Diagnosis & Treatment (Nephrology)

This sub-category of Diagnosis & Treatment (Nephrology) deals with the different diagnosis methods and treatment options for kidney disease.

  • Urine examination, blood examination, and imaging examination are the ways to diagnose kidney disease.
  • Urine examination includes test strip methods, protein analysis, urine sediment, and bacteriological examination. Additionally, other examination methods like determination of specific gravity, minerals, and urine sodium can help detect nephrology disease.
  • Blood examination plays another crucial role in the diagnosis & treatment of nephrological disease. It includes Creatinine, cystatin C, glomerular filtration rate (GFR), urea, phosphate, calcium and parathormone, erythrocytes, hemoglobin, iron metabolism, blood gas analysis, immunological parameters, etc.
  • The different types of diagnostic imaging tools for kidney disease are sonography (ultrasound), computed tomography scan (CT scan), magnetic resonance tomography (MRT), digital subtraction angiography (DSA), kidney perfusion scintigraphy, and kidney biopsy.
  • Tools for diagnostic imaging can help confirm conditions that a doctor might have suspected by revealing what is going on inside the body with certainty. To properly diagnose and treat you, your doctor may order any number of examinations if he recommends imaging.
  • Usually, treatment decision is made based on symptoms, other health issues, remaining kidney function, and nutritional health.
  • Medicines may help treat and manage acute and chronic kidney diseases.
  • Kidney failure, also called end-stage renal disease (ESRD), is a condition (GFR <15 ml/min) in which the kidneys cannot function properly.
  • Kidney transplantation and dialysis (hemodialysis or peritoneal dialysis) are two treatment options for ESRD.
  • Hemodialysis is the most used treatment option to remove waste and extra fluid from the blood using soft tubes, an artificial kidney (dialyzer), and a machine.
  • Treatment for kidney failure called peritoneal dialysis uses the lining of your stomach, or belly, to filter blood inside the body.
  • A kidney transplant is an operational procedure in which a healthy kidney from a deceased or living donor is transplanted into a patient whose kidneys function no longer properly.

Post-Transplant Erythrocytosis (PTE)

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Post-Transplant Erythrocytosis (PTE)

Introduction Post-transplant erythrocytosis (PTE) is defined as elevated hemoglobin (Hb) levels greater than 17 g/dL or hematocrit (Hct) levels greater than 51% for more than six months in the absence of thrombocytosis, leukocytosis, or another probable source of erythrocytosis following kidney transplantation. Erythrocytosis, also called polycythemia, is a disorder of red blood cells that occurs … Read more

Lithotripsy: Kidney Stone Treatment

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Lithotripsy

Introduction Lithotripsy is a medical procedure used to break up kidney stones and other stones in the urinary tract into smaller fragments so that they can be more easily passed out of the body. Types of Lithotripsy Extracorporeal Shock Wave Lithotripsy (ESWL) Intracorporeal Lithotripsy Electrohydraulic Lithotripsy (EHL) Laser Lithotripsy Ultrasound Lithotripsy Indications of Lithotripsy Lithotripsy … Read more

Kidney Transplant (Renal Transplant)

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Kidney (Renal) Transplant

Introduction A kidney (renal) transplant is a surgical procedure that replaces a damaged kidney with a healthy kidney obtained from a donor. The best replacement therapy for people with end-stage renal disease (ESRD) is a kidney transplant since it extends lifespan and quality of life. Advantages of Kidney Transplant Indications of Kidney Transplant Contraindications of … Read more

Kidney Biopsy

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Kidney Biopsy

Introduction A kidney (renal) biopsy is an invasive diagnostic technique that is performed to collect a segment of renal tissue, generally with the use of a needle or similar surgical tool. In patients with the renal parenchymal disease, kidney biopsy continues to be the gold standard for diagnosis, treatment, and prognosis prediction. Indications of Kidney … Read more

The Acid Concentrate in Bicarbonate Dialysis

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Acid Concentrate

The Acid Concentrate in Bicarbonate Dialysis The acid concentrate is vital in bicarbonate dialysis. Due to the diffusion of dissolved substances from the blood into the dialysis solution and vice versa, the blood concentrations can be increased, decreased, or kept constant. Sodium Sodium significantly influences the volume and osmolarity of the extracellular fluid. Therefore, sodium … Read more

Recirculation in Hemodialysis (Access Recirculation)

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Recirculation in Hemodialysis

Recirculation Recirculation in hemodialysis occurs when blood that has already been dialyzed is fed back into the dialyzer. Causes of Recirculation in Hemodialysis Fistula-Related Recirculation Cardiopulmonary Recirculation Blood Tubing System-Related (extracorporeal circuit) Recirculation The Vascular Access The Blood Tubing System Recognizing Recirculation during Hemodialysis Measuring Method of Recirculation in Hemodialysis Urea based Non-urea based The … Read more

Effectiveness of Hemodialysis

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Kt/V

As the effectiveness of hemodialysis depends on the urea value, let´s first understand urea. Each dialysis facility must record and report the so-called quality indicators of every patient quarterly. These include:  Measurement of the effectiveness of hemodialysis There are mainly two ways to measure the effectiveness of hemodialysis. The Urea Reduction Rate (URR) K×t/V K … Read more

Proportioning of Dialysis Solution

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Proportioning of the Dialysis Solution Proportioning means the defined enrichment of the dialysis solution with electrolytes. The electrolytes are now available as an acid concentrate in liquid form in containers, canisters, and the bicarbonate – as Bicart or Bibag. The acid concentration usually contains five electrolytes: sodium (Na+), potassium (K+), calcium (Ca2+), magnesium (Mg2+), and … Read more

Dialysate (Dialysis Solution)

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Dialysate Components

Dialysate (Dialysis Solution for the Hemodialysis) Dialysate, also called dialysis fluid or dialysis solution, is a simple composition of pure treated water, an acidic component (acid) and a base component (sodium bicarbonate). It is mixed in the dialysis machine before it comes to the dialyzer. The electrolyte and acid-base imbalances are typical effects of end-stage … Read more

Bicarbonate in Bicarbonate Dialysis

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Bicarbonate in Bicarbonate Dialysis There is a significant role of bicarbonate in bicarbonate dialysis. Two concentrates are used in bicarbonate dialysis: the so-called acid component and a bicarbonate solution (8.4%). Bicarbonate Buffer Hydrogen ions (H+) formed during metabolism are buffered to form carbonic acid (H2CO3), which decomposes into carbon dioxide (CO2) and water (H2O). Carbon dioxide … Read more