritis Glomerulonephritis is common, with an approximated worldwide incidence of 0.5-2.5 per 100,000 clients each year, depending on the particular type. However, the threat of development of end-stage renal condition (ESRD) is high in chronic Glomerulonephritis. Expected Prognosis of Glomerulonephritis In acute Glomerulonephritis, the lasting prognosis usually is good. Greater than 98% of people are asymptomatic after five years, with chronic kidney failure reported 1-3% of the moment. Within a week or so of starting, many patients with acute Glomerulonephritis begin to experience a reduction in fluid retention and hypertension. Natural Progression of Glomerulonephritis Suppose Glomerulonephritis is left without treatment or remains undiagnosed or neglected. It can lead to chronic renal failure, end-stage kidney disease, hypertension, congestive heart failure, lung oedema. It may eventually lead to stage of regular dialysis and a kidney transplant. Related Blogs Dietary Changes You Can Make To Improve Your Kidney Health

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A hydrocele is a scrotal enlargement caused by fluid accumulation in the thin layer surrounding one or both the testes. Hydrocele is commonly found in newborns and gets typically cured on its own by the age of one. A hydrocele can develop in older boys and adult men due to scrotal inflammation or injury. A hydrocele rarely causes complications and may not require any treatment. However, scrotal swelling must be assessed by a clinical practitioner to rule out other harmful causes mimicking the condition. Associated Anatomy of Hydrocele Testis Types of Hydrocele 1. Communicating Hydrocele This type of condition makes contact with the fluids in the abdominal cavity. The anomalies of the vaginal processes (blind-ended invagination of the abdominal wall during foetal development) causes a communicative hydrocele. In such circumstances, the possibility of hydrocele and hernia formation increases. 2. Non-communicating Hydrocele In this type of condition, even after the closure of the inguinal canal, some excess fluid remains in the scrotum surrounding the testicle. This disease may persist from birth or appears later in life for no apparent cause. Some schools of literature classify hydrocele into Primary (obliteration of the communication between the abdomen and scrotum) and Secondary (arising due to infection such as filaria, tuberculosis, syphilis, etc. or trauma). Hydrocele Causes Congenital defects in newborns Post-herniorrhaphy complication (a nerve pain experienced after hernia surgery) Filariasis caused by Wuchereria bancrofti, tuberculosis, syphilis Trauma and inflammation Hydrocele Symptoms Painless swelling in one or both the scrotum In adults, heaviness and discomfort due to swelling Pain in highly inflamed scrotum Diurnal changes in swelling Hydrocele Diagnosis  A physician may conduct a physical examination to check the change in the swelling on pressure or may see the collection of fluid by illuminating the scrotum with a shining light. Laboratory studies in the form of Serum alpha-fetoprotein and human chorionic gonadotropin (hCG) urinalysis can be performed to rule out differential diagnoses such as testicular tumours or Epididymitis/Orchitis. Additionally, imaging studies using ultrasonography or Duplex ultrasonography can be performed to evaluate testicular tumours, spermatocele, testicular atrophy, and aberrant blood flow in the testis. Differential Diagnosis of Hydrocele Varicocele Spermatocele Inguinal hernia Epididymal cyst Testicular tumour Scrotal edema Epididymitis/Orchitis Epididymo-orchitis. Hydrocele Treatment Most cases of hydrocele require no treatment and get resolved spontaneously with the remedy of primary aetiology. Complicated and symptomatic hydrocele is treated by surgical intervention. There are two types of surgery performed: Plication Excision and eversion Those who have contraindications for surgery may undergo aspiration of accumulated fluid. After taking out the fluid, a sclerosant (shrinking agent) is injected. However, the fluid may re-accumulate within a short period. Risk Factors of Hydrocele Most cases of hydrocele are congenital, related to the following risk factors: Low birth weight Gestational use of progestin. However, later in life, the following risk factors influence the development of hydrocele. Injury to the scrotum Infection (including Sexually transmitted infections, STIs), and inflammation. Hydrocele Prevention No such preventive measures are useful to prevent congenital hydrocele. However, hydrocele in adults can be prevented by avoiding injury, such as wearing an athletic