What Is A Kidney Biopsy
A kidney biopsy is a procedure that involves taking a small sample of kidney tissue from the transplanted kidney so that it can be tested to see if rejection is present. A kidney biopsy can be performed by an interventional radiologist or by a transplant team physician in an outpatient setting or in the hospital.
In order to take a biopsy, the skin above your kidney is numbed with medication and a small nick is made in the skin to allow a small needle to pass through to your kidney. Several kidney tissue samples will be collected. The tissue samples are examined under a microscope to establish a diagnosis. The biopsy procedure generally takes between 20 and 30 minutes. You are required to lie flat for two hours following the procedure to prevent bleeding.
Eating A Healthy Diet
In general, a heart-healthy Mediterranean-style diet is best, says Erin Rossi, RD, a nutritionist who specializes in kidney disease at the Cleveland Clinic. A 2014 study in the Clinical Journal of the American Society of Nephrologyfound that this sort of eating pattern reduces the risk to develop chronic kidney disease by about 50%.
All patients with CKDeven at the early stagesneed to watch their salt intake since even slight damage to your kidneys can affect how it filters sodium, adds Rossi.
Follow the recommendation of groups like the American Heart Association and NKF and consume under 2,300 milligrams a day. You may also want to moderate your daily protein intake slightlygenerally, the rule of thumb is 0.8 grams per kilogram of body weight or roughly 55 grams of protein a day for a 150-pound person, says NKF. In the later stages of kidney disease, you may need to restrict potassium and phosphorous as well.
What Can Be Done To Help
Can you reverse kidney disease in Stage 1 or 2? It may not be reversible, but your primary care doctor can treat your kidney disease. Mild kidney disease is treated by:
- Treating any conditions that cause kidney disease i.e. diabetes, hypertension
- Reducing the use of medications that can harm the kidneys i.e. anti-inflammatories
- Encouraging smoking cessation
- Reducing alcohol intake
- ACE inhibitor blood pressure medications to control protein in urine
The following natural treatments have some promising results in preventing loss of kidney function. Remember to check with your doctor before using them. They may also help slow the progression of irreversible kidney disease:
1. Mineral Clay
Kidney disease can cause your phosphate levels to rise. This can cause your electrolytes to drop and decreases your kidney’s ability to keep up with the excessive amounts of phosphates. Using mineral clay may help to reduce the phosphate build-up and take strain off the kidneys. Mineral clay has shown in studies to be as effective as prescription phosphate binders and has fewer incidences of side effects.
2. Sodium Bicarbonate
Sodium bicarbonate has been shown in studies to reduce and slow the progression of kidney disease. This product that is in everyone’s kitchen and readily available may actually reduce the risk of people with kidney disease going on dialysis.
3. Kidney Diet
Going on a diet that is “kidney friendly” may help slow the progression of kidney disease. This includes:
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How Is Acute Kidney Transplant Rejection Treated
Tissue biopsy remains the gold standard for evaluating immunologic graft damage, and the histologic definition of acute rejection has evolved in recent years. Intravenous steroids and T cell depletion remain the standard therapy for T cell-mediated rejection and are effective in reversing most cases.
Working With Your Doctor To Manage Kidney Disease
While most types of kidney disease are not reversible, its still possible to maintain health and quality of life by working with your doctor and making lifestyle changes pertinent to your diagnosis. Its important to realize that no two cases of kidney failure are the same, and you should continue to rely on your care team to provide the best course of care. Make and keep regular appointments, adopt a kidney-friendly diet, and make other everyday changes to lessen symptoms.
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What Happens When The Body Rejects A Transplant
When a patient receives an organ transplant, the immune system often identifies the donor organ as foreign and targets it with T cells and antibodies made by B cells. Over time, these T cells and antibodies damage the organ, and may cause reduced organ function or organ failure. This is known as organ rejection.
How Can Doctors Tell If I Have Ckd
Many people with Stage 1 CKD do not have any symptoms. However, if you have a family history of kidney disease, or a health condition that can damage your kidneys, such as diabetes or high blood pressure, your doctor may test the health of your kidneys.
To find out if you have CKD, doctors will do tests, such as:
- eGFR blood tests
- Blood pressure checks
- Imaging tests to take detailed pictures of the inside of your body, such as ultrasound, CT scan or MRI
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Can You Reverse Kidney Disease
The kidneys filter your blood and take out harmful waste and toxins. They also pull extra fluids out of your body and flush all of this out as urine. Kidney disease prevents the kidneys from cleaning out your blood and the toxins can build up in your body causing illness.
Kidney disease doesn’t happen overnight, but slowly over a period of time. It occurs when the filters in the kidneys become damaged and cease to function. You have millions of these filters and healthy ones can take over cleaning your blood. The ones that ceased to function are gone forever. This means it is important to treat kidney disease early on to prevent further damage.
