Kidney disorders occur when the kidneys do not function normally.
The kidneys, a pair of organs located on the left and right side of the abdomen, are an essential component of the urinary tract. The kidneys are responsible for removing toxins, chemicals, and waste products from the blood. These organs also regulate acid concentration and maintain water and electrolyte balance in the body by excreting urine.
Nephropathy is a term that is used to describe kidney damage. Many diseases and disorders may lead to nephropathy or even kidney failure.
Examples of kidney disorders include Fanconi syndrome, glomerulonephritis, focal segmental glomerulosclerosis (FSGS), kidney cancer, kidney stones, and nephrotoxicity. These disorders may develop for a wide variety of reasons. Some disorders may be caused by exposure to toxic chemicals or medications, while others may be inherited.
Treatment and prognosis varies depending on the type and severity of the kidney disorder. Most patients are able to recover completely if they are diagnosed and treated in the early stages of the disease. However, if left untreated, many disorders may lead to kidney failure, which is a fatal condition, unless the patient receives a kidney transplant.
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common types and causes of kidney disorders
Fanconi syndrome: Fanconi syndrome occurs when the tubes in the kidneys do not work properly. Normally, the kidneys filter out waste products in the blood and regulate the amount of salt and other electrolytes in the body. They also reabsorb important molecules, including glucose, amino acids, small proteins, water, calcium, potassium, magnesium, bicarbonate, and phosphate. Patients with Fanconi syndrome are unable to reabsorb these molecules. As a result, the blood becomes overly acidic, and patients typically experience excessive thirst, increased urination, bone disease, and stunted growth.
Fanconi syndrome may be caused by inherited disorders. For instance, cystinosis galactosemia, glycogen storage disease, hereditary fructose intolerance, Lowe syndrome, Wilson disease, tyrosinemia, medullary cystic disease, and vitamin D dependency, have been shown to cause Fanconi syndrome.
In addition, some environmental factors may cause patients to develop Fanconi's syndrome later in life. For instance, exposure to heavy metals (e.g. cadmium, lead, mercury, platinum, or uranium), certain drugs (e.g. gentamicin), other substances (e.g. Lysol®, paraquat, toluene, and lysine supplements), and kidney transplantation may cause Fanconi syndrome.
Glomerulonephritis: Glomerulonephritis is a kidney disease that occurs when the kidneys are unable to properly remove waste and excess fluids from the body.
If the condition develops suddenly over a short amount of time it is considered acute. If glomerulonephritis develops gradually over a longer period of time, it is considered chronic.
Sometimes glomerulonephritis occurs by itself. In some cases, the condition may be caused by other illnesses, such as an autoimmune disease called lupus, a lung and kidney disease called Goodpasture's syndrome, diabetes, or immunoglobulin A (IgA) nephropathy. IgA nephropathy occurs when a protein, called immunoglobulin A, builds up inside the kidneys. Glomerulonephritis may also develop with diseases that cause inflamed blood vessels (vasculitis). Examples of vasculitis disorders that may cause glomerulonephritis include polyarteritis and Wegener's granulomatosis.
Glomerulonephritis may also develop after a bacterial or viral infection, such as streptococcus, HIV (human immunodeficiency virus), hepatitis B, or hepatitis C.
Focal segmental glomerulosclerosis (FSGS): Focal segmental glomerulosclerosis (FSGS) is a type of glomerular disease (disease that affects the glomeruli) that can cause permanent kidney disease in children and adults. It affects kidney function by attacking the glomeruli, the tiny structures inside the kidneys where blood is filtered. The term glomerulosclerosis is used to describe the scarring or hardening of the tiny blood vessels inside the kidneys. Consequently, protein and sometimes, red blood cells, leak into the urine.
The most common sign of FSGS is nephrotic syndrome, which is characterized by fluid in the body tissues that causes swelling (edema), excess protein in the urine (proteinuria), hypoalbuminemia (abnormally low levels of albumin, which is normally the most plentiful protein in the blood), and high cholesterol.
The cause of FSGS is usually unknown. However, some cases may be inherited.
Kidney cancer: The kidneys may develop cancer. The most common type of kidney cancer in adults is called renal cell carcinoma, which starts inside the cells that line tubes in the kidneys. The most common type of kidney cancer in children is called Wilms' tumor.
The exact cause of kidney cancer remains unknown. However, researchers believe that several factors, including smoking, obesity, high blood pressure, exposure to environmental toxins (e.g. asbestos), and exposure to radiation may increase a patient's risk of developing kidney cancer. In addition, patients who are undergoing dialysis or who have a history of von Hippel-Lindau disease or bladder cancer have an increased risk of developing kidney cancer.
If diagnosed and treated quickly, most patients experience a full recovery. However, if left untreated, kidney cancer may spread to other parts of the body.
Kidney stones (renal calculi): Kidney stones (also called renal calculi, urinary calculi, urolithiasis, or nephrolithiasis) usually develop when the urine becomes too concentrated. As a result, minerals and other substances in the urine form hard crystals on the inner surfaces of the kidneys. Overtime, these crystals may combine to form a small, hard mass, or stone. There are four different types of kidney stones: calcium stones (also called calcium oxalate stones), struvite stones, uric acid stones, and cystine stones.
Calcium stones are the most common type of kidney stones, accounting for 80% of cases. Calcium stones develop when there are high levels of calcium (hypercalcemia) and oxalate in the blood. Patients who consume excessive amounts of vitamin D or have overactive thyroids may have high levels of calcium in the blood. Vitamin D is found in many foods, including fish, eggs, fortified milk, and cod liver oil. The sun also helps the body produce vitamin D. Patients who consume large amounts of oxalic acid or undergo intestinal bypass surgery may have high levels of oxalate in the blood. Oxalic acid is found in some plants, such as spinach, alfalfa, angelica, black haw bark, and rhubarb.
Struvite stones are usually caused by chronic urinary tract infections. The bacteria that cause these infections release enzymes that increase the amount of ammonia in the urine. This excess ammonia may form large, sharp stones that can potentially damage the kidneys.
Uric acid stones form when there is excess uric acid in the urine. Uric acid is a waste product that is formed when the body breaks down proteins. These stones are usually caused by a cancer treatment called chemotherapy. It may also develop in patients who eat high-protein diets. Some patients are genetically predisposed to develop uric acid stones.
Cystine stones develop in patients who have an inherited disorder called cystinuria. This disorder causes the kidneys to release too many amino acids, which then form stones.
Nephrotoxicity: Nephrotoxicity is a term used to describe toxic damage in the kidneys. When the kidneys become damaged, they are unable to remove excess fluid and waste from the blood. As a result, the electrolytes in the blood, including potassium and magnesium, will build up to toxic levels. When there are high levels of potassium in the blood, the condition is called hyperkalemia.
Certain medications, such as cyclosporine (Neoral® or Sandimmune®), tenofovir (Viread®), and gentamicin (Garamycin®), may have a poisonous effect on the kidneys. This may occur if patients take doses that are too high. Patients with kidney disease have an increased risk of developing nephrotoxicity because their kidneys are already weakened.