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How To Protect Kidneys From Further Damage?
Question: I experienced an infarction of my right kidney in December 2012. The initial onset was extremely sudden: pain in R side, headache and nausea within five minutes of each other, had been asymptomatic prior to that. Initial tests showed no blood in urine, no elevated white count, CT scan ruled out kidney stones. Was sent home after overnight observation and pain under control. Ten days later identical symptoms re-appeared, CT showed infarction covering about 20% of upper portion of R kidney. No cause was ever determined - blood clots, inflamatory diseases, etc. many tests all came back negative - they even checked for fibromuscular dysplasia - not it. This past week, over course of an afternoon and into evening I experienced increasing feeling of bloating and dull ache in abdomen. Pain intensified and settled into L side just under ribs, went to ER. Pain radiated around across lower back, excruciating. Blood work showed no blood in urine, but presence of bacteria, very very slight uptick in WBC count, I had no fever or headache. I was released ten hours later after the pain subsided (with help of medication) with a diagnosis of probable pyelonephritis. My family physician has been monitoring my kidney function via blood work every three or four months since Dec 2012, and it is generally fine - occasional low GFR. My questions are: #1 - are these two events indicative of progressive kidney disease ? and #2 If so, what can be done to protect my kidneys from further damage?
Brief Answer:
renal infarction
Detailed Answer:
Hi XXXX
Infarction of right kidney- Infarction of kidney is a significant event and can be because of atherosclerotic disease ( calcium and cholesterol deposit in the arteries), Hypercoagulable states ( protein c and s deficiency ), some connective tissue disorders, sickle cell disease, post cardiac catheter interventions and valvular heart disease. I am sure your doctor must have tried to find the cause of infarction at that time. To prevent it from recurring a 6 month course of anti coagulant therapy is generally given and if a cause is identified and it is treatable then action is taken.
infarction may or may not recur. common symptoms are pain vomiting and blood in urine.
present episode of pain can be--
1. a similar episode of infarction in the left kidney,
2. pyelonephritis ( infection of the kidney) but then you should have fever and urine test should show WBC in large number in microscopic examination.
3. back pain from spine- this can be differentiated from the other causes by the fact that it increases by movement like bending to pick something from the floor.
Your doctor can examine you to pinpoint the cause.
Infraction can be diagnosed best by a CT scan.
Renal function monitoring is best done by serum creatinine level or estimated GFR levels. Once the GFR is reduced to less than 50ml/min or serum creatinine is increases. the disease is self progressive. but the rate of progression may be so slow that your kidney may last for you 10 to 20 years. but it can be faster also . So that is the job of the nephrologist to see what are the factors that can be modified to control the rate of progression of the kidney disease. Coming to your questions--
The two events do not describe progression of kidney disease. - that can only be concluded if there is a serial rise or serum creatinine levels or a fall in GFR levels.
what can be done- the cause of kidney damage if identified should be treated. If it is repeated episodes of infarction then anti coagulants, if it is pylonephritis then antibiotics. dietary restrictions as per the GFR levels should be followed. stop any use of painkiller ( NSAIDS) medicines, avoid tobacco products. blood pressure control if high are other measures that will decrease progression of disease.
You have to be in regular follow-up of your doctor.
Best wishes.
renal infarction
Detailed Answer:
Hi XXXX
Infarction of right kidney- Infarction of kidney is a significant event and can be because of atherosclerotic disease ( calcium and cholesterol deposit in the arteries), Hypercoagulable states ( protein c and s deficiency ), some connective tissue disorders, sickle cell disease, post cardiac catheter interventions and valvular heart disease. I am sure your doctor must have tried to find the cause of infarction at that time. To prevent it from recurring a 6 month course of anti coagulant therapy is generally given and if a cause is identified and it is treatable then action is taken.
infarction may or may not recur. common symptoms are pain vomiting and blood in urine.
present episode of pain can be--
1. a similar episode of infarction in the left kidney,
2. pyelonephritis ( infection of the kidney) but then you should have fever and urine test should show WBC in large number in microscopic examination.
3. back pain from spine- this can be differentiated from the other causes by the fact that it increases by movement like bending to pick something from the floor.
Your doctor can examine you to pinpoint the cause.
Infraction can be diagnosed best by a CT scan.
Renal function monitoring is best done by serum creatinine level or estimated GFR levels. Once the GFR is reduced to less than 50ml/min or serum creatinine is increases. the disease is self progressive. but the rate of progression may be so slow that your kidney may last for you 10 to 20 years. but it can be faster also . So that is the job of the nephrologist to see what are the factors that can be modified to control the rate of progression of the kidney disease. Coming to your questions--
The two events do not describe progression of kidney disease. - that can only be concluded if there is a serial rise or serum creatinine levels or a fall in GFR levels.
what can be done- the cause of kidney damage if identified should be treated. If it is repeated episodes of infarction then anti coagulants, if it is pylonephritis then antibiotics. dietary restrictions as per the GFR levels should be followed. stop any use of painkiller ( NSAIDS) medicines, avoid tobacco products. blood pressure control if high are other measures that will decrease progression of disease.
You have to be in regular follow-up of your doctor.
Best wishes.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dr. Bansal: Thank you for this comprehensive reply. I have been off all NSAIDs since Dec 2012 - which has been difficult due to arthritis pain (still managing to take martial arts classes 3-4 times per week - 3rd degree black belt) My follow-up question is: What are the dietary restrictions to be followed regarding GFR levels?
P.S. Just so you know, I do follow up with my primary care physician on a regular basis. I have not seen her since the most recent event. Due to the holiday weekend she only received the hospital's report today, and I expect she will be in contact with me by tomorrow re whether or not she wants me to come in. Again, thank you.
YYYY@YYYY
P.S. Just so you know, I do follow up with my primary care physician on a regular basis. I have not seen her since the most recent event. Due to the holiday weekend she only received the hospital's report today, and I expect she will be in contact with me by tomorrow re whether or not she wants me to come in. Again, thank you.
YYYY@YYYY
Brief Answer:
diet in CKD
Detailed Answer:
Diet,
proteins- 0.8 gm per kg / day
calories - 35 kcal/kg /day
avoid juices and dry fruits.
decrease meat products.
less salt , avoid foodstuff rich in potassium and phosphorus.
Best wishes
diet in CKD
Detailed Answer:
Diet,
proteins- 0.8 gm per kg / day
calories - 35 kcal/kg /day
avoid juices and dry fruits.
decrease meat products.
less salt , avoid foodstuff rich in potassium and phosphorus.
Best wishes
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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