Kidney diseases

1. RENAL DISORDERS
By
K. Sanjay
BD230907

2. Renal disorder
 Kidney disorder means the kidneys are damaged and can’t
filter blood the way they should.
The person are at greater risk for kidney disease if the person
have diabetes or high blood pressure.

3. Types
Glomerulonephritis
Diabetes Insipidus

4. Glomerulonephritis
Glomerulonephritis is a type of kidney disease.
It involves damage to the glomeruli (tiny filters) inside our
kidneys.
If you have glomerulonephritis, our kidneys can have trouble
removing waste and fluid from our body.
Many mild(Acute) cases resolve with treatment. If the condition
becomes severe(Chronic), it can lead to kidney failure.

5. Risk factors for glomerulonephritis
A personal or family history of kidney disease.
Taking certain medications.
Exposure to specific toxins.
Having certain viral infections or bacterial infections.
Having an autoimmune condition.

6. Complications of glomerulonephritis
Blood clots, including deep vein thrombosis (DVT) or
pulmonary embolism (PE).
Chronic kidney disease (CKD).
Hypertension (high blood pressure).
High cholesterol.
Kidney failure, which can happen quickly or after several years.
Nephrotic syndrome (nephrosis), with protein in the stool, often
leading to foamy stool and swelling in our body.

7. Causes glomerulonephritis
A complication of bacterial endocarditis, an infection in our
heart valves.
A complication of infections like strep throat, HIV or hepatitis
C.
Problems with our immune system attacking healthy parts of
our body, such as with lupus.
Genetics, meaning it runs in our biological family (this is rare).
Certain types of cancer (like multiple myeloma).

8. Symptoms of glomerulonephritis
 Blood in the stool.
 Nausea.
 Rash
 Shortness of breath.
 Pain in your joints or abdomen.
 Swelling in your legs or face.
 Stool that appears foamy or bubbly.
 High blood pressure.
 Jaundice.
 Weight loss

9. Diagnosis of glomerulonephritis
Urine test: This test will determine the protein or blood in our
urine.
Blood test: This test will measure the level of creatinine (a
waste product our kidneys filter) in a sample of our blood.
Kidney biopsy: A healthcare provider will use a needle to
remove a piece of tissue from our kidney and send it to a lab for
analysis.

10. Imaging tests: Our provider may order imaging tests such as
ultrasound, X-ray or CT scan. These tests check the size and
shape of our kidneys, look for blockages and help diagnose
other problems

11. Treatment for glomerulonephritis
 No specific treatment.
 Changes to your diet so eat less protein and salt, which put extra strain
on our kidneys.
 Immunosuppressants, if a problem with our immune system causes
glomerulonephritis.
 Medicine to lower our blood pressure, such as angiotensin-converting
enzyme (ACE) inhibitors or angiotensin blockers (ARB).
 Corticosteroids to decrease inflammation.
 Dialysis, which helps clean our blood, remove extra fluid and control
blood pressure.

12. Diabetes insipidus
Diabetes insipidus is a rare disorder that causes the body to
make too much urine. While most people make 1 to 3 quarts of
urine a day, people with diabetes insipidus can make up to 20
quarts(about19 litres) of urine a day.
People with this disorder need to urinate frequently, called
polyuria. They may also feel thirsty all the time and drink lots
of liquids, a condition called polydipsia.

13. Risk Factors for Diabetes Insipidus
A family history of diabetes insipidus
Medical history of a traumatic head injury or brain surgery
Use of certain medications that can lead to kidney problems,
including diuretics, and some prescriptions for mental health
conditions, such as lithium
History of metabolic disorders including high levels of calcium
in the blood or low levels of potassium in the blood

14. Complications of diabetes insipidus
The main complication of diabetes insipidus is dehydration, which
happens when our body loses too much fluid and electrolytes to work
properly.
Symptoms of dehydration may include:
 Thirst
 Dry mouth
 Feeling dizzy or light-headed when standing
 Feeling tired
 Difficulty performing simple mental tasks
 Nausea
 Fainting

15. Types of diabetes insipidus
Central diabetes insipidus
In central diabetes insipidus, your body doesn’t make enough vasopressin, also
called “antidiuretic hormone.” Vasopressin is produced in our hypothalamus, a small
area of our brain near the pituitary gland. When the amount of fluids in our body falls
too low, the pituitary gland releases vasopressin into our bloodstream. The hormone
signals our kidneys to conserve fluids by pulling fluids from our urine and returning
fluid to our bloodstream. But if our body can’t make enough vasopressin, the fluid may
get flushed out in our urine instead.
Causes of central diabetes insipidus include
 Damage to our hypothalamus or our pituitary gland from surgery, infection,
inflammation, a tumor, or a head injury
 An autoimmune disorder
 An inherited gene mutation

