Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
What causes the kidneys to fail? Kidney failure comes
foremost from poor blood supply and, as such, is often seen
after resuscitations where there is a period of very little
blood flow. Diabetes is also a cause as are certain
medications, infections, severe untreated dehydration and
obstruction of the urinary system. This obstruction can be
from a swollen prostate or tumor.
In children, diabetes is a problem, as well as reflux, which
must be detected early to save the kidneys. Therefore, all
children under five with urinary tract infections should be
studied. Infection and post-infectious complications can be a
cause as well as rheumatological causes.
As you can see the causes are many, and the manifestations of
acute kidney failure are nonspecific. As the poisons the
kidney deals with accumulate in the body, an acute kidney
failure patient may just feel generally lousy, without any
specific complaints. Fortunately, with treatment, most acute
renal failure can be treated without complications.
Medications that can cause this syndrome include the
antibiotic gentamycin, all NSAIDs -- drugs such as ibuprofen
and aspirin. Taking all these drugs on the short term is
unlikely to cause any problems.
How do we detect kidney failure? Simple blood tests will
point to the accumulation of potassium, urea, creatinine, and
phosphorus in the blood, as well as lowering calcium levels.
A simple, quick test is the urinalysis. The useful test can
screen for infection, diabetes (sugar will appear in the
urine as well as perhaps acids) and failure (protein in the
urine is one of the first signs as well as clumping of cells
called casts seen under the microscope). Often to confirm and
quantify results, a 24-hour urine collection is required.
How can you be kind to your kidneys? As blood flow is
important, exercise may help. Lowering your high blood
pressure and controlling diabetes will also help. There have
been many studies saying that cranberry and blueberry juice
help reduce infection.
I hope these articles have enhanced your concentration for
the next time you say Asher Yotzar. Next we will begin
to speak about another amazing organ that deals with the
poisons in the body: the liver. A person can live without
kidneys with the miracle of dialysis, but cannot live without
a liver, unless a new one is inserted.
A message from Glaxo, sponsor of this column. Impetigo
are honey-colored infections commonly seen in kids. Minor
suture infections are common. An easy treatment that works
right where it should is Bactroban cream, the first locally
absorbed antibiotic. Other antibiotic creams do not work
because they are not absorbed well. Bactroban can make your
life so much easier, while being effective as well.
