Kidney disease
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Kidney disease | |
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Other names | Renal disease, nephropathy |
Pathologic kidney specimen showing marked pallor of the cortex, contrasting to the darker areas of surviving medullary tissue. The patient died with acute kidney injury. | |
Specialty | Nephrology, urology |
Complications | Uremia, death |
Kidney disease, or renal disease, technically referred to as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by blood tests. Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to nephritic syndrome and nephrotic syndrome respectively. Kidney disease usually causes a loss of kidney function to some degree and can result in kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option.
Chronic kidney disease is defined as prolonged kidney abnormalities (functional and/or structural in nature) that last for more than three months.[1] Acute kidney disease is now termed acute kidney injury and is marked by the sudden reduction in kidney function over seven days. In 2007, about one in eight Americans had chronic kidney disease.[2] This rate is increasing over time[1] to where about 1 in 7 Americans are estimated to have CKD as of 2021.[3]
Causes
Causes of kidney disease include deposition of the
Analgesics
One cause of nephropathy is the long term usage of pain medications known as
Specifically, long-term use of the analgesic phenacetin has been linked to renal papillary necrosis (necrotizing papillitis).
Diabetes
Diabetic nephropathy is a progressive kidney disease caused by
Autosomal dominant polycystic kidney disease
Gabow 1990 talks about Autosomal Dominant Polycystic Kidney disease and how this disease is genetic. They go on to say "Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disease, affecting a half million Americans. The clinical phenotype can result from at least two different gene defects. One gene that can cause ADPKD has been located on the short arm of chromosome 16."[5] The same article also goes on to say that millions of Americans are effected by this disease and is very common.
COVID-19
COVID-19 is associated with kidney disease. In patients hospitalized with COVID-19, the prevalence of acute kidney injury is estimated to be 28%, and the prevalence of renal replacement therapy is estimated to be 9%.[6]
Diet
Higher dietary intake of animal protein, animal fat, and cholesterol may increase risk for microalbuminuria, a sign of kidney function decline,[7] and generally, diets higher in fruits, vegetables, and whole grains but lower in meat and sweets may be protective against kidney function decline.[8] This may be because sources of animal protein, animal fat, and cholesterol, and sweets are more acid-producing, while fruits, vegetables, legumes, and whole grains are more base-producing.[9][10][11][12][13][14][15][16][17][18]
IgA nephropathy
IgA nephropathy is the most common
Iodinated contrast media
Kidney disease induced by iodinated contrast media (ICM) is called
Lithium
Lithium, a medication commonly used to treat bipolar disorder and schizoaffective disorders, can cause nephrogenic diabetes insipidus; its long-term use can lead to nephropathy.[21]
Lupus
Despite expensive treatments, lupus nephritis remains a major cause of morbidity and mortality in people with relapsing or refractory lupus nephritis.[22]
Xanthine oxidase deficiency
Another possible cause of Kidney disease is due to decreased function of
Polycystic disease of the kidneys
Additional possible cause of nephropathy is due to the formation of cysts or pockets containing fluid within the kidneys. These cysts become enlarged with the progression of aging causing renal failure. Cysts may also form in other organs including the liver, brain, and ovaries. Polycystic kidney disease is a genetic disease caused by mutations in the PKD1, PKD2, and PKHD1 genes. This disease affects about half a million people in the US. Polycystic kidneys are susceptible to infections and cancer.
Toxicity of chemotherapy agents
Nephropathy can be associated with some therapies used to treat cancer. The most common form of kidney disease in cancer patients is acute kidney injury (AKI) which can usually be due to volume depletion from vomiting and diarrhea that occur following chemotherapy or occasionally due to kidney toxicities of chemotherapeutic agents. Kidney failure from break down of cancer cells, usually after chemotherapy, is unique to onconephrology. Several chemotherapeutic agents, for example cisplatin, are associated with acute and chronic kidney injuries.[23] Newer agents such as anti-vascular endothelial growth factor (anti-VEGF) are also associated with similar injuries, as well as proteinuria, hypertension, and thrombotic microangiopathy.[24]
Diagnosis
The standard diagnostic workup of suspected kidney disease includes a medical history, physical examination, a urine test, and an ultrasound of the kidneys (renal ultrasonography). An ultrasound is essential in the diagnosis and management of kidney disease.[25]
Treatment
Treatment approaches for kidney disease focus on managing the symptoms, controlling the progression, and also treating co-morbidities that a person may have.[1]
Dialysis
Transplantation
Millions of people across the world have kidney disease. Of those millions, several thousand will need dialysis or a kidney transplant at its end-stage.[26] In the United States, as of 2008, 16,500 people needed a kidney transplant.[26] Of those, 5,000 died while waiting for a transplant.[26] Currently, there is a shortage of donors, and in 2007 there were only 64,606 kidney transplants in the world.[26] This shortage of donors is causing countries to place monetary value on kidneys. Countries such as Iran and Singapore are eliminating their lists by paying their citizens to donate. Also, the black market accounts for 5–10 percent of transplants that occur worldwide.[26] The act of buying an organ through the black market is illegal in the United States.[27] To be put on the waiting list for a kidney transplant, patients must first be referred by a physician, then they must choose and contact a donor hospital. Once they choose a donor hospital, patients must then receive an evaluation to make sure they are sustainable to receive a transplant. In order to be a match for a kidney transplant, patients must match blood type and human leukocyte antigen factors with their donors. They must also have no reactions to the antibodies from the donor's kidneys.[28][26]
Prognosis
Kidney disease can have serious consequences if it cannot be controlled effectively. Generally, the progression of kidney disease is from mild to serious. Some kidney diseases can cause kidney failure.
See also
- Hematologic Diseases Information Service
- Mesoamerican nephropathy, an enigmatic chronic kidney disease of Central America
- Protein toxicity
References
- ^ PMID 27349639.
- PMID 17986697.
- ^ "Chronic Kidney Disease in the United States, 2021". www.cdc.gov. 2022-08-02. Retrieved 2022-10-09.
- ^ Longo et al., Harrison's Principles of Internal Medicine, 18th ed., p. 2982
- PMID 2239929.
- PMC 7723763. Retrieved 2024-04-05.
- PMID 20299364.
- PMID 21251540.
- PMID 24708763.
- PMID 12450898.
- PMID 20872351.
- PMID 7050706.
- PMID 24513954.
- PMID 21700817.
- PMID 24513976.
- PMID 25151260.
- PMID 23393104.
- S2CID 21268495.
- PMID 3329736.
- .
- S2CID 36253297.
- PMID 22982174.
- ^ Portilla D, Safar AM, Shannon ML, Penson RT. "Cisplatin nephrotoxicity". In: UpToDate, Palevsky PM (Ed), UpToDate, Waltham, MA, 2013. http://www.uptodate.com/contents/cisplatin-nephrotoxicity
- PMID 21146124.
- PMID 26838799.
- ^ a b c d e f Tabarrok, Alex (January 8, 2010). "The Meat Market". Wall Street Journal.
- ^ Scheve, Tom (7 May 2008). "How Organ Donations Work". HowStuffWorks. Retrieved 9 March 2015.
- ^ "The Waiting List". www.kidneylink.org. Archived from the original on 2017-07-13. Retrieved 2015-03-09.