KIDNEY ABNORMALITIES

Alteration in urination pattern

Polyuria :
●
Increased volume of
urination within
24hrs,Normally adults
produce 1..2 liter urine
perday
●
In adult : > 3l
In children: >2l
Polyuria causes
 SYMPTOMS AND
SIGNS OF POLYURIA
●
Thirst, increased fluid intake:
thirst will usually accompany
polyuria.
●
Nocturia: will usually be a feature
of true polyuria
●
weight loss, malaise, headache
and shortness of breath
●
Symptoms suggestive of diabetes
insipidus: daily urine output may
be greater than 10 litres. A
pituitary tumour may cause
headaches, visual disturbance
and symptoms of pituitary
hormone excess or deficiency.
●
General - eg, dehydrated (acute
presentation of type 1 diabetes,
diabetes insipidus, chronic kidney
disease) or anaemia (chronic
kidney disease).
●
Blood pressure and pulse:
tachycardia and postural
hypotension with dehydration
●
Eyes: diabetes eye complications
(retinal haemorrhages, exudates,
new vessel formation, cataracts).
A pituitary tumour may cause a
visual field defect.
●
Abdomen: palpable kidneys in
renal disorders.
●
Neurology: peripheral neuropathy
in diabetes mellitus or chronic
kidney disease
 TREATMENT
●
Cut how much much fluid you drink especially caffeine and
alchohol
●
If a medicine you take is the cause, talk to your doctor about
switching to another drug or changing your dose
●
The most effective treatment for polyuria is aimed at the
underlying cause. For example, lithium-induced nephrogenic
diabetes insipidus could potentially be treated by
discontinuing the lithium.
●
Polyuria caused by diabetes mellitus is likely to be
improved once the patient's blood glucose levels are under
control
 NOCTURIA
Getting up at night more frequently to urinate like
two or more times

●
It can occur at any age, but becomes more common
with advancing age.
CAUSES OF NOCTURIA

●
In women, nocturia often occurs in
conjunction with pregnancy,
menopause, or uterine prolapse.
●
Nocturia in men is sometimes
associated with an enlarged
prostate
●
Aging ,Diabetes milletus,
Hypercalcaemia
●
Tumor of the bladder, ureters or
urethra
●
More sodium intake and
hypertension
●
Urinary tract infections
 SYMPTOMS OF
NOCTURIA
●
Cloudy urine ●
Difficulty breathing or rapid
●
Difficult or painful urination, or breathing
burning with urination (dysuria) ●
Feeling very thirsty
●
Foul-smelling urine ●
Fever and chills
●
Frequent urination ●
Loss of bladder or bowel control
●
Frequent urination that often ●
Missed menstrual periods
produces only a small amount of ●
Night sweats
urine
●
Pain or burning with urination
●
Sleep disturbances
●
Urgent need to urinate
●
Unexplained weight loss
●
Urinary retention
●
Wheezing
●
Chest pain or pressure
●
 TREATMENT
●
Restrict fluids in the evening (especially coffee, caffeinated beverages, and
alcohol).
●
Time intake of diuretics (take them mid- to late afternoon, six hours before
bedtime).
●
Take afternoon naps.
●
Elevate the legs (this helps prevent fluid accumulation).
●
Wear compression stockings (this also helps prevent fluid accumulation).
●
Medications:
●
Anticholinergic medications (these can reduce symptoms of an overactive
bladder).
●
Bumetanide (Bumex®), Furosemide (Lasix®) (diuretics that assist in regulating
urine production).
●
Desmopressin (DDAVP®) (helps the kidneys produce less urine)
 SUPRAPUBIC PAIN
●
Pain happens in your lower abdomen near where your hips and many important
organs, such as your intestines, bladder, and genitals, are located.
●
In bladder infection, pain in the lower abdomen is typically dull and pressurelike.
●
Common renal causes of supra-pubic pain include pyelonephritis, perinephric
abscess, and nephrolithiasis.
●
most common uterine diseases include pregnancy and dysmenorrhea. Ovarian and
fallopian tubal complications include tubo-ovarian abscess, ovarian cyst,
endometriosis, salpingitis, and ectopic pregnancy.
●
Finally, uretral/bladder complications include infectious mechanisms of the
genitourinary tract such as cystitis, urethritis, and prostatitis.
●
less common causes of pelvic/supra-pubic pain, may include primary dermatologic
and musculoskeletal problems as well as referred pain and neuropathies related to
underlying vertebral and spinal cord complications. Specifically, the
 TREATMENT
●
Use a hot pack or cold compress to relieve pain.
●
Drink cranberry or lingonberry juice, or use oral
cranberry tablets to manage a UTI. The scientific
evidence is conflicting about the effectiveness of
cranberry juice, but it won’t hurt and may help.
●
Take a break from exercise or strenuous physical activity
until the pain subsides. Try alternating lower-body and
upper-body exercises to prevent suprapubic pain.
●
Stretch regularly to avoid straining your muscles when
you exercise or do physical activities.
 DYSURIA
●
Painful urination (dysuria) is discomfort or burning with urination, usually
felt in the tube that carries urine out of your bladder (urethra) or the area
surrounding your genitals (perineum).
●
It is more common in women than in men. In men, it is more common in
older men than younger men
●
In women, urinary tract infections are a common cause of painful urination.
In men, urethritis and certain prostate conditions are frequent causes of
painful urination.
●
Women may report internal urethral discomfort, sometimes described as a
pressure, or an external burning from the flow of urine across irritated or
inflamed labia. Men typically feel a burning sensation proximal to the glans
penis.
 CAUSES OF
DYSURIA
●
Bladder stones
●
Chlamydia trachomatis
●
Cystitis (bladder inflammation)
●
Drugs, such as those used in cancer treatment, that have bladder irritation as a side effect
●
Genital herpes
●
Gonorrhea
●
Having a recent urinary tract procedure performed, including use of urologic instruments for testing or treatment
●
Kidney infection (pyelonephritis)
●
Kidney stones
●
Prostatitis
●
Sexually transmitted diseases (STDs)
●
Soaps, perfumes and other personal care products
●
Urethral stricture (narrowing of the urethra)
●
Urethritis (infection of the urethra)
●
Urinary tract infection (UTI)
●
Vaginitis
●
Yeast infection (vaginal)
 SYMPTOMS
●
Fever
●
Foul or stronger-smelling urine
●
Cloudy or bloody urine
●
Increased urinary frequency or urge to urinate
●
Flank pain
●
Itching
●
Burning
●
Blisters or sores for genital herpes
●
Abnormal discharge
 TREATMENT
●
Oral antibiotics for ●
NATURAL REMEDIES
bacterial infections or
STDs
●
Antifungal medications
for vaginal yeast
infections
●
Uristat, a painkiller
specifically for pain
related to a urinary tract
infection
 URINARY URGENCY
●
an unusually intense and immediate desire to void,
sometimes leading to involuntary voiding or urge
incontinence.
●
Urinary urgency can sometimes indicate a urinary tract
infection (UTI) or a problem with the bladder or prostate.
In other cases, it may be a side effect of a medication.
●
Urinary urgency occurs when the pressure in the
bladder builds suddenly, and it becomes difficult to hold
in the urine. This pressure causes a strong and
immediate need to urinate.
 CAUSES
●
● drinking too much liquid
●
drinking caffeinated or alcoholic
● beverages
●
diabetes
●
pregnancy, especially in the third
trimester, when there’s pressure on the
bladder
●
prostate enlargement or infection
●
anxiety
●
diuretics
●
interstitial cystitis, a chronic infection in
the bladder
●
overactive bladder
●
vaginal infection
 TREATMENT
●
Drinking less liquid and
avoiding caffeine and
alcohol can help
●
Bladder training
●
Physical theraphy
●
Medication:antimuscarin
ics such as oxybutynin
and tolterodine, aim to
relax the bladder.
 URINARY
FREQUENCY
●
Urinary frequency is the need to urinate many times during the day, at night
(nocturia), or both but in normal or less-than-normal volumes. Frequency may
be accompanied by a sensation of an urgent need to void (urinary urgency).
●
Urinary frequency usually results from disorders of the lower genitourinary
tract. Inflammation of the bladder, urethra, or both causes a sensation of the
need to urinate. However, this sensation is not relieved by emptying the
bladder, so once the bladder is emptied, patients continue trying to void but
pass only small volumes of urine.
●
CAUSES
●
Urinary tract infections (UTIs)
●
Urinary incontinence
●
Benign prostatic hyperplasia (BPH)
●
Urinary tract calculi
 HEMATURIA
●
Blood in the urine, or hematuria, When visible to the
naked eye, it is called gross hematuria; the urine
may appear bloody.
●
Blood may be detected only during microscopic
urinalysis, known as microscopic hematuria; smaller
amounts of blood may tinge the urine with a pinkish
or brownish cast.
 CAUSES AND
TREATMENT
involve taking
●
Urinary infection
●
●
2. Enlarged Prostate in older men
antibiotics to clear a
●

