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Начало/Nephrology office

Nephrology office

The kidneys are blood filters of the body – each day more than 1500 litres of blood pass through them (around 20% of blood amount ejected by heart). The kidneys filter from this blood amount about 200 litres of urine, afterwards concentrated to approximately 1.5 l with the help of which waste products form metabolism, toxins, unnecessary metabolites are discharged.

Other important kidneys’ functions are:

-          Maintaining the blood pressure by forming and releasing hormones and enzymes 

-          Production of red blood cells 

-          Keeping the bones healthy 

-          Regulation of electrolyte and acid-alkaline balance 

As the kidneys role is related to important processes, their injury may be dangerous and disturb a number of functions of the body. At the same time, the kidney diseases (nephropathy) may take their course in symptom-free manner and this is why, they may remain masked for long time after which their treatment is usually difficult.   

In order to improve the possibilities for prevention and early establishment of renal diseases it is recommended once a year studies to be conducted at the general practitioner of urine and serum creatinine. For patients with diabetes mellitus or arterial hypertension, it is advised such studies to be made per 6 months.

Patients should be referred to neurologist if there are diversions in the following indicators:

·         proteinuria

·         hypertonia 

·         aggravated renal function

·         availability of leucocyturia and bacteriuria

·         protracted kidney failure

·         swelling syndrome

·         microscopic or macroscopic haematuria 

 

According the data of Bulgarian kidney association, about 25% of persons examined in Bulgaria older than 18 years have some renal lesion, and 8,1% - reduced kidney function. The most frequent diseases are:

 ·         Renal stone disease 

This is the most frequently met nephrology problem for which in the renal pelvis, calculus (stones) are formed. The causes for this disease occurrence are the insufficient drinking of liquids, infections, unbalances diet, increase of acidity in the body, endocrine diseases. This disease often takes its course without expressed clinical symptoms, but when such are available they include difficult urination and acute unilateral pain in waist.

This is diagnosed after clinical and ultrasound examinations accompanied with clinical and microbiological studies of urine.  

The disease is treated most frequently conservatively – with medication and increased drinking of liquids, and in more severe cases when the stone is of big size, extracorporal shock-wave lithotripsy is applied which is non-surgical method of breaking by directed waves) or surgical removal.

·          Pyelonephritis 

This inflammation due to bacterial infection of kidneys and urinary tract that may be both acute and chronic. The factors predisposing the disease development are the immune system weakening, obstruction of urinary tract, lesion of nerves around bladder, vesicoureteral reflux (return of urine from the bladder to ureters and kidneys). Because of ureter smaller length in females, the disease is more spread among women.

As in most inflammations, the increased body temperature may be a signal for pyelonephritis. The other symptoms include frequent urination accompanied by burn sensation or pain, pains in back, waist, abdomen and groin, presence of pus or blood in urine.

Besides physical examination in order to prove the disease microbiological and imaging studies are required - often abdomen echography .

In the treatment of chronic pyelonephritis a complex therapy should be applied with broad-spectrum antibiotics .

·         Kidneys cysts 

In most cases they are hereditary-related and are vesicles full of liquid usually urine. The disease development may comprise a long period of time and may be related to the formation of multiple gradually growing cysts. When they reach sufficient size to press the kidney, they may damage its structure and functions.

The symptoms include pain in the waist area, blood in urine and availability of stones in kidneys.

The disease is diagnosed after ultrasound study and the treatment is a light and pain-free procedure – puncture under echography control.