cup during contact sports. Pathophysiology of Hydrocele The testicles normally descend into the scrotum from the abdominal cavity in the developmental stage of a foetus. Each testicle is accompanied by a sac that allows fluid to surround the testicles. Each sac normally shuts, and the fluid is absorbed. After the sac closes, the fluid may remain entrapped (noncommunicating hydrocele). Within the first year of life, the fluid usually is progressively absorbed. However, the sac does occasionally remain open (communicating hydrocele). Fluid might flow back into the abdomen if the sac changes size or if the scrotal sac is squeezed. Inguinal hernia is frequently linked with communicating hydroceles. In adults, the major pathology is inflammatory swelling. Expected Prognosis of Hydrocele Infantile hydrocele is expected to get resolved on its own. Moreover, hydroceles that require surgical intervention can be repaired without any postoperative complications by an expert surgeon. Prognosis of adult hydrocele depends on the extent and severity of the underlying infection or injury. Natural Progression of Hydrocele Quality of life is generally not impacted due to hydrocele. However, complicated conditions require management, else leading to severe complications such as infection, atrophy, hernia, accumulation of blood, rupture, etc. Epidemiology of Hydrocele A high percentage (approximately 80 to 90 percent) of term infants possess such defects at birth. However, this reduces to approximately one-third or less at two years of age. The same persists in adult life at a frequency of 20%. Only 6% of these require clinical attention due to complications.

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The deposition of salts and minerals inside the kidneys results in kidney stones. Other terms for kidney stones are renal calculi, urolithiasis, and nephrolithiasis. Kidney stone formation may be faster with a higher concentration of urine. The higher urine concentration causes the crystallisation of salts and minerals and the subsequent sticking together of these crystals to form kidney stones. Kidney stones are treatable with timely diagnosis and treatment. BLK-Max Hospital is one of the best kidney stones treatment hospitals in Delhi. Types of Kidney Stones Calcium stones: These are the commonest among all types of kidney stones. Uric acid stone: Several conditions can lead to acidic urine. Uric acid stone formation occurs because uric acid crystals are not soluble in acidic urine. Struvite stones: Infection stone is another name for struvite stones. Struvite stones comprise ammonia, a waste product, and magnesium which is a mineral. Cystine stones: The occurrence of cystine stones is rare. It relates to the high concentration of cystine in the urine. The formation of these stones begins in early childhood. It is a hereditary and metabolic condition. Kidney Stones Causes Several causes can lead to the formation of kidney stones: Infections: Frequent infections of the urinary tract Low urine output: Consistently low urine volume can result in concentrated and darker urine that encourages the formation of kidney stones. Diet: Intake of foods that contain excess amount of calcium oxalate and uric acid Kidney Stones Symptoms Smaller kidney stones can pass easily through urine, causing no symptoms. The following signs and symptoms may be present if the stones get lodged in the ureters: Severe and intense pain below the ribs and in the back Pink or red-coloured urine The pain may be fluctuating in severity More frequent, painful, and burning urination Fever with chills suggesting an infection Kidney Stones Diagnosis Routine health exams or X-ray investigations may underline the presence of kidney stones causes that do not have any symptoms (silent kidney stones). The doctor may suspect a kidney stone if you are experiencing intense pain, discolouration of urine, and other symptoms. Following are some diagnostic tests that help detect the presence of kidney stones in addition to a physical examination: Blood Tests To examine the presence of calcium or uric acid in the blood. Urinalysis The test will help detect blood in urine along with bacteria and the presence of minerals that are responsible for kidney stone formation. Imaging tests Abdominal X-ray KUB and USG Abdomen are standard imaging tests. Advanced imaging techniques like CT scans help detect smaller kidney stones that may not show on X-ray images and Ultrasound. Urologists are the medical specialists who diagnose and do kidney stone treatment. Kidney Stones Treatment Your doctor chooses an appropriate kidney stone treatment option by considering the size