●
3. Kidney or bladder stones
●

●
4. Period in women
urinary tract infection
trying a prescription
●

●
5. Prostate infection ●
●

●
6. Kidney disease
medication to shrink an
●

●
7. Kidney trauma
enlarged prostate
●
8. Bladder cancer (mostly in smokers)
●

●
9. Kidney cancer
●
having shock wave
●

●
10. Cancer of the lining of the urinary tract
therapy to break up
●

●
11. Anti-swelling drugs (joint swelling and pain pills)
bladder or kidney
●

●
12. Tough workout stones.
 FLANK PAIN
●
Flank pain refers to discomfort in your upper
abdomen or back and sides. It develops in the area
below the ribs and above the pelvis. Usually, the
pain is worse on one side of your body.
●
Kidney pain is a visceral pain usually produced by
distention of the renal capsule and typically dull,
aching, and steady
●
a kidney infection
●
a kidney abscess
●
kidney stones
●
dehydration
●
a bladder infection
●
shingles
●
Tietze’s syndrome
●
arthritis, especially spinal arthritis
●
a spinal fracture
●
disc disease
●
a pinched nerve in the back
●
a muscle spasm
 URETERAL COLLIC
●
Ureteric colic is defined as
a medical condition
characterized by the
presence of a urinary stone,
leading to a severe urinary
system pain.
●
An excruciating pain that
can strike without a
warning, ureteric colic or
renal colic is caused by
dilation, stretching and
spasm of the ureter.
CAUSES
●
●
Ureteric colic is primarily caused by the passage of
solid material along the ureter, most commonly a
stone that has originated in the kidney
STONE TYPES
●
●
Calcium oxalate (75 Typically result from
hypercalciuria from hyperexcretion
Causes: hyperparathyroidism, exogenous calcium
intake (i.e. antacids)
●
Magnesium-ammonium-phosphate (struvite)
stones (15%) Result from urinary tract infection
with urea-splitting organisms (Klebsiella,
Pseudomonas, Providencia and Proteus species)
●
Uric acid stones (5-10%) Caused by hyperexcretion
of uric acid
●
Tend to be radiolucent
●
Cystine stones (1-2%)