Kidney Disease

Kidney Disease overview and Definition

In kidney failure the filtration capability of the kidney is lost. There are various reasons for the kidney failure

Structure of Kidney Disease

The nephrons are the functional unit of the kidney. The kidney consists of proximal convoluted kidney, distal convoluted kidney, collecting duct.  A nephron consists of the two parts namely the corpuscles and tubules. The tubules aids the kidney in monitoring the passasges of fluids and chemicals. The tubules includes the distal convoluted tubule, proximal convoluted tubule, loop of henle and the collecting duct. The cortex is the outer covering structure of the kidney. It leads to medulla where the renal pyramids are located. The renal pyramids consists of collecting ducts

Clinical signs & symptoms



Loss of appetite

Fatigue and weakness

Sleep problems

Changes in how much you urinate

Decreased mental sharpness

Muscle twitches and cramps

Swelling of feet and ankles

Persistent itching

Chest pain, if fluid builds up around the lining of the heart

Shortness of breath, if fluid builds up in the lungs

High blood pressure (hypertension) that's difficult to control

Differential Diagnosis

The different stages of CKD form a continuum. The stages of CKD are classified as follows [3]

Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m 2)

Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m 2)

Stage 3a: Moderate reduction in GFR (45-59 mL/min/1.73 m 2)

Stage 3b: Moderate reduction in GFR (30-44 mL/min/1.73 m 2)

Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m 2)

Stage 5: Kidney failure (GFR < 15 mL/min/1.73 m 2 or dialysis)



Tests and procedures used to diagnose bladder cancer may include:

  • Cystoscopy:

It is the small, narrow tube (cystoscope) through the urethra. The cystoscope has a lens and also it emits light and what happens in the inside of your urethra and bladder, to examine these structures for signs of disease.


It is the procedure of removing the tissue from the kidney

In cystoscopic procedure , it has some specialized  tool through which the scope and into your bladder to collect a cell sample (biopsy) .

Examining a urine sample (urine cytology). A sample of your urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology.

  • Imaging tests. Imaging tests, such as computerized tomography (CT) urogram or retrograde pyelogram, are used to reveal the structures in the urinary tract.

During a CT urogram, a contrast dye is injected intravenously by the hand and eventually flows into your kidneys, ureters and bladder. X-ray images taken during the test provide a detailed view of your urinary tract

Retrograde pyelogram is an X-ray exam used to get a detailed look at the upper urinary tract. The threads a thin tube (catheter) through your urethra and into your bladder to inject contrast dye into your ureters. The dye then flows into your kidneys while X-ray images are captured.

After determining  the above mentioned test the doctor might suggest the following diagnostic test:

Tests may include:

  • CT scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Bone scan
  • Chest X-ray

certain cases, the following tests may be ordered as part of the evaluation of patients with CKD:

  • Serum and urine protein electrophoresis, serum and urine free light chains: Screen for a monoclonal protein possibly representing multiple myeloma
  • Antinuclear antibodies (ANA), double-stranded DNA antibody levels: Screen for systemic lupus erythematosus
  • Serum complement levels: Results may be depressed with some glomerulonephritides
  • Cytoplasmic and perinuclear pattern antineutrophil cytoplasmic antibody (C-ANCA and P-ANCA) levels: Positive findings are helpful in the diagnosis of granulomatosis with polyangiitis (Wegener granulomatosis); a positive P-ANCA result is also helpful in the diagnosis of microscopic polyangiitis
  • Anti–glomerular basement membrane (anti-GBM) antibodies: Their presence is highly suggestive of underlying Goodpasture syndrome
  • Hepatitis B and C, human immunodeficiency virus (HIV), Venereal Disease Research Laboratory (VDRL) serology: These conditions are associated with some glomerulonephritides .
  • Imaging studies and consideration of bladder function studies: These evaluate for possible obstruction and other urologic abnormalities



The urine dipstick method is used to evaluate the presence of chronic kidney disease. The patient is asked to investigate the presence of proteinuria. There is also presence albumin specific dipstick method to detect the presence of albumin the urine.  Urine sediments suggestive of  red blood cells and RBC casts suggest of proliferative glomerulonephritis.



Avoid products that are abundance in salt

Take lower potassium diet

Limit the amount of the protein intake