of the stone, severity of symptoms, and presence of infections. Waiting for the Natural Passage of the Kidney Stones Smaller stones that cause no infection and severe symptoms can pass through urine depending upon the patient's condition. Patients should come for regular follow up while on conservative kidney stone treatment as even small stones may require active intervention sometimes. Medical Therapy of Kidney Stones Besides antibiotics to treat infections that may occur because of kidney stones, Doctors may recommend medication therapy to improve the chances of stone removal. Some medicines from the alpha-blocker category relax the ureters and enable the stone to pass out spontaneously in some cases. Active Intervention Shock Wave Lithotripsy for Kidney Stones Removal of stones may require breaking the stones into smaller pieces that can easily pass in the urine. The Extracorporeal Shock Wave Lithotripsy (ESWL) disintegrates the large stones. Surgical Treatment of Kidney Stones Percutaneous Nephrolithotomy (PCNL) - Surgical removal of significantly large stones is possible by using Percutaneous. Retrograde Intrarenal surgery (RIRS) - Retrograde Intrarenal surgery is another minimally invasive technique for kidney stones. It is done through natural urine passing with the help of flexible instruments and laser. Surgical removal of significantly large stones is possible by using Percutaneous Nephrolithotomy. It involves passing the nephroscope through a small incision in the back. Risk Factors of Kidney Stones Drinking less water Family history Diets with high protein and sodium content Diseases of the digestive tract Medical conditions like cystinuria or hyperparathyroidism Medication and nutritional supplements Higher BMI or obesity History of specific metabolic diseases Recurrent infections of the urinary tract Lack of exercise or a sedentary lifestyle Related Blogs Prevent Kidney Stones - Causes, Risks, & Treatment Options Common Urologic Conditions and Their Surgical Treatment Options Dietary Changes You Can Make To Improve Your Kidney Health 7 Things To Avoid For a Healthy Kidney

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Polycystic Kidney Disease (PKD) is an inherited disease in which clusters of water-like fluid cysts develop in the kidney, leading to kidney dysfunction. The cysts are non-cancerous round sacs containing fluid, causing kidneys to enlarge. Associated Anatomy of Polycystic Kidney Disease (PKD) In this disease, the kidney gets affected due to cysts which can vary in size. Cysts can also develop in the liver, spleen, pancreas and sometimes in the brain. Polycystic Kidney Disease (PKD) Causes Genes: Abnormality in genes result in this disease. In many cases, the disease passes from the parents to the children, and they can easily get affected. If both the parents have Autosomal Dominant Polycystic Kidney Disease (ADPKD), the child has a higher chance of being born with PKD. Sometimes, a child is born with autosomal dominant polycystic kidney disease in a rare case, even though the parents never had it. Polycystic Kidney Disease (PKD) Symptoms Signs and symptoms progress between the age of 30 and 40. If one parent has Autosomal Dominant Polycystic Kidney Disease, the child has a higher chance of infection from the disease. Moreover, if both parents have genes to pass on this disease, each child has a 25% chance. That is why this disease is known as a hereditary disease. The major signs and symptoms of PKD are: Back pain or side pain Hypertension Headache Blood in urine Infection in kidney Kidney failure Enlargement of abdomen A feeling of fullness in the abdomen Urinary tract infection. Stages of Polycystic Kidney Disease (PKD) Different stages of the condition: Stage 1: Normal kidney function Stage 2: Slightly worse than normal kidney function Stage 3A: Slight to average worse kidney function Stage 3B: Moderate worse kidney function Stage 4: Kidney function worse than normal Stage 5: Kidney failed or at risk of failure Polycystic Kidney Disease (PKD) Diagnosis If you are experiencing PKD symptoms, it can be diagnosed by CT scans, kidney ultrasound, and MRI tests. Your healthcare provider can also do a genetic test using your blood or saliva sample, but it will take months to get the genetic test results. Polycystic Kidney Disease (PKD) Treatment Take Tolvaptan The National Institute for Health and Care Excellence recommends Tolvaptan for adults to treat ADPKD. This medicine slows the growth of cysts and also improves kidney function. Quit smoking Smoking is the root cause of various diseases. A person who has PKD should avoid smoking as much as they can. Diet changes