The composition of blood is kept constant mainly through the selective elimination of water and solutes by the kidneys rather than by these materials in food. This control involves balancing the body’s input of ions and water with the amounts excreted. Disease of kidneys, and in some instances of the ureter, bladder and urethra, reduce the efficiency of the kidney’s functions, disturbances in protein, acid-base solute and water homeostasis and in excretion of the metabolic end-products will result.
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 uremia (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. It is inflammation of the glomeruli, small round filters located in the kidney. The most common type of nephritis is glomerulonephritis.
Acute glomerulonephritis usually develops a few weeks after a strep infection of the throat or skin. Symptoms of glomerulonephritis include fatigue, high blood pressure, and swelling (especially in the hands, feet, ankles and face). With proper medical treatment, symptoms usually subside within a few weeks, or at the most, a few months.
Pyelonephritis usually occurs suddenly, and the acute form of this disease is more common in adult women. It is commonly caused when bacteria are carried into the urinary tract by the backward flow of urine from the bladder. Symptoms include fever and chills, fatigue, burning or frequent urination, cloudy or bloody urine, and aching pain on one of both sides of the lower back or abdomen. It can be treated successfully if diagnosed early. Follow-up urinalysis studies will determine if the patient remains bacteria-free. If the infection is not cured or continues to recur, it can lead to serious complications such as bacteraemia (bacterial invasion of the bloodstream), hypertension, chronic pyelonephritis and even permanent kidney damage. Patients who are severely ill with acute pyelonephritis may need to be hospitalized.
Kidney stones are solid accumulations of material that form in the tubal system of the kidney. They 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 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. Sometimes, tiny crystals called “silent stones” may form in the urine that never cause any pain. Kidney stones cause problems when they interfere with the normal flow of urine. They can block the flow down the ureter – the tube that carries urine from the kidney to the bladder. Because the kidney isn’t used to feeling any pressure, when pressure builds from backed-up urine the kidney may swell. If the kidney is subjected to this pressure for some time, it may damage delicate kidney structures.
Nephrotic syndrome refers to a large protein loss in the urine frequently in association with low blood protein levels, an elevated blood cholesterol and severe retention of body fluid, causing swelling. This disease can be a primary disorder of the kidney or secondary to an illness, affecting many parts of the body.
Long-standing high blood pressure (hypertension) 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. Long standing diabetes can lead to kidney failure. However, tight control of blood glucose levels over the years may reduce those complications. Certain medications, toxins, pesticides and “street” drugs (i.e., heroin) can also produce kidney damage.
Post-Text Assignments I. Arrange the following words in pairs of synonyms.
II. Translate and memorize the following words and phrases.
a) a substance that makes the urine less acidic; to cling to each other; a solid mass; to notice blood in urine; to move closer to the bladder; to feel pain in the vulva; to determine chemical composition; a number of reasons for stone formation; surgical removal of a stone; to allow the stone to be crushed; to be removed through an incision; to prevent certain types of kidney stones; the cause of stone formation.
b) стрептококова інфекція горла чи шкіри; бути розмішеним у нирці; вітамінні добавки; виникати раптово; гостра форма захворювання; часте сечовипускання; пити багато рідини; тверде накопичення; блокувати потік сечі; розчиняти речовини; наявність каміння; помічати кров у сечі; спричинити утворення каміння; приймати сечогінні препарати; подрібнювати каміння.
III. Arrange the following words in pairs of antonyms.
IV. In each set of words one is the odd one out: different from the others. Find the word that is different and say why.
nephritis pyelonephritis kidney
Kidney is the odd one out. It is an organ; the others are kidney diseases.
polycystic kidney disease
V. Match the terms with their definitions.
inflammation of a kidney
exceeding the normal or permitted excreting of urine
inflammation of the urinary bladder
the act or an instance of the kidney failing
bacterial invasion of the bloodstream
a period of illness
any of various kidney diseases in which the glomeruli are affected
VI. Complete the following sentences choosing suitable words form the box.