The body has two kidneys, one on each side of the back. Their main function is to filter and clean our blood by reabsorbing important substances and removing waste through the urine. Kidneys play an essential role in our bodies, and their function is vital for our survival.
Changes in kidney function often result in urinary issues such as frequent urination or dark brown or foamy urine. Common kidney health-related problems are chronic kidney disease, renal cysts, renal stones and renal cancer.
At Aare Urocare, we provide discreet environment and specialised treatments tailored to your bladder, kidney and prostate conditions. We offer a range of treatments — from minimally invasive methods to surgical intervention.
Chronic Kidney Disease
Chronic kidney disease (CKD), or chronic renal disease, is a condition that refers to the gradual loss of kidney function over time. The kidney’s ability to filter blood is gradually lost in CKD, leading to high fluid levels and the accumulation of waste in the body. The kidneys become damaged and cannot filter blood the way they used to. The most common causes of CKD include diabetes and high blood pressure, both of which cause progressive damage to the kidney.
What Are The Symptoms of CKD ?
- Feeling tired or lethargic
- Having problems concentrating
- Loss of appetite
- Having problems sleeping
- Muscle cramps and twitches
- Sudden change in weight
- Swollen foot and ankles
- Puffiness around the eyes
- Dry, itchy skin
- Shortness of breath that gets worse on lying flat, on exertion
- Increased urination at night
- Decreased or no urine output
- Nausea and vomiting
- Sudden weight change
The main goal of CKD treatment is to halt and/or delay the progression of CKD, which can include treating and controlling the underlying cause of CKD. CKD is a complex illness, and treatment options vary among individuals as everyone’s risk factor profile is different. It is important to speak to a kidney specialist for a proper assessment. Some mainstays of treatment include:
There is no indefinite cure for Chronic Kidney Disease. However, it can be effectively managed to ease symptoms and prevent your condition from worsening. This includes:
– Lifestyle changes: Adopting a healthier lifestyle, such as regulating your salt intake, eating a healthy diet and quitting smoking.
– Medication: Taking medications that help control associated symptoms, such as high blood pressure and high cholesterol.
– Dialysis: Dialysis treatments to help perform kidney functions such as removing waste products from the body.
– Kidney transplant: For severe CKD in its late stages, a kidney transplant may be recommended to improve survival.
Your kidney specialist will run tests to discern what stage of kidney disease you are in and what caused your kidney disease.
After which, they will work with you in crafting a treatment plan based on your current condition, lifestyle and needs.
During haemodialysis, blood is pumped out of the body to a machine and returned via tubes that connect the patient to the machine. The dialysis machine serves a similar filtering function to the kidney – it helps to filter waste out of the blood and make sure important chemicals, salts, and nutrients are retained in the blood. Patients with end-stage kidney failure will often need long-term haemodialysis to help them.
PD is another alternative to haemodialysis. In PD, instead of using a machine to filter the blood, the inside lining of the patient’s own stomach is used. Holistic care is an important part of PD and a specialist team of nephrologists, dietitians, and nurses will be involved in your care.
A kidney transplant is an important treatment for CKD and is an avenue of treatment for suitable patients. Having a kidney transplant means that patients do not have to embark on dialysis. If there is a suitable candidate and donor, patients may be offered to do a kidney transplant if they are surgically fit. A pre- and post-transplant care team will be discussed with the patient in addition to the requirements to ensure good and proper long-term care.
Kidney/ Renal Cysts
Kidney cysts are round, fluid-filled pouches inside the kidney. Kidney cysts can be associated with serious diseases that can impair kidney function. However, most kidney cysts are known as simple kidney cysts, and they are present in 1 in 10 people, with the incidence of these cysts increasing as someone gets older. Simple renal cysts are non-cancerous and rarely cause complications.
Generally, renal cysts do not cause any signs or symptoms. However, if they grow large enough, symptoms may include:
- Dull pain on your back, near the flank
- Upper abdominal pain
- Fever if infected
Renal cysts are diagnosed by imaging tests of the kidneys (e.g. CT scan or MRI scan), and kidney function blood tests may also be taken to determine whether or not the cyst is affecting the kidney.
Overall, treatment is not necessary for kidney cysts that do not cause symptoms. Oftentimes, renal cysts are detected incidentally, i.e. on a scan that was not initially meant to analyse the kidney for cysts, for whatever medical indication. As long as there are no signs and symptoms, and as long as kidney function is not impaired by the cyst, no treatment is needed. Long term follow-up might be indicated to monitor for any growth or change in renal function due to the cyst.
However, if the kidney cysts cause symptoms, treatment can include:
- Drainage of the cyst
- Surgery to remove the cyst
Kidney/ Renal Stones
Kidney stones (also known as renal calculi) are deposits that form inside the kidney. They are hard and are typically made of minerals and salts. Kidney stones tend to form when the urine becomes concentrated, resulting in the minerals and salts solidifying and sticking together to form hard deposits.
There are many causes of kidney stones and they include dehydration, diets high in salt/protein/sugar, obesity, certain medical conditions (including digestive diseases and previous surgery, repeated urinary tract infections, etc.), and certain medical drugs. Having a family or personal history of kidney stones can also increase your likelihood of developing stones. Kidney stones can be found all over the urinary tract when they pass, which consists of the kidneys, bladder, ureter, and urethra.