16. Nephrogenic diabetes insipidus
In nephrogenic diabetes insipidus, our body makes enough
vasopressin but our kidneys don’t respond to the hormone as they should.
As a result, too much fluid gets flushed out in our urine.
Causes include
 Low levels of potassium in your blood
 High levels of calcium in your blood
 A blocked urinary tract
 An inherited gene mutation
 Chronic kidney disease, though rarely

17. Dipsogenic diabetes insipidus
In this type of diabetes insipidus, a problem with our
hypothalamus causes the person to feel thirsty and drink more
liquids. As a result, may need to urinate often.
Causes include
Damage to our hypothalamus from surgery, infection,
inflammation, a tumor, or a head injury
Some medicines or mental health problems

18. Gestational diabetes insipidus
Gestational diabetes insipidus is a rare, temporary condition that can
develop during pregnancy. This type of diabetes insipidus occurs when the
mother’s placenta NIH(National Institutes of Health) external link makes
too much of an enzyme that breaks down her vasopressin.
Women who are pregnant with more than one baby are more likely
to develop the condition because they have more placental tissue. Because
the liver plays a role in curbing the enzyme that breaks down vasopressin,
diseases and conditions that affect liver function also increase risk.

19. Symptoms of Diabetes insipidus
Symptoms of diabetes insipidus in adults include:
 Being very thirsty, often with a preference for cold water.
 Making large amounts of pale urine.
 Getting up to urinate and drink water often during the night.

20. Symptoms of Diabetes insipidus
A baby or young child who has diabetes insipidus may have these symptoms:
 Large amounts of pale urine that result in heavy, wet diapers.
 Bed-wetting.
 Being very thirsty, with a preference for drinking water and cold liquids.
 Weight loss.
 Poor growth.
 Vomiting.
 Fever.
 Headache.
 Problems sleeping.
 Vision problems.

21. Diagnosis of Diabetes insipidus
Urinalysis NIH external link. A urinalysis can show if our urine is too diluted, or
watery. It can also show if the level of glucose in our blood is too high, which is caused
by diabetes mellitus, not diabetes insipidus.
Blood tests NIH external link. A blood test can measure sodium levels and the amount
of certain substances in our blood, which can help diagnose diabetes insipidus and, in
some cases, determine the type.
Water deprivation test. This test can help health care professionals diagnose diabetes
insipidus and identify its cause. The test involves not drinking any liquids for several
hours. A health care professional will measure how much urine the person pass, check
our weight, and monitor changes in our blood and urine. In some cases, the health care
professional may give a man-made version of vasopressin or other medicines during the
test.

22. Magnetic resonance imaging (MRI) NIH external link.
An MRI uses magnets and radio waves to make pictures of our brain
tissues. Our health care professional may order this test to look for damage
to our hypothalamus or pituitary gland that could cause diabetes insipidus

23. Treatment for diabetes insipidus
Central diabetes insipidus
Desmopressin is the first-line treatment for central diabetes insipidus. The
patient can take desmopressin as an injection (shot), a pill or in a nasal spray.
Gestational diabetes insipidus
Healthcare providers also sometimes use desmopressin to treat gestational
diabetes insipidus.
Dipsogenic diabetes insipidus
Healthcare may recommend the patient take a small dose of desmopressin at
bedtime.
Side effects of desmopressin:
Headache. Abdominal pain.
Nausea. A blocked or runny nose.
Nosebleeds.

24. Treatment for diabetes insipidus
Treatment for nephrogenic diabetes insipidus
 It is more complicated and sometimes involves a combination of
approaches.
 Healthcare providers often treat it with medications called thiazide
diuretics, which reduce the amount of urine our kidneys produce. Our
provider may also suggest taking non-steroidal anti-inflammatory drugs
(NSAIDs), such as ibuprofen, to help further reduce urine volume when
they’re used in combination with thiazide diuretics. If our medication
causes nephrogenic diabetes insipidus, our healthcare provider can
sometimes treat it by changing our medication.
 It might take a while to find the right combination that works best for
the patient.