KIDNEY AND URINARY TRACT       

       HEALTH for WOMEN AND MEN

What are the kidneys ?

The kidneys are bean shaped organs located near the middle of your back, just under the rib cage.  Most people have two kidneys, but it is possible to enjoy perfect health with only one, as is the case with kidney donors or people born with only one kidney.

What do the kidneys do ?

The kidneys perform a number of functions that are vital in maintaining optimum health.  They play an essential part in cleansing and maintaining blood, by removing wastes and adjusting levels of specific substances.  They do this by filtering the blood and producing urine.  In order to function, the kidneys need an adequate supply of blood, nutrients and oxygen.  In the kidneys the blood passes through a complex system of filters and tubules.  The excess fluid and waste passed out through a drainage system into the bladder and is then excreted as urine.

What can go wrong ?

 1.  Haematuria

 This is the medical term for blood in the urine.  For some, the blood content of the urine can be very visible.  In others the amount of blood in the urine is so small that it can only be detected by testing the urine with a dipstick.  Providing there is no contamination of the urine with vaginal blood, haematuria often means that there is a problem with the kidneys or urinary tract.  The most common problems are bladder infections, inflammation of the filters in the kidney (nephritis), stones or tumours.  All of these can be treated and in all cases, the shorter the time between discovering blood in the urine and determining the cause, the greater the likelihood that treatment will be effective.  Some people have microscopic amounts of blood in the urine at all times - this is a benign condition which doctors call microscopic haematuria.

2.  High Blood Pressure

High blood pressure and kidney disease are closely related.  If uncontrolled, high blood pressure can lead to kidney damage and kidney failure.  Many kidney diseases can also cause high blood pressure.  Checking that your blood pressure is within normal limits is therefore an important part of detecting and preventing early kidney disease.  A doctor or nurse can check your blood pressure quickly and without pain.  It is important to note that a single high reading does not imply that you have high blood pressure.  Several readings may need to be taken to confirm this.  The medical name for high blood pressure is hypertension.

 3.  Diabetes

 Diabetes can occur early in life but is more common in older people.  The latter - maturity onset diabetes - is associated with poor diet, obesity and inactivity.  High blood sugar levels that are not controlled can lead to thickening of the blood vessel walls and ultimately affect the kidneys.  Together diabetes and obesity can cause the kidney to work harder resulting in the ultimate destruction.

This condition is called diabetic nephropathy.  Diabetes can cause damage to many other body organs and can predispose to arteriosclerosis, or hardening of the arteries.

4.  Stones

Kidney stones are one of the most common and most painful medical problems known.  They occur when chemical salts in the urine precipitate and form solid material.  The size of the stone can vary from as small as a grain of rice to as big as an apple.  1 in 10 men and 1 in 35 women will develop a kidney stone in their lifetime and in the majority of these cases no cause will be found.

 There is no convincing evidence that diet affects the risk of developing kidney stones.

 However studies have shown that people affected by stones drink less water and pass a smaller volume of urine that people who don't get stones.

Common Problems for Women

1.  Incontinence

We think of incontinence as a disorder of the very old, but it is quite common in younger women.  Its very nature inhibits open discussion.  As well as being embarrassing, it is also responsible for disrupting social lives and personal relationships.  Incontinence can lead to infections of the bladder and kidneys and can cause irritation to skin.

There are several potential causes of urinary incontinence.  Bladder testing (urodynamic studies) can often establish just what form of incontinence is present.  Many women are helped by simple bladder exercises.  Medication and surgery may be useful in some cases.

2. Cystitis and Urinary Tract Infections (UTI)

Cystitis is an infection in the urine that causes the bladder lining to become raw and inflamed.  It is more common in women, very young children and the elderly.  Cystitis is the most common type of UTI.

 The symptoms are burning pain on passing urine and a feeling of having to pass urine frequently.  Some people get associated fever and blood in their urine.

Generally, cystitis is a nuisance because of the symptoms and the inconvenience, but not a serious condition unless it is ongoing or left untreated.  Should the infection reach the kidneys, the situation can become more serious.  This will be accompanied by the additional symptoms of chills, fever and joint pain.

An appointment with a doctor will usually result in the testing of a urine sample and the prescription of an appropriate antibiotic.  Most antibiotic treatment is effective in 1 to 3 days.

Common Problems for Men

1.  Prostate

The prostate is a small gland found in men which wraps around the urethra (the tube that allows urine to pass out from the bladder).  With age, most men get some enlargement of the prostate gland.  This can cause blockage to the flow or urine with poor stream and difficulty starting and stopping urination.  If the urinary blockage is severe, urinary infection becomes more common and kidney damage can occur.  Prostate cancer may cause similar symptoms.

An enlarged, obstructing prostate can be a problem for approximately 3 out of 10 men as they enter their older years.  If symptoms are severe, a doctor should be consulted and medication or surgery might be instigated.  Appropriate treatment usually relieves most symptoms without altering sex drive or the ability to achieve an erection.  It is recommended that all men over the age of 50 have their prostate checked as part of their annual medical examination.

2.  Arteriosclerosis

This condition is caused by a build-up of cells and fatty deposits in the lining of blood vessels.  Blood is more likely to clot in these narrowings and both blood clots and cholesterol can lead to the complete blockage of blood flow.  This damage can contribute to kidney failure, stroke, heart attack and poor circulation of the legs.  The major causes are cigarette smoking, high blood pressure, high levels of blood cholesterol and triglycerides and diabetes.

Quitting smoking, overcoming obesity, lowering blood cholesterol and controlling blood pressure can therefore contribute to the prevention of arteriosclerosis and its associated complications.

                      For more information please phone the New Zealand Kidney

                        Foundation's Information Line (free phone) 0800 427 427