Points to Remember about Kidney Stones
Kidney Stones (Renal Calculi)
Kidney stones, one of the most painful of the urologic disorders, have beset
humans for centuries. Scientists have found evidence of kidney stones in a
7,000-year-old Egyptian mummy. Unfortunately, kidney stones are one of
the most common disorders of the urinary tract. Each year, people make
almost 3 million visits to health care providers and more than half a million
people go to emergency rooms for kidney stone problems.
A person with a family history of kidney stones may be more likely to
develop stones. Urinary tract infections, kidney disorders such as cystic
kidney diseases, and certain metabolic disorders such as
hyperparathyroidism are also linked to stone formation
For unknown reasons, the number of people in the United States with kidney
stones has been increasing over the past 30 years. In the late 1970s, less than
4 percent of the population had stone-forming disease. By the early 1990s,
the portion of the population with the disease had increased to more than 5
percent. Caucasians are more prone to develop kidney stones than African
Americans. Stones occur more frequently in men. The prevalence of kidney
stones rises dramatically as men enter their 40s and continues to rise into
their 70s. For women, the prevalence of kidney stones peaks in their 50s.
Once a person gets more than one stone, other stones are likely to develop.
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A person with a family history of stones or a personal history of more
than one stone may be more likely to develop more stones.
A good first step to prevent the formation of any type of stone is to
drink plenty of liquids—water is best.
Someone who is at risk for developing stones may need certain blood
and urine tests to determine which factors can best be altered to
reduce that risk.
Some people will need medicines to prevent stones from forming.
People with chronic urinary tract infections and stones will often need
a stone removed if the doctor determines that the stone is causing the
infection. Patients must receive careful follow-up to be sure that the
infection has cleared
Bladder Cancer
Cancerous tumours can grow through your bladder and spread to
other parts of your body (through the bloodstream or the lymph
system) where they may grow and form secondary tumours. This
spread of cancer is called a metastasis.
Transitional cell carcinoma (TCC) starts in the layer of cells that
forms the lining of the bladder.
Squamous cell carcinomas (SCC) originate in one of the types
of cell in the bladder lining.
Adenocarcinomas originate in glandular cells.
Bladder cancer is also classified according to how far it has spread.
If the cancer is only in the bladder lining, it is called a superficial
cancer.
If the cancer has spread to the muscle wall of the bladder it is
called an invasive cancer.
Invasive cancers can spread through the bladder wall into nearby
organs such as the prostate gland in men, the vagina in women, the
bowel, or lymph nodes. Further spread to other organs such as the
bones and liver is possible
Symptoms:
hematuria
a burning feeling when passing urine
a need to pass urine frequently
pain in the pelvis
Causes: Smoking, Environmental factors, Diet
Diagnostics: Cystoscopy, Biopsy, IVP, CT scan
Treatment: Surgery, Chemotherapy, Radiation Therapy or
combination thereof.
Key Points about Testicular Cancer
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Nearly all testicular cancers are one of two general types:
seminoma or nonseminoma. Other types are rare.
This disease occurs most often in men between the ages of 20
and 39. It accounts for only 1 percent of all cancers in men.
Risk factors include having an undescended testicle, previous
testicular cancer, and a family history of testicular cancer.
Symptoms include a lump, swelling, or enlargement in the
testicle; pain or discomfort in a testicle or in the scrotum; and/or
an ache in the lower abdomen, back, or groin .
Diagnosis generally involves blood tests, ultrasound, and
biopsy.
Treatment can often cure testicular cancer, but regular followup exams are extremely important .
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Key Points about Prostate Cancer
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The prostate is a gland in the male reproductive system that
makes and stores a component of semen .
The most common risk factor for prostate cancer is age.
Prostate cancer often does not cause symptoms for many
years. By the time symptoms occur, the disease may have
spread beyond the prostate.
The symptoms of prostate cancer can also be caused by
noncancerous conditions.
Two tests can be used to detect prostate cancer in the absence
of any symptoms: a digital rectal exam and a blood test to detect
a substance made by the prostate called prostate-specific antigen
(PSA).
The diagnosis of prostate cancer can be confirmed only by a
biopsy .
Prostate cancer is described by both grade and stage.
Three treatment options are generally accepted for men with
localized prostate cancer: radical prostatectomy, radiation
therapy, and surveillance (also called watchful waiting).
Definition of Wilms tumor: A disease in which malignant (cancer) cells are
found in the kidney, and may spread to the lungs, liver, or nearby lymph
nodes. Wilms tumor usually occurs in children younger than 5 years old.
Wilms tumor is a curable disease in the majority of affected children.
Approximately 500 cases are diagnosed in the United States annually. More
than 90% of patients survive 4 years after diagnosis, which is an
improvement over the 80% survival observed from 1975 to 1984.[2] The
prognosis is related not only to the stage of disease at diagnosis, the
histopathologic features of the tumor, patient age, and tumor size, but also to
the team approach to each patient by the pediatric surgeon, radiation
oncologist, and pediatric oncologist.[2-5] Previous clinical trials have, in
part, evaluated with some success whether reduced therapy is sufficient to
control disease in patients with early-stage, favorable-histology Wilms
tumor.
Kidney Cancer
Each year, about 28,000 Americans find out they have kidney cancer. The
most common type of kidney cancer in adults is renal cell cancer. A less
common type is called transitional cell cancer. The most common type of
kidney cancer in children is Wilm’s tumor. This fact sheet has been written
to tell you about renal cell cancer. For more information about transitional
cell cancer and Wilm’s tumor, contact the National Cancer Institute’s Cancer
Information Service at 1-800-4-CANCER.