It is essential to have a healthy diet including beans, fish, pulses, eggs, fruits, and vegetables to maintain your blood pressure. Proper hydration Staying hydrated by drinking the right amount of fluid is beneficial in treating PKD. Risk Factors of Polycystic Kidney Disease (PKD) There are many risk factors of PKD, such as: Frequent kidney infections: If a person frequently suffers from kidney infections, it can increase the risk of the condition. High blood pressure: Individuals who have hypertension affect about 60 to 70 per cent of PKD patients and begin early in the course of the disease. Gender: Male gender has a higher chance of developing polycystic kidney disease than females. Affected men have a faster loss of renal function at the early beginning of the end-stage renal disease. Black racial background: The black racial background has higher chances of developing this disease than White Americans. Complications of Polycystic Kidney Disease (PKD) There are several complications associated with polycystic kidney diseases, such as chronic pain, loss of kidney function, cystic growth in the liver, high blood pressure, complications in pregnancy, and development of sacs in the colon wall and brain aneurysms, and heart valve abnormalities. PKD complications are preventable with the help of lifestyle changes, treatments and proper medication. Polycystic Kidney Disease (PKD) Preventions Primary Prevention of Polycystic Kidney Disease (PKD) Manage blood pressure: If you want to keep your kidneys healthy, you should manage your blood pressure by consuming less salt, taking proper medications, and maintaining your body weight. Limit alcohol: Consuming alcohol can severely affect your kidneys. Try to eliminate it from your lifestyle as much as possible. Take all prescribed medicines: It is imperative to take all the prescribed medication on time to halt the growth and relieve the kidney of the cysts. Exercise: Aim to do physical activity for 30 minutes a day and include it in your daily routine. Secondary Prevention of Polycystic Kidney Disease (PKD) Manage your blood sugar: Increased blood sugar levels lead to heart and kidney diseases. Therefore, it is vital to manage your blood sugar levels. Limit over-the-counter medicines: Do not take more than the recommended dose of over-the-counter medications prescribed by your healthcare professional. They can reduce the amount of blood flow to your kidneys. Avoid stress: Stress can cause numerous diseases which are harmful to health. Therefore, you have to avoid stress or anxiety as much as possible. Being stress-free maintains your blood pressure, crucial for the kidneys' proper functioning. Epidemiology of Polycystic Kidney Disease (PKD) Prevalence of PKD is higher in non-Hispanic White and Black than in Hispanic and Asian people. The disease usually affects men and women of all races. Expected Prognosis of Polycystic Kidney Disease (PKD) The severity of the disease varies from person to person. People can reach end-stage kidney disease between 55 and 65. Males have an increased risk of kidney failure. Natural Progression of Polycystic Kidney Disease (PKD) Polycystic Kidney Disease is very progressive, which means that if not appropriately treated, it may worsen with time. It can lead to chronic kidney disease, but this progression depends on the patient. Related Blogs Dietary Changes You Can Make To Improve Your Kidney Health

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Pyelonephritis is a bacterial infection causing inflammation of the renal pelvis. It is usually caused as a result of a urinary tract infection and affects the kidneys. In most cases, oral antibiotics can successfully treat this infection. Associated Anatomy of Pyelonephritis Pelvis, urethra, ureter, urinary bladder, kidney Alternate Name of Pyelonephritis Acute pyelonephritis, Chronic pyelonephritis Pyelonephritis Causes Gram-negative bacteria cause kidney infection by entering the urethra and reproducing in the bladder. Escherichia coli is the most common causative organism. Other causative organisms include Proteus and Klebsiella enterobacter. Primary congenital defect of the vesicoureteral orifice Obstruction of the urinary bladder outlet Hematogenous infection is less common. It can occur as a result of septicemia, infective endocarditis, or bacteremia. Weakened immune systems Female physiology. The shorter urethra in females makes it easier for bacteria to reach the kidneys. The presence of kidney stones can cause infection. Pyelonephritis Symptoms Pyelonephritis Symptoms often develop in hours or days. Chills and fever Flank pain Back pain Costovertebral angle pain Nausea