shanika@sundayobserver.lk

Renal failure:

The silent scourge

World Kidney Day March 8 :

Renal failure is on the rise not only in Sri Lanka but also worldwide. Since there is no particular cause for the malfunctioning of one's kidneys, health experts say that it can be controlled through a balanced diet, proper exercises and also taking immediate steps to control diabetes and hypertension, which are silently damaging the kidneys.

What are kidney diseases?

Kidney diseases are disorders that affect the kidneys; the two organs that remove waste products, produce certain hormones, and regulate the level of chemicals in blood.

How does the kidney function?

A major function of the kidneys is to remove waste products and excess fluid from the body. These waste products and excess fluid are removed through urine.

The production of urine involves highly complex steps of excretion and reabsorption.

This process is necessary to maintain a stable balance of body chemicals.

The critical regulation of the body's salt, potassium, and acid content is performed by the kidneys. The kidneys also produce hormones and vitamins that affect the function of other organs. For example, a hormone produced by the kidneys stimulates red blood cell production. In addition, other hormones produced by the kidneys help regulate blood pressure and others help control calcium metabolism.

There are two kidneys, each about the size of a fist, located on either side of the spine at the lowest level of the rib cage. Each kidney contains about one million functioning units, called nephrons.

A nephron consists of a filtering unit of tiny blood vessels, called a glomerulus, attached to a tubule. When blood enters the glomerulus, it is filtered and the remaining fluid passes along the tubule. In the tubule, chemicals and water are either added to or removed from this filtered fluid, according to the body's needs, with the final product being the urine we excrete.

Types of kidney diseases?

Kidney disease usually affects both kidneys. If the kidneys' ability to remove and regulate water and chemicals is seriously damaged by disease, waste products and excess fluid build up occur, causing severe swelling and symptoms of uraemia (kidney failure).

There are many different types and causes of kidney disease. These can be characterized as hereditary, congenital or acquired.

Hereditary Disorders

These can be transmitted to both males and females, and generally produce clinical symptoms from teenage years to adulthood. The most prevalent hereditary kidney condition is polycystic kidney disease. Other hereditary conditions include Alport's syndrome, hereditary nephritis, primary hyperoxaluria and cystinuria.

Congenital Disease.

This usually involves some malformation of the genitourinary tract, usually leading to some type of obstruction which subsequently produces infection and/or destruction of kidney tissue. The destruction can eventually progress to chronic kidney failure.

Acquired Kidney Disease.

These diseases are numerous, the general term being nephritis (meaning inflammation of the kidney). The most common type of nephritis is glomerulonephritis, and again, this has many causes.

Kidney Stones.

These are very common, and when they pass, the pain can be extremely severe in the side and back. Stone formation can be an inherited disorder, secondary to a malformation and/or infection in the kidney, or can occur without any prior problem. The pain can appear suddenly and in waves, and then disappear rapidly when the stone is passed.

Nephrotic Syndrome

This refers to a large protein loss in the urine [frequently in association with low blood protein (albumin) levels, an elevated blood cholesterol and severe retention of body fluid, causing swelling (edema).

This disease can be a primary disorder of the kidney or secondary to an illness, affecting many parts of the body (for example diabetes mellitus).

Long-standing High Blood Pressure (hypertension)

This can cause kidney disease itself or can be a result of a kidney disorder. Uncontrolled high blood pressure can accelerate the natural course of any underlying kidney disease.

Diabetes.

Long standing diabetes can lead to kidney failure. However, tight control of blood glucose levels over the years may reduce those complications.

Drugs and Toxins

Certain medications, toxins, pesticides and "street" drugs (i.e., heroin) can also produce kidney damage.

Causes and Risk Factors of Kidney Diseases

Unfortunately, the cause of many kidney diseases is still unknown, but controlling high blood pressure and diabetes can reduce the risk of many kidney diseases.

Symptoms of Kidney Diseases

Although many forms of kidney disease do not produce symptoms until late in the course of the disease, there are at least six warning signs that may indicate kidney disease:

1. Burning or difficulty during urination

2. An increase in the frequency of urination

3. Passage of blood in the urine

4. Puffiness around the eyes, swelling of the hands and feet

5. Pain in the small of the back just below the ribs

6. High blood pressure

Diagnosis of Kidney Diseases

Your doctor will obtain a complete medical history and perform a physical exam. He or she may recommend blood tests and certain urine tests, which can provide much information about your kidney function.

Treatment of Kidney Diseases.

Some kidney diseases can be successfully treated and others progress to advanced kidney failure, requiring dialysis and/or transplantation.

For example, kidney infections and kidney stones can often be successfully treated. Chronic inflammation of the glomerulus (glomerulonephritis) is the most common kidney disease, which slowly progresses to kidney failure. Your doctor may recommend certain medications or suggest a specific diet for you.

Needles that heal all ailments

by Dr. Nalin Wasantha Kumara

New treatments may finally succed in putting one or two painless needles.

For most victims, Arthritis simply means pain, stiffness in the joints sometimes moderate, sometimes severe, usually responsive to treatment with one of a number of days. Pain can be just the beginning, though for all the people who suffer from the variant of the disease known as rheumatoid arthritis.

This unfortunate minority may experience not just discomfort but also joint deformities, fatigue, nodules at tissue under the skin and inside internal organs and in rare cases, inflammation of the membrane surrounding the heart and lungs.

Unfortunately, even the most powerful existing medications, are carrying unacceptable side effects or our clinicians are understandably a bit giddy, therefore, at the news that after more than a decade of no progress, not just one but a number of new treatments are all at once streaming out of research labs.

The natural pain relieving biochemical now, known as endorphins are endogenous morphine substances which are found in the pituitary and parts of the CNS. Enkephalin is a sub fraction of endorphin a neuron transmitter occurring in the brain at the same sites where opiate receptors have been found.

