Prevention and Early Diagnosis of Kidney Diseases

Most kidney diseases can behave like “ silent killers “: they work undisturbed, without symptoms, for years and, when their effects are revealed, it can be late to run for cover. Attention to them is dictated by the need to prevent chronic renal failure and to reduce cardiovascular risk, which increases significantly already in the presence of mild renal failure.

We cannot therefore think that our kidneys are indestructible, or worse that they do not deserve any consideration; we don’t even have to think that kidney disease is always a deadly trap.

If the diagnosis is early, the treatments can be very effective. A healing is common. In any case, the evolution of the disease can be significantly slowed down, says the nephrologist in Delhi.

So, what can you do to find out about kidney injuries in time?

First of all, be careful of the signs that may indicate their appearance.

Here are the main ones:

• Emission of dark colored urine (up to a “coca cola” color) or blood red, or with bad smell. Even the formation of a lot of foam can have a meaning of abnormality;
• Significant increase in urinary volume, especially at night, and persistent thirst;
• Edemas, in the lower or diffuse limbs;
• Increase in blood pressure values ​​beyond the maximum normal limits;
• Pain in the lumbar area (up to real colic), sense of weight in the kidney not referable to lumbosciatalgia;
• Unexplained anemia, fatigue, significant malaise for no apparent reason;
• Burning urinating, fever (especially if with chills), need for frequent urination;

First of all, a fresh urine test must be performed (to avoid alterations caused by fermentation).

Most kidney diseases cause urinary changes, with the presence of:

• blood, mostly not evident to the naked eye, but only on chemical (hemoglobin) and microscopic (micrometry) examination;
• albumin (albuminuria) isolated, or associated with other blood proteins (proteinuria);
• white blood cells, a sign of inflammation of the kidney or urinary tract, often, but not always, of infectious origin;
• other elements, such as the so - called cylinders, which are “molds” of proteins, cells or cellular debris, precipitated in the lumen of the tubules and then mobilized by the flow of urine;

A separate case is that of cancer cells that can be highlighted by the so-called urinary cytological examination.

Abnormal amounts of albumin, blood and white blood cells can be easily searched for by immersing a test strip in the urine. It is this safe and rapid research method that is used in the screening of kidney disease. In case of abnormality, the examination will be supplemented by the microscopic one of the urinary sediments.

Very reliable and rapid automatic equipment is now spreading in the most modern laboratories, which allow to combine the chemical examination with that of the urinary sediment.

As always happens in medicine, there are exceptions to the kidney disease rule = urinary alterations. The most common exception is that of nephroangiosclerosis and some hereditary diseases, at least in the initial phase, such as polycystic kidneys, which can be present without there being obvious urinary changes.

It should also be borne in mind that, in the course of their progression towards an ever more serious renal failure, chronic kidney diseases often cause arterial hypertension.

In turn, kidney damage can be caused by an arterial hypertension that is not initially linked to nephropathy (by far the most common condition is that of the so-called essential arterial hypertension).

Measuring blood pressure is therefore another important step to discover nephropathy in time and, often, to prevent it.

A simple urine test and a blood pressure check therefore allow you to suspect the existence of a kidney disease, but unfortunately the normal results are not enough to rule it out categorically.

For this reason, it is necessary to identify people at risk of developing nephropathy in order to subject them to more detailed investigations.

Detecting the presence of a condition at risk of developing nephropathy, and not rarely if more than one is associated with it, is however very important if you want to prevent the onset of kidney damage.

To prevent kidney disease, the most important risk conditions for their appearance must be taken into account and, if possible, prevented and corrected, suggests the nephrologist in Noida.

Here are the main risk conditions for the development of a kidney:

• aging (over 60 years)
• hypertension
• diabetes
• prolonged use of medications without medical supervision, especially non-steroidal anti-inflammatory drugs
• severe hypercholesterolaemia
• important obesity
• kidney stones
• recurrent urinary tract infections
• lower urinary tract obstruction (e.g. high prostate hypertrophy)
• previous kidney disease
• ongoing immunological diseases (lupus, rheumatoid arthritis etc.)
• presence of kidney disease in family members

Taking these conditions into account, nephrologist in Delhi suggests some good rules for defending our kidneys.

