Page 10 - Seniors Today October 2020
P. 10

Developmental And Congenital
         Conditions
         There are numerous developmental
         anomalies of the kidney that the patient is
         born with (congenital). Some of these are
         genetically transmitted within families
         while others are sporadic occurrences.
         Some of these conditions will manifest
         themselves with problems in early
         childhood or adolescence, while yet others
         may not manifest until middle age or later.       Remember that Ayurvedic preparations often contain
                                                           heavy metals, which can damage the kidneys
         Yet other anomalies of the kidney may
         remain undetected through life or come to          developmental obstruction of the junction
         notice incidentally during investigations for      of the ureter and the kidney (PUJO). Left
         other complaints.                                  untreated this will result in gradual but
                                                            irreversible kidney damage. Surgery for
         Vesico-Ureteric Reflux & Pelviureteric             repair of the defect is usually undertaken                    The kidneys manage the excretion of toxins from drugs and other socially acceptable poisons
         Obstruction                                        laparoscopically or robotically, with good                    of heavy metals (a word of warning;                fluid is them let out with the impurities
         These are two common developmental                 results.                                                      numerous Ayurvedic preparations contain            thus filtered. The advantage is that it can
         conditions that may cause affect the kidneys                                                                     heavy metals) may also be responsible.             be done in the convenience of the patient’s
         in childhood or early adulthood.                   Adult Polycystic Kidneys                                      Inflammatory conditions of the kidney, or          home and does not tie him down to a
         Normally the entry of the ureter into the          This is a genetically inherited disease that                  glomerulonephritis may have varied causes          machine.
         bladder is guarded by a one-way valve that         runs in families. The affected individual                     and many of them may lead to kidney                 In Renal transplantation a kidney is taken
         permits urine to enter the bladder but does        usually has no complaints until late                          failure.                                           from a healthy volunteer and implanted
         not allow urine in the bladder to flow back        adulthood when he or she may develop                            The treatment options for a patient              into the patient. The immediate results
         towards the kidney. When this mechanism            urinary infections, bleeding or renal failure.                in this situation are dialysis or renal            of this surgery are good in a majority of
         is defective it result in VesicoUreteric           Symptomatic and supportive treatment is                       transplantation.                                   cases. The long term chances of having a
         Reflux (VUR). The child gets frequent              usually necessary until or unless kidney                        Dialysis may be done by passing the              functional transplanted kidney after 15
         urinary infections, with the potential of          failure develops, when kidney dialysis or a                   patient’s blood through a machine where            years is about 50%. Living donors, by a
         kidney damage with each such episode.              renal transplantation will be required.                       the blood is cleared of impurities and             national law may only be blood relatives,
         The usual treatment in milder cases is to                                                                        excess water by passing it through a filter.       or spouse. In exceptional cases permission
         administer long-term antibiotics, until            Renal Failure                                                 This is the more common form of dialysis           may be granted for a more distant
         such time as the reflux settles with growth        When the kidneys have been damaged                            and is referred to as haemodialysis or blood       relative. Receiving or offering a kidney
         of the child. If reflux is of a severe degree      irreversibly to such an extent that life                      dialysis. This involves the patient attending      for financial considerations is a criminal
         or if antibiotic regimes do not control the        cannot be sustained, the patient is said to                   a nearby hospital (or a machine installed in       offence punishable under law. Kidney for
         infection, surgery for reimplantation of           be in end-stage renal disease. The causes                     the patient’s home) 2 to 3 times a week. The       transplantation may also retrieved from
         the ureters into the bladder needs to be           of this could be many and manifold.                           other form of dialysis is Peritoneal Dialysis,     a deceased donor (who is irreversibly
         resorted to. This can be done either by open       Diabetes and high blood pressure are                          or tummy dialysis, which involves a                brain dead) while the heart is still beating,
         surgery or in a minimally invasive manner          probably the most common causes. The                          instilling a solution in the abdominal cavity      according to well-laid-out strict criteria.
         with Laparoscopy or Robotic Assisted               other causes may be repeated infections                       through a silicone catheter (permanently           The kidneys are vital organs that we often
         Laparoscopy.                                       with or without obstruction (caused by                        installed for the purpose), keeping in             take for granted. They will stand us in good
          Another cause of repeated bouts of urinary        stones or any other pathology). Poisons and                   there for a length of time to allow filtration     stead, provided we take adequate preventive
         infection and pain in the kidney would be          toxins, such as analgesic abuse or ingestion                  through the lining of the abdomen. The             care and do not abuse them.


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