Problems of Kidney Disease
Causes of Kidney Disease
Various inflammatory and degenerative diseases may invoke the kidney diffusely, covering entire nephrons and nephron segments. In such conditions the normal functions of the nephron are disrupted, and nuritional disturbances in the metabolism of protein, electrolytes, and water follow. The main function disrupted in these diseases is that of filtration and reabsorption. Several of these diseases are given here as representative of such conditions. These include acute glomerulonephritis, the nephrotic syndrome, and chronic renal failure.
Usually some streptococcal infection has preceded and is related to the onset of glo-merulonephritis. It has a more or less sudden onset, and after a brief course in the majority of cases, especially among children, recovery is complete. In others the disease may progress or become latent only to develop later into chronic glomerulonephritis. The disease process involves primarily the glomeruli. As a result of loss of glomerular function specifically filtration function, degeneration of the tubules adjoining follows.
Classic symptoms include blood and protein in the urine and varying degrees of edema, hypertension, and renal insufficiency. Oliguria (diminished urine output) or anuria (no mine output) may occur because of acute or chronic renal failure.
PROTEIN, Controversy exists concerning the use of a low-protein diet. Studies seem to indicate, however, that no advantage is found in restricting protein. In short-term acute cases in children, pediatricians and nutritionists in general favor overall optimum nutrition with adequate protein unless renal failure develops. This complication usually lasts no more than 2 or 3 days and is managed by conservative treatment.
SODIUM Salt also is not restricted unless complications of edema, hypertension, or renal output become dangerous. In such cases a 500 to 1,000 mg. sodium diet may be used. In most patients, especially children with acute poststreptococcal glomerulonephritis, diet modifications are not crucial. Treatment centers mainly on bed rest and drugs. The diet should simply be an optimum one, including basic nutrition for healing.
WATER Water intake should be adjusted to output as a rule, including losses in vomiting or diarrhea. During periods of diminished urine output the intake of water may be only 500 to 700 ml. a day.