The kidneys in our body are like silent workers, aren't they? They do a lot of work without us even realizing it. They clean our blood all day long, control the amount of water in the body, and remove unnecessary waste products. But sometimes, these kidneys also have problems. Today we are going to talk about a disease that affects such kidneys. That is renal parenchymal disease, or in English `(Renal Parenchymal Disease)` . This name may sound a bit complicated when you hear it, but let's understand it simply.
What is Renal Parenchymal Disease?
Simply put, this is a group of conditions that damage the kidneys. It mainly affects the part of the kidney called the ``Parenchyma'' . Now you may be wondering what this parenchyma is. That is, the main parts of the kidney that work, or help the kidney function. This parenchyma has two main parts:
1. Renal Cortex : This is the outermost part of the kidney. The tiny filtering units in our kidneys, called nephrons , start here. These nephrons are like little filters. They have two parts. One is a blood vessel called a glomerulus . The other is a small tube called a renal tubule .
- Glomeruli are the first places where blood is filtered.
- The function of the renal tubules is to reabsorb the water, nutrients, and minerals needed by the body and excrete unnecessary waste products through urine.
- In addition, the kidney cortex also produces a hormone called `Erythropoietin (EPO) .` This `(EPO)` hormone helps our `Bone Marrow` to produce red blood cells.
2. Renal Medulla : This is located on the inner side of the kidney. Most of the nephrons are located in this part.
So, doctors call any condition that affects either the cortex or the medulla of the kidney a renal parenchyma disease. It is also called by other names, for example, bilateral renal parenchyma diseases, and kidney parenchymal disease.
What are the main types of this disease?
This disease can be divided into two main types:
- Acute Renal Parenchymal Disease : This starts suddenly.
- Chronic Renal Parenchymal Disease : This progresses slowly and lasts for a long time.
Is this disease dangerous?
It really depends on the cause of the disease and the severity of the disease. Some mild cases can get better with treatment. But in severe cases, it can lead to `Kidney Failure` . You know, kidney failure is something that can be life-threatening if left untreated.
What are the early signs that can be recognized?
Often, there are no major symptoms in the early stages of this disease. That's what makes it a little scary. But as the disease progresses and your kidneys lose function, you may experience symptoms like these:
- Blood in the urine (Hematuria)
- Dry and itchy skin
- Feeling of extreme fatigue
- Appetite
- Decrease in the number of red blood cells in the blood (Anemia)
- Nausea and vomiting
- Passing more urine than usual
- Swelling around the eyes
- Swelling of the hands, feet, and ankles (Edema)
If you have one or more of these symptoms, it is very important to see a doctor.
What causes this?
The two main causes of chronic kidney disease are high blood pressure and diabetes . However, there may be other causes:
- Autoimmune diseases , such as Lupus Nephritis
- Glomerulonephritis (inflammation of the filtering units of the kidneys)
- `Kidney Cancer`
- Polycystic Kidney Disease ( kidney cysts)
- `Sickle Cell Disease`
Things that can cause sudden (Acute) kidney parenchymal disease are:
- Severe allergic reaction (Anaphylaxis)
- `Bacterial Infections`
- `Kidney Stones`
- `Kidney Tumors`
- Pulmonary Embolism (a blood clot in a blood vessel leading to the lungs)
- `Severe Dehydration`
- `Viral Infections`
Some medications can also cause this `(Acute)` condition. Examples:
- `Angiotensin-converting enzyme inhibitors (ACE Inhibitors)`
- `Angiotensin II receptor blockers (ARBs)`
- `Nonsteroidal Anti-inflammatory Drugs (NSAIDs)` (e.g. Ibuprofen, Diclofenac)
Who is more likely to develop this disease?
Anyone can develop this disease, but you are at a slightly higher risk if you have the following:
- If anyone in the family has this kidney parenchyma disease
- If you have diabetes
- If you have heart disease
- If you have `High Blood Pressure`
Also, if you are over 60 years old and regularly use over-the-counter (OTC) and prescription NSAID painkillers, your risk may be even higher.
What are the possible complications of this disease?
If this disease is not properly controlled, various complications can occur. Some of them are:
- Increased acidity of body fluids (Metabolic Acidosis)
- Increased phosphate (phosphorus) levels in the blood (Hyperphosphatemia)
- Increased potassium levels in the blood (Hyperkalemia)
- Decreased red blood cell count (anemia)
- Pain caused by the deposition of uric acid in the joints (Gout)
- Osteoporosis
- Weakened immune system
Important: Not everyone will experience these complications. However, if you take care of the disease and get proper treatment, you can largely avoid them.
How do you accurately diagnose this disease? (Diagnosis)
A doctor will ask about your symptoms, review your medical history, ask about the medications you take, and perform a physical exam. Then, if they suspect you have the disease, they will order several tests to confirm the diagnosis. Some of these include:
- Kidney Function Tests : These include blood tests and urine tests . Blood tests check your estimated glomerular filtration rate (eGFR) and serum creatinine level . Urine tests check for proteinuria and blood in the urine.