What is renal cell cancer?
Renal cell cancer is an abnormal mass growing in the kidney. It is a
malignant type of cancer, which means it may spread to other parts of the
body, most often the bones or lungs.
What causes kidney cancer?
The risk of kidney cancer increases with age, and it occurs most often
between 50 and 70. Kidney cancer affects almost twice as many men as
women. In addition, it is somewhat more common among African American
men than white men. Other possible risk factor for kidney cancer include:
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Smoking
Obesity
Some occupational exposures, such as coke oven workers in steel
plants or asbestos in the workplace
Some types of radiation treatment, such as that used for disorders of
the uterus.
Heavy, long-term use of phenacetin, a pain relieving drug, which is no
longer sold in the U.S.
Long-term dialysis treatment
An inherited disorder called Von Hippel Lindau Disease.
What are the symptoms of kidney cancer?
In the early stages, kidney cancer usually causes no obvious signs or
symptoms. However, as the tumor grows, symptoms may include:
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blood in the urine
a lump or mass in the kidney area
Less often, patients may have a pain in the side that doesn’t go away, high
blood pressure or anemia (a decrease in the number of red cells in the
blood).
How is kidney cancer detected?
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CT scan, MRI or ultrasound, which can show the presence of a tumor
and help determine whether it is benign or malignant.
An IVP (intravenous pyelogram) a series of x-rays that are taken after
a dye has been injected.
How is kidney cancer treated?
Treatment depends on the stage of the disease, the patient’s general health
and age and other factors. You may be treated by a team of specialists
including a urologist, an oncologist (cancer specialist) and a radiation
oncologist. Kidney cancer is usually treated with surgery, radiation therapy,
biological therapy, chemotherapy or hormone therapy. Sometimes, a
combination of methods may be used.
Causes, incidence, and risk factors
There are many possible causes of kidney damage. They include:
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Decreased blood flow, which may occur with extremely low
blood pressure caused by trauma, surgery, serious illnesses,
septic shock, hemorrhage, burns, or dehydration
Acute tubular necrosis (ATN)
Infections that directly injury the kidney such as acute
pyelonephritis or septicemia
Urinary tract obstruction (obstructive uropathy)
Autoimmune kidney disease such as interstitial nephritis or
acute nephritic syndrome
Disorders that cause clotting within the thin blood vessels of the
kidney
o Idiopathic thrombocytopenic thrombotic purpura (ITTP)
o Transfusion reaction
o Malignant hypertension
o Scleroderma,
o Hemolytic-uremic syndrome
o Disorders of childbirth, such as bleeding placenta abruptio
or placenta previa
Symptoms
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Decrease in amount of urine (oliguria)
Urination stops (anuria)
Excessive urination at night
Ankle, feet, and leg swelling
Generalized swelling, fluid retention
Decreased sensation, especially in the hands or feet
Decreased appetite
Metallic taste in mouth
Persistent hiccups
Changes in mental status or mood
o Agitation
o Drowsiness
o Lethargy
o Delirium or confusion
Coma
o Mood changes
o Trouble paying attention
o Hallucinations
Slow, sluggish, movements
Seizures
Hand tremor (shaking)
Nausea or vomiting, may last for days
Brusing easily
Prolonged bleeding
Nosebleeds
Bloody stools
Flank pain (between the ribs and hips)
Fatigue
Breath odor
High blood pressure
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Signs and tests
Examination and testing can help diagnose acute kidney failure and
help rule out other problems that can affect kidney function.
Many patients have generalized swelling caused by fluid retention.
The doctor will use a stethoscope to listen to the heart and lungs. A
heart murmur, crackles in the lungs, inflammation of the lining of the
heart (pericarditis), or other related to extra fluid may be heard.
The results of laboratory tests may change suddenly (within a few
days to 2 weeks).
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Urine tests (urinalysis) may be abnormal.
Serum creatinine, BUN, creatinine clearance, and serum
potassium levels may increase.
Arterial blood gas and blood chemistries may show metabolic
acidosis.
Kidney or abdominal ultrasound are preferred tests, but
abdominal x-ray, abdominal CT scan, or abdominal MRI can tell
if there is a blockage in the urinary tract.
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Blood tests may help reveal the underlying cause of kidney
failure.
Treatment
Once the cause is found, the goal of treatment is to restore kidney
function and prevent fluid and waste from building up in the body
while the kidneys heal. Usually, you have to stay overnight in the
hospital for treatment.
The amount of liquid you eat (such as soup) or drink will be limited to
the amount of urine you can produce. You will be told what you may
and may not eat to reduce the build-up of toxins normally handled by
the kidneys. This diet may be high in carbohydrates and low in
protein, salt, and potassium.
You may need antibiotics to treat or prevent infection. Diuretics
("water pills") may be used to help the kidneys lose fluid.
It will be very important to avoid dangerous hyperkalemia (increased
blood potassium levels) by using IV (intravenous) calcium,
glucose/insulin, or potassium exchange resin (Kayexalate).
Dialysis may be needed, and can make you feel better. It is not
always necessary, but it can save your life if your serum potassium is
dangerously high. Dialysis will also be used if your mental status
changes, your potassium level starts to rise, you stop urinating,
develop pericarditis, become overloaded with fluid, or cannot
eliminate nitrogen waste products from your body.