This article will help you understand about kidney disease and if it can be reversed. There is also helpful information on how it can be treated to prevent further damage to the kidneys.
Urine Color For Kidney Disease
The color of your urine tells a lot about your overall wellness. Urine color changes may indicate potential issues with your internal organs. Below is a list of the different urine colors and their meaning:
Pale yellow or clear You are well hydrated and overall healthy.
Amber or dark yellow You are dehydrated. Or you should reduce your tea, coffee, and dark soda intake.
Orange There might be bile in your bloodstream, or you could be dehydrated. Alternatively, you may have taken a certain medication or vitamin that can cause this.
Pink or red Foods like beetroot or strawberries may alter your urine color, but blood might be a sign of kidney failure.
Foamy Urine with bubbles shows the presence of proteins, a sign of kidney disease.
Brown or Coke colored This can signify aggressive intrinsic kidney disease.
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Answers To Common Rejection Questions
Rejection is when your bodys immune system starts to attack your transplanted kidney. It happens when your immune system recognises the kidney as coming from a different person and thinks it isnt supposed to be there.
Rejection can still occur even if youre taking all of your medicines. If you dont take your medicines as prescribed, the risks of rejection are higher. Its very important to take all of your tablets exactly as they are prescribed for you.
Rejection happens in between 10 to 15 in every 100 patients during the first year after a kidney transplant.
Some patients have a higher risk of rejection than others. If you have had a previous transplant, a blood transfusion, or a pregnancy you may have produced defence proteins . These antibodies increase the risk of rejection.
Rejection is suspected when the organ starts to work less well. Diagnosis usually requires a sample of the organ tissue to be removed with a needle to look at under a microscope.
A biopsy is usually done using local anaesthetic to numb the skin. There are risks of bleeding and damage to the transplant, but these are rare. Your transplant team will explain the risks of having a biopsy to you.
Your health, and the health of your transplanted organ, will be closely monitored in clinic.
Treatment is with stronger immunosuppressant medicines.
The treatment will depend on the type of rejection you have.
Defence protein rejection
Is Ibuprofen Bad For My Kidneys
While NSAIDs rarely affect the liver, they have important adverse effects on the kidneys that you should know about. Here is the science behind the problem.
Ibuprofen and other NSAIDs block prostaglandins, natural body chemicals that normally dilate blood vessels leading to the kidneys. Blocking prostaglandins may lead to decreased blood flow to the kidneys, which means a lack of oxygen to keep the kidneys alive. That can cause acute kidney injury.
Acute kidney injury can occur with any NSAID, though seems to be a bigger culprit. In one study, folks who took NSAIDs had twice the risk of acute kidney injury within 30 days of starting to take the medications. People with existing kidney problems more often get in trouble.
The good news is these effects are reversible if you stop taking NSAIDs.
Remember, acute kidney injury from NSAIDs doesnt cause any symptoms. if you are taking ibuprofen for long periods of time, its not a bad idea to have a check of your kidney function with a quick blood test. The test may show a rise in creatinine if your kidneys are being affected, usually seen within the first 3 to 7 days of NSAID therapy.
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How To Deal With Kidney Transplant Rejection
The treatment for hyperacute rejection, which is often severe and occurs within minutes, is immediate. It involves total removal of the foreign tissue. However, for chronic rejection, which responds poorly to treatment and is considered irreversible, only re-transplant can be helpful. Investigation on the use of inhaled cyclosporine is also being done to prevent or delay chronic rejection in lung transplants.
For acute kidney transplant rejection, a few treatment strategies may be done:
Some immune-suppressing drugs can be helpful, such as
- Cyclosporine, which interferes with T cell communication in the immune system. Treatment starts immediately after the kidney transplant to overpower the immune system and it is indefinitely continued.
- Corticosteroids, which also block T cell communication. They are often given at high doses immediately after the kidney transplant, and then the dose will be, reduced. Doses are increased if rejection later occurs.
- Azathioprine, which slows the production of T cells. It is typically used for maintenance of long-term immunosuppression.
- Other newer drugs include sirolimus, tacrolimus and mizoribine , which all decrease the response of the immune system to the new kidney.
2. Blood Transfusions
These are sometimes given to patients who do not respond to antibody or immunosuppressive therapy by removing antibody molecules that are specific to the transplanted kidney.
3. Bone Marrow Transplant
How Can Kidney Rejection Be Prevented
Kidneys are filtering units of the body and help in cleaning the body of impurities such as metabolic waste and extra fluid. They are bean-shaped and located in the lower body. Usually, middle and old age people suffering from diabetes, high blood pressure, and bladder infections have a higher chance of kidney failure. If the kidneys get damaged, the waste starts accumulating inside the body and can lead to kidney failure.
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Statistics On Kidney Disease
Some of the statistics on kidney disease are quite surprising and alarming. Kidney disease affects over 37 million people in the United States. It is a very serious disease that is often overlooked. Kidney disease usually takes less priority to many other diseases such as diabetes, cancer, and heart disease.