1. Prevention means first of all treating diseases that can induce kidney damage: first of all arterial hypertension, arteriosclerosis and diabetes. Naturally, first of all, the conditions that can favor their appearance must be corrected, such as obesity, the so - called dysmetabolic syndrome, too sedentary life, varying, if necessary, the lifestyle.

2. In keeping with the previous rule, avoid diets very rich in calories, sugar, sweets, animal fats and salt, and smoking.

The traps are many. Canned and preserved foods are generally rich in salt; even the bread of some regions is quite rich: in case of need, consuming bread without salt can be useful. It is always good to drink water with a certain abundance: a liter and a half or two a day is a safe dose. The smoke can also be harmful to the health of the kidneys, warns the nephrologist in Gurgaon.

3. Do not resign yourself to living with high cholesterol and excess body weight, which can promote arteriosclerosis, high blood pressure and diabetes.

4. Regularly check the blood pressure, knowing that it is considered an optimum pressure equal to or less than 130 of 80 mm of mercury, and that values above 140/90 are defined as pathological, at any age (although in diabetics is suggested keep the pressure at values ​​lower than 130/80), suggests the kidney specialist in Delhi.

5. If you are hypertensive, have diabetes or signs of arteriosclerosis, also take care to protect the kidneys, by implementing all the measures recommended by the doctor for kidney in Delhi. However, it is not enough to be content with following treatments: it is also necessary to check that the results are really what you want. For example, in the case of high blood pressure, the treatment can be considered effective only if blood pressure values ​​lower than the classic “140 out of 90" are obtained. Today there are many drugs to control arterial hypertension and it is often obtained by combining several medicaments in small doses, with reduction of negative side effects and enhancement of the positive effect. It is also important to know that some of these drugs, such as ACE inhibitors and so-called receptor antagonists, in addition to the antihypertensive effect, also have a specific renoprotective action.

6. In the case of diabetes, make sure to obtain well-controlled glycemic levels, with values ​​of the so-called glycated hemoglobin as close as possible to the norm, and also in this case check blood pressure very well and resolve any overweight conditions, says the kidney specialist in Noida.

7. Maintaining a proper diet and careful control of body weight, which is always important: taking medications does not authorize you to neglect dietary rules.

8. Do not resign yourself to living with urinary tract infections, kidney stones or chronic obstruction of the urinary tract, for example from prostatic hypertrophy.

9. Avoid prolonged use of potentially nephrotoxic drugs, such as analgesics or anti-inflammatory drugs, especially if taken without medical supervision; this does not mean that those who need it should give it up, but it is advisable, if you use them frequently, to remember to check the kidney situation periodically, advices the kidney specialist in Gurgaon.

10. Carry out, even if it feels good, a simple urinalysis during other laboratory tests, or in any case with a two-year deadline, and do not neglect any minor anomalies revealed by the urinalysis, such as blood or proteins in very large quantities modest. On the other hand, it should not be forgotten that in some situations, such as in the presence of kidney damage due to high blood pressure or arteriosclerosis, the urine test is often normal for a long time.

11. Perform, under all risk conditions, a check on renal function with the determination of creatininemia, possibly repeating it at regular intervals, for example annual, or every six months if the risk is high. Creatinine is a muscle mass product which is eliminated by the kidney and accumulates in the blood when kidney function decreases. Blood values ​​above 1.2 mg / dl in women and 1.4 mg / dl in men may indicate functional kidney damage and warrant further investigation. Using simple mathematical formulas and commonly used calculators it is easy to deduce the value of renal filtration from creatininemia. This control, which has supplanted the traditional one of blood urea nitrogen, can constitute a first alarm bell, particularly important when the urine test is normal, for an evolutionary nephropathy.

12. Be careful of minor and nonspecific signs of kidney disease, such as edema of the lower limbs, hypertension, even if not constant, chronic or relapsing urinary tract infections, the emission of urine of a different color or odor than usual.

All these signs do not always indicate the presence of kidney disease or urinary tract, but it is best to make sure that they are truly harmless, suggests the nephrologist in Delhi.