Kidney stones typically do not cause symptoms unless they move around the kidney or when they are passed out of the kidney into the ureters. When the kidney stone is lodged in the ureters, it can block the flow of urine, which causes the kidney to swell and for the ureter to go into spasm, resulting in abdominal pain which can be very severe. Symptoms during such an episode are coined as renal colic, and they include:
- Severe, sharp pain in the side of the back below the ribs, which can radiate to the lower abdomen and groin and comes in waves and fluctuates
- Nausea and vomiting
- Painful urination
- Blood in the urine
- Nausea and vomiting
Passing kidney stones out into the urine can be painful, and the location of pain will vary based on how far the stone has moved down the urinary tract. However, stones cause no damage if they are recognised early and if treatment can be instituted. Your specialist will recommend treatment options based on the clinical scenario and the size of the kidney stone.
Sometimes, you may just be given some painkillers and an instruction to drink water in order for you to pass the stone. This can be the case if the stone is small and if the medical team thinks the stone can be passed out of the body with no complications.
To remove a stone, your specialist might pass a small, thin, hollow tube with a video camera attached to it (ureteroscope) through your urethra, into your bladder and ureter to remove the scope. Special tools can be used to break the stone or snare it such that it can pass out of the ureter and into the urine. A stent (a small removable tube) might be placed into the ureter to relieve the swelling and promote healing.
Sound waves can be used to send strong vibrations to the kidney stone and cause it to break into smaller pieces so that they can be passed into the urine.
A kidney stone can be removed via a small incision through your back. Surgery is generally only recommended if the renal stone is big or very hard.
To minimise your risk of kidney stones, some lifestyle changes include:
- Drinking enough water
- Adopting a diet low in salts
- Reducing your intake of calcium supplements (but maintaining a diet that is calcium-rich instead)
- Regular exercise
- Maintaining good control of your medical comorbidities.
Kidney/ Renal Cancer
Kidney cancer, or renal cell cancer, is a condition in which cancer cells form in the kidney tubules. The main risk factors for renal cancer include smoking and misuse of certain pain medications. Other risk factors include obesity, hypertension, a family history of kidney cancer, and having certain medical conditions that run in the family, including von Hippel-Lindau disease (VHL) and hereditary papillary renal cell carcinoma.
Typically, there are no symptoms in the early stages of kidney cancer, and they tend to only appear as the tumours increase in size. Symptoms of kidney cancer include:
- Loss of appetite
- Weight loss that is sudden, unexpected, and unintended over a short period
- Blood in the urine
- Pain on urination
- A lump in the abdomen
- Pain at the side of your back below the ribcage/flank that is not getting better
- Feelings of lethargy, chest pain, shortness of breath
The treatment of kidney cancer depends on the stage of the cancer as well as each patient’s age and medical background. Treatment modalities include:
- Surgery to resect the kidney
- Immunotherapy and targeted therapy
Also known as albuminuria, this symptom refers to having too much protein in the urine. High levels of protein could be indicative of a condition affecting the kidneys. Proteinuria often appears as foamy or frothy urine. However, the definite way to determine its presence would be through a urine test. Other accompanying symptoms may include:
- Oedema (swelling in the hands and feet, belly and face)
- Frequent urination
- Shortness of breath
As protein is meant to be filtered (in the kidney) and kept as nutrients for the body, protein in your urine could mean that your kidneys are not working as well as they should be, or that they are damaged.
Common causes of protein in the urine include:
- Kidney disease (diabetic nephropathy)
- Chronic kidney disease
- Kidney infection (pyelonephritis)
- Nephrotic syndrome
- Kidney stones
- Heart disease
- High blood pressure
Protein in your urine should not be overlooked as this could be an early sign of chronic kidney disease, and increases your risk of other conditions such as cardiovascular disease.
Treatment for proteinuria depends on its underlying cause. This could be conservative measures such as medication, diet changes and exercise.
Why you need a kidney specialist
A kidney specialist or urologist specialises in the diagnosis and treatment of conditions affecting the urinary tract. This includes the kidneys, bladder, and urethra, as well as the male reproductive system.
While a general doctor can provide basic treatment for urinary tract infections and other common urological conditions, a kidney specialist has specialised training and expertise in diagnosing and treating a wide range of urological conditions. They are also better equipped to deal with any complications arising from kidney and urological issues. They are the best placed to perform surgical procedures to treat kidney, prostate and bladder issues.
The kidneys play an integral part in filtering waste before it is excreted as urine in the body. When the kidneys fail, it often causes urinary issues as well and can be life-threatening when left untreated.
If you suffer from symptoms that may be related to kidney health, such as blood in your urine, painful urination and voiding issues, please consult a urologist for a proper diagnosis and a specialised treatment plan.
Dr Fiona Wu
Dr Fiona Wu is the Medical Director of Aare Urocare and an experienced Consultant Urologist.
Kidney Health and Kidney Stones Removal are among Dr Fiona’s clinical interests. She is a strong believer that kidney conditions are highly treatable with minimally-invasive techniques.
Terai, A. “Risk factors for renal cysts.” PubMed, https://pubmed.ncbi.nlm.nih.gov/15180627/. Accessed 6 June 2022.