Believe it or not, kidney disease causes more deaths than breast or prostate cancer. There seems to be a lack of mentorship and information for people who are newly diagnosed with kidney disease.
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High Prograf Or Cyclosporine Level
Even though Cyclosporine, Rapamune and Prograf allow renal transplants to be successful both these drugs can damage the kidney over time. There is a very fine line between giving you enough medication to prevent rejection and not too much to cause kidney damage. Sometimes this problem can be solved by measuring the drug levels in your blood, but a kidney biopsy may be performed to determine if there is chronic damage to your kidney from medication. Your doctor may recommend changing your medication.
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Kidney Failure From Severe Dehydration
Severe dehydration is one of the most common causes of reversible kidney failure. Dehydration can be a serious life-threatening disorder. Read Hospitalized for Dehydration if you would like to understand what to expect when hospitalized for dehydration. Kidney failure is one of the most common complications of dehydration.
During the early stages of every dehydration, your kidneys essentially shut themselves down to preserve water. Once the dehydration is corrected, the kidneys start to open up and quickly get your urine production back to normal. The blood tests I mentioned earlier help decide whether the kidney failure is still in the early rapidly reversible state. If the ratio of BUN to Cr is equal to or more than 20, your kidney failure from dehydration is likely in the early rapidly reversible stage.
When the treatment of dehydration is delayed for several days, your kidneys go into the second stage of kidney failure. Small tubes inside the kidneys start to die off and you have structural damage inside the kidneys. This type of kidney failure is medically called Acute Tubular Necrosis or ATN. Necrosis simply means dying off. ATN is still reversible in most cases, but it takes longer to recover from. The tubes that die off will have to regenerate so that the kidney failure can ultimately be reversed. It may take a few weeks to reverse the kidney failure when ATN is present.
Cranberries And Cranberry Juice: Improves Kidney Function Naturally
The presence of optimal amounts of vitamin C, anti-inflammatory anthocyanins, potassium, sodium, and phosphorus in cranberries and their juice, makes them useful in enhancing kidney functioning and regulating blood pressure.
It is healthier to use unsweetened concentrate on making cranberry juice, which should be diluted with water in a ratio of 1:3.
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Tackling Chronic Kidney Transplant Rejection: Challenges And Promises
- 1Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- 2Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- 3Organ Transplant Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- 4Department of Urology, Beijing Youan Hospital, Capital Medical University, Beijing, China
- 5Department of Medicine, Nephrology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
How Is Kidney Rejection Treated
If your doctor tells you that you are having kidney rejection, it does not mean that your new kidney will fail. It could mean that your doctor may just need to adjust your medicines to keep your body from rejecting your kidney.
The usual treatment for kidney rejection is to change the amount of immunosuppressant medicine to a higher dose. Treatment depends on the severity of the rejection. Your doctor may have you stay in the hospital for 3-5 days for treatment.
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Kidney Damage From Diabetes
Kidney damage from diabetes can occur in people with type 1 diabetes, type 2 diabetes, prediabetes, or any other condition that can cause hyperglycemia .
When poorly managed, these conditions can lead to consistently high blood glucose levels, which in turn can damage the blood vessels and nephrons in your kidneys.
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Acute Kidney Failure Complications
Acute kidney failure can sometimes cause complications. These include:
- Fluid buildup. Acute kidney failure can sometimes cause a buildup of fluid in your body. If fluid builds up in your lungs, this can cause shortness of breath.
- Chest pain. If the lining that covers your heart becomes inflamed, you may have chest pain.
- Acidic blood . If your blood has too much acid due to acute kidney failure, you can end up with nausea, vomiting, drowsiness, and breathlessness.
- Muscle weakness. When your bodys fluids and electrolytes are out of balance, you can get muscle weakness. In serious cases, this can lead to paralysis and heart rhythm problems.
- Permanent kidney damage. Acute kidney failure can become chronic and your kidneys will stop working almost entirely or completely. This is called end-stage renal disease. If this happens, you will need to go on permanent dialysis or get a kidney transplant.
- Death. Acute kidney failure can lead to loss of kidney function that is so bad, it can cause death.
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How Organ Rejection Works
Unfortunately, your new heart is also foreign and your immune system treats it the same as it would a bacteria or virus. Rejection is your body’s attempt to protect you by attacking a foreign protein that has entered your body.
Currently, the only way to diagnose rejection is a heart biopsy. Routine biopsies begin approximately two weeks after your transplant and then as ordered by your transplant cardiologist. The biopsies will become less frequent as time goes on as long as you are not experiencing frequent episodes of rejection.
Episodes of rejection of your transplanted organ occur at random times following surgery, and are most frequent within the first few weeks or months after surgery. There is nothing other than taking the prescribed medications that you can do to prevent them. Treatment for rejection is determined by severity and the time interval since transplantation.