and vomiting Anorexia Urinary tract infection (UTI) symptoms include smelly or cloudy urine, urgency, frequency, and a burning sensation while urinating. Atypical symptoms Epigastric pain Lower abdominal pain Severe cases Bacteremia Sepsis, shock Multiple organ system failures Acute renal failure Stages of Pyelonephritis Acute pyelonephritis is an infection that develops quickly. It is an upper urinary tract infection. An ascending infection most often causes acute pyelonephritis. Chronic pyelonephritis results from recurrent or inadequately treated episodes of acute pyelonephritis. Predisposition to infection, such as vesicoureteral reflux or chronically obstructing kidney stones. Chronic pyelonephritis results in scarring of the kidney. Pyelonephritis Diagnosis & Test Two common laboratory tests are advised. Routine urinalysis helps to check for pus or pyuria (present in nearly all patients), bacteria or bacteriuria, and the presence of WBCs and RBCs in urine. Urine culture to check for bacterial growth in urine. It helps choose the treatment depending on the type of bacteria strain cultivated. If additional problems are suspected, imaging tests are advised. The doctor may order an ultrasound to look for cysts, cancer/tumours, or other obstructions in the urinary tract. A CT scan (with or without injectable dye) may be conducted if a patient does not respond to treatment within 72 hours. This test can also detect obstructions in the urinary tract. Radioactive imaging to check for scarred lesions. Differential Diagnosis of Pyelonephritis The differential diagnosis for pyelonephritis includes inflammatory disease of the pelvis, cholecystitis, and appendicitis. Pyelonephritis Treatment Rehydration Oral antibiotics are taken for 7–14 days, including oral fluoroquinolones and aminoglycosides. In severe infections, hospitalisation and intravenous administration of ceftriaxone and fluoroquinolones are usually advised. A surgical procedure is required if a structural problem with the urinary tract is causing recurrent infections. Risk Factor of Pyelonephritis It can affect any age group. Most commonly in older adults and children. Young females are more susceptible than males. The female urethra is much shorter than the male. Pregnant women Kidney stones or people suffering from bladder conditions Individuals suffering from vesicoureteral reflux, where small amounts of urine back up from the bladder into the ureters and kidneys. Kidney transplant Immunocompromised individuals, such as HIV/AIDS Sexual intercourse Indwelling catheter Urinary Tract Obstruction Certain medications Pyelonephritis Preventions Infections of the kidney begin as bladder infections in the lower tract. Keeping bacteria out of the urinary system and bladder can help prevent kidney infections. Some preventive measures include Drink plenty of fluids to prevent the buildup of germs. Using the toilet in a sitting position instead of squatting can relax the pelvic floor muscles and ensure the bladder empties well. Do not rush while urinating. Use a heating pad on your belly, back, or side. Possible Complications of Pyelonephritis Chronic kidney disease is a complication of pyelonephritis. The kidneys may be irreparably damaged if the infection persists. Other complications include: Renal abscess formation Recurrent infections (usually seen in people with an anatomic problem that allows bacteria to cause infection easily) Renal scarring or high blood pressure The infection spreads in and around the kidneys. Papillary necrosis, or death of the renal papillae tissue, has a much worse prognosis because it can affect the kidney's overall ability to function. Acute renal failure Bacteria from the kidneys can enter the bloodstream, causing life-threatening sepsis. Epidemiology of Pyelonephritis It occurs more often in females than males, with an annual rate of 15-17 cases per 10,000 females compared to 3-4 cases per 10,000 males. Young, sexually active females are the most at-risk group. Pregnant patients are at a higher risk. Patients with kidney stones have an increased risk of pyelonephritis. Expected Prognosis of Pyelonephritis If diagnosed and treated early, pyelonephritis responds well to treatment. It is important to undergo all laboratory investigations and take all medications prescribed by the doctor. Natural Progression of Pyelonephritis If left untreated, pyelonephritis can lead to potentially serious complications such as papillary necrosis and scarring of the kidneys. This scarring leads to chronic kidney disease, high blood pressure, septicemia, and renal failure. Abscess formation in or around the renal tissue is also possible.