Both body acupuncture and ear acupuncture have been found to raise blood serum and cerebrospinal fluid CSF levels of endorphins and enkaphalins. Nuloyone is an opiate antagonist which blocks morphine, blocks endorphins, and also blocks the anal gesia produced by stimulation of auricular reflex points and body acupuncture points.

The excitement began with a growing understanding of how rheumatoid arthritis works. Unlike its mere common cousin osteoarthritis, which causes pain in more than 20 million mostly older Americans through simple deterioration of joint cartilage, rheumatoid arthritis is a complex disease involving an immune system gone awry.

Most experts believe the trigger for rheumatoid arthritis is an ordinary infection in a joint, to which the immune system mounts an ordinary response.

Then, for some unknown reason, the white blood cells that are fighting invading microbes attack the joint itself-specifically the synovial sac, which acts as both a cushion that keeps bones from banging together and a source of lubricating fluid.

Even as the white cells attack they send out signs, in the form of hormones called cytokines, that rally more troops to their aid. Meanwhile, the besieged synovial cells secrete prostaglandins, which cause inflammation. All this makes the joint redden and become sore.

Modern scientific researches has been found that acupuncture can benefit not only for arthritis but also headache, heavy bleeding flushes, white discharges, menopause depression. In addition to sexual disorders in male and female infertility, sterility, premature ejaculation, impotency.

Herpes, pain intercourse, in female and all sexual troubles. Asthma, sinusitis, migraine, skin disorders, eczema, psoriasis, pimples, overweight, cholesterol, gastritis, blood pressure, diabetes, Parkinson's disease. Paralysis, varicose vein psychological disorders, mental depression, insomnia, schizophrenia, hysteria, mania and phobia.

Mm.........Mm....It's constipation...

James knew he had to go. But when he got to the boys' bathroom at school, he sat down on the commode and nothing happened. He waited a couple of minutes and nothing. He tried hard but it kind of hurt. After a while a little poop came out, but it was small and hard, sort of like marbles.

James flushed, zipped up, and washed his hands. He didn't feel much better. Why? He was constipated.

What is Constipation?

Constipation (say: con-stuh-pay-shun) is not having a bowel movement (pooping) as often as you usually do or having a tough time going because the poop is hard and dry. Normal poop is sort of soft and easy to pass, so it shouldn't be too hard to have a bowel movement.

What Are the Symptoms?

Besides not pooping as often as you usually do, you may feel full and a little uncomfortable if you're constipated. Your belly may feel stretched, too. When you do go to the bathroom, you may feel like you have to work really hard to get the poop out, and it may hurt a little to go.

If your poop is hard and dry, pushing it out may cause tiny tears in the skin of your anus. If this happens, you might see a bit of blood on the toilet paper when you wipe. After you're done, you may have only gone a little and may feel like you still have to go.

Sometimes when a kid's really constipated, some watery poop like diarrhoea might leak out around the hard poop that's still inside. This can cause a messy accident, even for kids who stopped having accidents a long time ago.

If you think you're constipated, or if you see blood on the toilet paper after you wipe, tell your parents. It's probably no big deal, but it's a good idea to let them know what's going on.

Why Do Kids Get Constipated?

Constipation is pretty common, and different things can cause it. Some reasons why kids get constipated include:

Unhealthy diet. If you fill your diet with fatty, sugary, or starchy foods and don't eat enough fibre, your bowels may slow down. Fibre - found in fruits, vegetables, and whole grains - can keep your poop from getting hard and dry. So reach for an apple!

Not enough exercise. Moving around helps food move through your digestive system. If you don't get enough active play time - like running around outside - you could get constipated.

Not enough fluid. Drinking water and other liquids keeps poop soft as it moves through your intestines. When you don't drink enough, the poop can get hard and dry, and you might get stopped up.

Not going to the bathroom when you need to. Sometimes kids don't go to the bathroom when they have to. Maybe they don't want to use the bathroom at school, or maybe they just don't want to stop what they're doing right then. But if you make a habit of ignoring your body's signals that it's time to go, that might make it harder to go later on.

Stress. Kids may get constipated when they're anxious about school or something at home. This can happen during scary events, like starting at a new school, or even if you're just worried about a lot of homework and tests coming up. If you think stress is plugging things up for you, talk to an adult you trust about it.

Irritable bowel syndrome. Some kids have a condition called irritable bowel syndrome (IBS). It can act up when they're stressed or when they run into certain triggers, like fatty or spicy foods.

A kid who has IBS may have constipation sometimes and diarrhoea sometimes, as well as belly pain and gas. Some medical conditions - like diabetes, lupus, or problems with the thyroid gland - can also cause constipation, but these aren't that common in kids.

If you're worried that your constipation is a sign of something else, talk to your parents and your doctor.

How Is It Treated?

If you're constipated you probably won't need any special treatment. Chances are you'll soon start going regularly again on your own.

If your doctor decides you should come in for a visit, he or she might suggest some medicine or something else to get you going. But don't take any medicine for your constipation unless your doctor recommends it.

Other than some medicine, the doctor might order an X-ray or other types of tests that look inside your digestive system. But usually constipation is just constipation. You eventually poop and feel better.

What Can I Do to Help Myself?

You can follow these steps when you're constipated and even when you're not! Drink plenty of water. This can keep your poop from getting too hard and dry. Eat more fibre. Fruit, vegetables, and whole grains, such as oatmeal and popcorn, all add fibre to your diet. And fibre can keep things moving.

Exercise. Throw a ball with your friends, ride your bike, or shoot a few hoops. Activity helps you go to the bathroom regularly. In other words, if you get moving, your bowels will, too!

kidshealth.com