- Imaging tests : These can help doctors get a clear picture of the size, shape, and structure of the kidneys. They may order an ultrasound scan, an MRI (Magnetic Resonance Imaging) scan, or a CT (Computed Tomography) scan.
- Kidney Biopsy : In this test, a doctor takes a small piece of tissue from the kidney and tests it in a laboratory. This biopsy can provide information that other tests cannot.
How is it treated?
The treatment of renal parenchymal disease depends on several factors. These include:
- What exactly causes the disease and how serious it is.
- Your age and overall health.
Your treatment options may include:
- Avoid using NSAID painkillers and other medications that can worsen kidney disease.
- Completely abstain from tobacco use (smoking, vaping, chewing tobacco, etc.).
- Engaging in regular physical exercise.
- Maintaining a healthy weight that suits you.
- Taking the necessary medications to control blood pressure, cholesterol, and diabetes.
- Talk to a Renal Dietitian to develop a diet that is beneficial for the kidneys. This may include a diet that reduces protein, lowers blood cholesterol levels, and limits salt (sodium) and potassium.
If the disease is severe, the following treatments may be necessary:
- Corticosteroids (a type of medicine that reduces inflammation)
- `Dialysis` (cleaning the blood with the help of a machine when the kidneys are not working properly)
- Immunosuppressants (medicines that reduce the activity of the immune system)
- `Kidney Transplant`
If I have this disease, what should I expect?
If you have this disease, you need to work with your medical team to control the damage to your kidneys and maintain their function for as long as possible. Here are some things to do:
- Maintaining a diet that is beneficial to the kidneys.
- Regularly monitor your blood sugar levels and blood pressure.
- Visit a nephrologist and have your kidneys checked regularly.
- Taking the medicine prescribed by the doctor exactly and on time.
How long can you live with this disease?
It's hard to give a single answer to this question. Because it depends on many things, such as the severity of the disease, your age, gender, and overall health. If your kidneys are severely damaged, your life expectancy may be reduced. If you're on dialysis, you're usually expected to live for 5 to 10 years.
But remember! This is just an average. Many people live much longer with proper treatment and a kidney transplant. Even people with end-stage renal disease can live for 20-30 years. So, talk to your doctor and learn more about your condition.
Are there ways to avoid this disease? (Prevention)
Although not all causes can be prevented, you can reduce your risk of developing the disease by doing these things:
- Engage in vigorous exercise at least five days a week, for at least 30 minutes a day.
- Limiting alcohol consumption.
- Maintaining a healthy weight that suits you.
- If you have a high risk of developing kidney disease (e.g. diabetes, high blood pressure), see a doctor regularly for checkups.
- Completely abstain from smoking.
- Reducing the amount of salt added to foods.
- NSAID painkillers should only be used as directed by a doctor.
What foods should a person with this disease avoid?
If you have renal parenchymal disease, it is very important to see a renal dietitian . He or she will create a diet plan that is suitable for you and that is good for your kidneys. You will usually need to limit foods that are high in salt, protein, phosphorus, and potassium. Some examples are:
- Avocado
- Banana
- Canned food
- Salty snacks like chips and pretzels
- Citrus fruits and juices, such as oranges
- Dried fruits
- Processed meats (such as sausages, meatballs)
- Spinach
Important: This list may not be for everyone. Ask your nutritionist for specific advice on what foods are good for you and what you should avoid.
When should you see a doctor?
If you have diabetes, high blood pressure, or another condition that can lead to kidney disease, see your doctor regularly for checkups. Early detection and understanding your risk factors can help prevent further damage to your kidneys.
When do you need to go to the Emergency Treatment Unit (ETU) ?
Symptoms of renal parenchymal disease usually appear after significant damage to the kidneys has occurred. If you experience any of these symptoms, see a doctor immediately:
- If the muscles are frequently twisted
- If you have an appetite
- If you feel very tired
- If you have difficulty concentrating or sleeping
- If you have an itchy skin
- If you have hiccups that won't stop
- If your hands, ankles, or feet are swollen
- If you urinate more or less than normal
What questions should you ask the doctor?
When you visit the doctor, it may be helpful to ask these questions:
- How do you know if I have renal parenchymal disease?
- How serious is it?
- What treatments do you recommend?
- What can I do to protect my kidneys?
- Can you recommend a specialized nutritionist for kidney patients?
- Can you tell me about a support group that helps people with this disease?
Finally, what to remember (Take-Home Message)
Renal Parenchymal Disease is a condition that affects the function of your kidneys. The main goal of treatment is to manage the disease to maintain kidney function for as long as possible. Many people live with this disease for many years.
However, when you receive a diagnosis like this and have to undergo constant treatment, you may feel frustrated and angry. This is normal. Talking about this with your trusted family and friends can help you. You can also join support groups for people with this condition. If you have any questions, don't be afraid to talk to your doctor. They will help you. You are not alone!
` Kidney disease, renal parenchymal disease, kidney parenchyma, kidney function, kidney failure, kidney disease, kidney function, diabetes, high blood pressure
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