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Varicocele is a condition where the veins in the scrotum are enlarged or swollen. These usually develop due to abnormalities in the veins of the scrotum. Associated Anatomy of Varicocele Scrotum Varicocele Causes The scrotum of the males is the skin pouch that holds the testicles and their supportive structures. The structures that emerge from the testicles are called spermatic cords. These spermatic cords consist of the blood vessels that supply blood to and from the testicles and the ejaculatory ducts that carry the sperm from the testicles to the ejaculation duct. The blood vessels, specifically veins of the scrotum, may become abnormally enlarged due to blood pooling, resulting in a varicocele. The reasons behind this enlargement or swelling are not known. Certain reasons have been offered, such as: Poor circulation in the spermatic cord due to poorly functioning veins Possible backflow of blood in the veins Sluggish movement of blood resulting in accumulation. Varicocele Symptoms In most cases, men who develop varicoceles face no symptoms at all. Varicoceles are painless in most cases. Some symptoms include: Development of dull pain in the testicular areas Discomfort in the scrotal area while sitting down A feeling of heaviness in the scrotum, almost like dragging Dilated veins that are visible and can be felt. The sensation reported is “worm-like”. The abnormal difference in the size of the testicles due to difference in blood flow. Stages of Varicocele Depending on the diagnosing characteristics, the varicocele is assigned a particular grade. Grade 1: Varicocele that is detected only on imaging such as ultrasound, not physically palpable. Grade 2: Varicocele that is palpable only when the patient is Valsalva manoeuvre. Grade 3: Varicocele that is physically palpable regardless of the patient’s position Grade 4: Varicocele that causes visual deformity in the scrotum. Varicocele Diagnosis Varicoceles are physically visible, hence are diagnosed through visual examinations. Smaller varicoceles can be diagnosed by physical exams where the doctor will ask you to “bear down” the testicles to diagnose varicoceles that are not visible. They may also require scrotal ultrasounds if the varicoceles are even smaller. Differential Diagnosis of Varicocele The differential diagnosis for a varicocele is the physical palpability of the varicocele coupled with the ultrasound. Varicocele Treatment Unless varicoceles cause any problems, they don’t need to be treated. The urologist may recommend surgery that clips off the veins causing the varicocele to boost sperm movement for men who are having trouble with fertility due to the varicoceles. However, if the varicoceles do not negatively impact your life, the surgery can be avoided. Any OTC pain killer medications can be used for pain due to varicoceles. Home remedies are also recommended, such as ice packs and routine changes in clothing options such as tighter underwear to prevent jostling of the scrotum. Risk Factors of Varicocele There are no known causes as to why the development of varicoceles takes place. Due to this reason, no particular risk factors have been identified. However, statistics suggest that boys going through puberty are more likely to develop varicoceles than adult men. This is because the body undergoes a major growth spurt; hence the demand for blood supply is higher, which may cause irregular blood flow to the testis, resulting in a varicocele. Possible Complications of Varicocele Varicoceles may negatively impact the fertility of some men due to obstructed blood flow to the testicles or obstructed sperm flow to the penis. This is the most common complication of varicoceles. However, it is easily treatable through surgeries where the doctors eliminate the varicoceles by cutting the enlarged veins. Varicocele Preventions Primary Prevention of Varicocele Avoid prolonged standing. Avoid constipation. Avoid heavy weight lifting. The cause of a varicocele is not clear yet; due to this reason, there are no prevention strategies that can be formulated to prevent the development of a varicocele. Secondary Prevention of Varicocele There are no known causes of a varicocele. Hence, it is not possible to prevent the reoccurrence of a varicocele. Epidemiology of Varicocele Very little is known about the causes behind a varicocele. However, it has been observed that boys undergoing puberty are more likely to develop a varicocele than adults due to the growth spurts. Expected Prognosis of Varicocele Varicoceles are not life-threatening and, in most cases, painless. Hence, men who have developed varicoceles can expect a healthy life even with the varicocele intact. In case it affects their fertility, urologists suggest surgery that can get rid of the varicocele, and in such cases, the males can expect their fertility to improve after the surgery by around 40-50%. Natural Progression of Varicocele The natural progression of an untreated varicocele is not life-threatening; varicoceles are not fatal and can allow you to live a healthy and normal life if they are painless or manageable with painkillers. Pathophysiology of Varicocele The scrotum of the males is the skin pouch that holds the testicles and their supportive structures. The structures that emerge from the testicles are called spermatic cords. These spermatic cords consist of the blood vessels that supply blood to and from the testicles and the ejaculatory ducts that carry the sperm from the testicles to the penis. The blood vessels, specifically veins of the scrotum, may become abnormally enlarged due to blood pooling, resulting in a varicocele.

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