Kidney Problems

Your kidneys filter waste and excess fluid that your body does not need. Their function is essential for good health.

Kidney Infections

A kidney infection occurs when bacteria in the bladder spreads into the ureters and kidneys. Repeated infections can cause kidney damage and, later, kidney failure.

Kidney Stones

Your kidneys filter out chemicals, wastes, and fluids that your body does not need. Some of these chemicals do not dissolve well and form crystals in the urine. Small crystals pass from the kidneys to the bladder. However, sometimes the crystals are larger, and cannot pass easily through the urinary tract. A clump of crystals of un-dissolved material in the urinary system is a stone. There are many substances that can make up a stone. A stone blocking the urinary system can be painful and dangerous.

There are multiple causes for the formation of renal stones such as inadequate daily water consumption, elevated levels of calcium, oxalate, or uric acid in the urine, high or low dietary consumption of certain foods and/or minerals, and urinary tract infection. A strong family history of kidney stones is common. An analysis of the stone composition as well as blood and urine analysis are important in determining the cause of stone formation. Our physicians feel it’s important not to just surgically treat a patient’s kidney stone(s) but also to do the necessary analysis to prevent further stone formation.

While some kidney stones may not produce symptoms (known as “silent” stones), people who have kidney stones often report the sudden onset of excruciating, cramping pain in their low back and/or side, groin, or abdomen. Typically, if you change body position, you will still have the pain. The pain typically waxes and wanes in severity, characteristic of colicky pain (the pain is sometimes referred to as renal colic). It may be so severe that it is often accompanied by nausea and vomiting. Kidney stones also characteristically cause blood in the urine. If infection is present in the urinary tract along with the stones, there may be fever and chills.

If you have any of these symptoms, you should call our office as soon as possible so we can diagnose and treat your condition.

Kidney Failure

Your kidneys keep your body functioning normally. They filter out the wastes and toxins your body does not need. When the kidneys start failing, toxic wastes build up in the blood. Blood salts like potassium and sodium cannot be regulated properly. When the kidneys are not able to cleanse wastes from the body, fluid and chemical imbalance occurs. This imbalance can lead to fluid retention, swelling, irregular heartbeat and death.

• Acute kidney failure – This is sometimes a reversible condition. It can be caused by an infection, kidney inflammation, ingestion of poison, serious injury, massive blood loss, burns, or medicine.
• Chronic kidney failure – This can be caused by diabetes, high blood pressure, congenital kidney problems, recurrent kidney infections, kidney stones, or an enlarged prostate that blocks the flow of urine.
• End-stage kidney failure or renal disease – This means that the damage is severe enough that the kidneys are not working adequately. This is a permanent failure of the kidneys. The fluid and chemical imbalance in the body becomes serious when kidney damage is severe and must be treated.

Kidney Failure

According to the American Cancer Society 2009 Statistics, neoplasms of the kidney account for 5% of all male cancers and approximately 3% of female cancers. For a detailed discussion of the diagnosis and management of kidney cancer, click here for the American Urological Association’s clinical guidelines. The most common kidney cancers:

• Renal Cell Carcinoma – This is cancer of the parenchyma (body) of the kidney. Symptoms may include blood in the urine or flank pain; however, most patients do not have symptoms at the time a tumor is found. Surgery is the only highly effective treatment for this type of cancer. Removal of the entire kidney may be necessary but attempts to save as much kidney tissue as possible are always considered depending on the size and location of the tumor. These kidney sparing approaches include partial removal of the kidney which can be done with minimally invasive surgery (laparoscopic).◦ Arises from the proximal tubular cell of the glomerulus and is an adenocarcinoma. This is by far the most common malignancy of the kidney.
• The classic triad of symptoms traditionally associated with renal cell carcinoma (which are hematuria, flank pain, and weight loss) are now rarely seen.
• It is much more common for renal cell carcinomas to be diagnosed incidentally during evaluation for abdominal pain or other abdominal complaint.
• Transitional Cell Carcinoma – This is cancer arising from the tissue lining the hollow portion of the kidneys, down through the ureters to the bladder, the bladder, and ending in the urethra (tube from bladder through penis). The majority of these tumors originate in the bladder (bladder cancer). The main treatment option is surgery. Cystoscopic and/or Ureteroscopic surgery (resecting the tumor(s) via a small telescopic-like instrument inserted into the bladder and/or the ureter and kidney) is usually the initial treatment. If the tumor is located in the kidney and/or the ureter, complete removal of these organs is often indicated, depending on the size and grade (aggressiveness) of the cancer, and the function of the other kidney. With bladder cancer, the organ can be spared in the majority of cases using routine cystoscopic techniques as well as immunotherapy and chemotherapy agents which are placed into the bladder. Our urologists are now able to successfully resect many small bladder tumors in our office using local sedation with minimal discomfort.
• Wilm’s Tumor
• Angiomyolipoma

Hydronephrosis

The kidneys continuously process blood as it flows through millions of intricate filter mechanisms called glomeruli. The kidneys help the body balance the volume, pH, and composition of fluid by expelling or reabsorbing electrolytes and a myriad of other substances in the blood. Urine is the end product of this filtering process. Urine flows from the kidneys to the bladder through a pair of small muscular tubes called ureters. The point where the kidney collecting system meets the ureter is called the ureteropelvic junction or UPJ for short.

If the outflow of urine becomes blocked, it causes a backup of urine into the kidney; a condition that is called hydronephrosis. If the obstruction occurs at the level of the UPJ, it’s called a UPJ obstruction. If the ureter becomes obstructed further downstream, or if the bladder is unable to effectively expel urine, the resulting back pressure can cause hydronephrosis.

Children may be born with a congenital UPJ obstruction. This congenital condition is called an ‘obstruction’ because the kidney collecting system appears dilated on a radiology study. Even so, there may not be a ‘functional’ obstruction; that is, urine may still flow normally through the UPJ despite the appearance of an obstruction. Further testing can determine whether the apparent obstruction is significant or not. Moreover, the dilated appearance often remains stable or improves without intervention. The exact cause of a congenital UPJ obstruction is often unknown, but experts theorize that muscular tissue in the region of the UPJ fails to contract normally, which impedes the flow of urine; thereby causing obstruction. If a UPJ obstruction is asymptomatic, the condition may never be detected.

If a UPJ obstruction, or any other cause of hydronephrosis, causes a significant obstruction, though, symptoms usually prompt patients to seek medical advice.