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What causes Acquired Cystic Kidney Disease ? | Researchers do not fully understand what causes cysts to grow in the kidneys of people with CKD. The fact that these cysts occur only in the kidneys and not in other parts of the body, as in PKD, indicates that the processes that lead to cyst formation take place primarily inside the kidneys.2 | NIDDK | Acquired Cystic Kidney Disease |
What are the symptoms of Acquired Cystic Kidney Disease ? | A person with acquired cystic kidney disease often has no symptoms. However, the complications of acquired cystic kidney disease can have signs and symptoms. | NIDDK | Acquired Cystic Kidney Disease |
What are the complications of Acquired Cystic Kidney Disease ? | People with acquired cystic kidney disease may develop the following complications:
- an infected cyst, which can cause fever and back pain. - blood in the urine, which can signal that a cyst in the kidney is bleeding. - tumors in the kidneys. People with acquired cystic kidney disease are more likely than people in the general population to have cancerous kidney tumors. However, the chance of cancer spreading is lower in people with acquired cystic kidney disease than that of other kidney cancers not associated with acquired cystic kidney disease, and the long-term outlook is better.1 | NIDDK | Acquired Cystic Kidney Disease |
How to diagnose Acquired Cystic Kidney Disease ? | A health care provider may diagnose a person with acquired cystic kidney disease based on
- medical history - imaging tests
Medical History
Taking a medical history may help a health care provider diagnose acquired cystic kidney disease. A health care provider may suspect acquired cystic kidney disease if a person who has been on dialysis for several years develops symptoms such as fever, back pain, or blood in the urine.
Imaging Tests
To confirm the diagnosis, the health care provider may order one or more imaging tests. A radiologista doctor who specializes in medical imaginginterprets the images from these tests, and the patient does not need anesthesia.
- Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care provider's office, an outpatient center, or a hospital. The images can show cysts in the kidneys as well as the kidneys' size and shape. - Computerized tomography (CT) scans use a combination of x rays and computer technology to create images. For a CT scan, a nurse or technician may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where an x-ray technician takes the x-rays. An x-ray technician performs the procedure in an outpatient center or a hospital. CT scans can show cysts and tumors in the kidneys. - Magnetic resonance imaging (MRI) is a test that takes pictures of the body's internal organs and soft tissues without using x-rays. A specially trained technician performs the procedure in an outpatient center or a hospital. Although the patient does not need anesthesia, a health care provider may give people with a fear of confined spaces light sedation, taken by mouth. An MRI may include the injection of contrast medium. With most MRI machines, the patient will lie on a table that slides into a tunnel-shaped device that may be open-ended or closed at one end. Some machines allow the patient to lie in a more open space. During an MRI, the patient, although usually awake, must remain perfectly still while the technician takes the images, which usually takes only a few minutes. The technician will take a sequence of images from different angles to create a detailed picture of the kidneys. During the test, the patient will hear loud mechanical knocking and humming noises from the machine.
Sometimes a health care provider may discover acquired cystic kidney disease during an imaging exam for another condition. Images of the kidneys may help the health care provider distinguish acquired cystic kidney disease from PKD. | NIDDK | Acquired Cystic Kidney Disease |
What are the treatments for Acquired Cystic Kidney Disease ? | If acquired cystic kidney disease is not causing complications, a person does not need treatment. A health care provider will treat infections with antibioticsmedications that kill bacteria. If large cysts are causing pain, a health care provider may drain the cyst using a long needle inserted into the cyst through the skin.
When a surgeon transplants a new kidney into a patient's body to treat kidney failure, acquired cystic kidney disease in the damaged kidneys, which usually remain in place after a transplant, often disappears.
A surgeon may perform an operation to remove tumors or suspected tumors. In rare cases, a surgeon performs an operation to stop cysts from bleeding.
Have Regular Screenings to Look for Cyst or Tumor Growth Some health care providers recommend all people with end-stage kidney disease get screened for kidney cancer using CT scans or MRIs after 3 years of dialysis. People with acquired cystic kidney disease should talk with their health care provider about when to begin screening. | NIDDK | Acquired Cystic Kidney Disease |
What to do for Acquired Cystic Kidney Disease ? | No specific diet will prevent or delay acquired cystic kidney disease. In general, a diet designed for people on hemodialysis or peritoneal dialysis reduces the amount of wastes that accumulate in the body between dialysis sessions.
More information is provided in the NIDDK health topics, Eat Right to Feel Right on Hemodialysis and Nutrition for Advanced Chronic Kidney Disease in Adults. | NIDDK | Acquired Cystic Kidney Disease |
What to do for Acquired Cystic Kidney Disease ? | - Acquired cystic kidney disease happens when a person's kidneys develop fluid-filled sacs, called cysts, over time. - Acquired cystic kidney disease occurs in children and adults who have - chronic kidney disease (CKD) - end-stage kidney disease (ESRD) - People with acquired cystic kidney disease may develop the following complications: - an infected cyst, which can cause fever and back pain - blood in the urine, which can signal that a cyst in the kidney is bleeding - tumors in the kidneys - To confirm the diagnosis, the health care provider may order one or more imaging tests: - Ultrasound - Computerized tomography (CT) scan - Magnetic resonance imaging (MRI) - If acquired cystic kidney disease is not causing complications, a person does not need treatment. - A health care provider will treat infections with antibioticsmedications that kill bacteria. - If large cysts are causing pain, a health care provider may drain the cyst using a long needle inserted into the cyst through the skin. - A surgeon may perform an operation to remove tumors or suspected tumors. In rare cases, a surgeon performs an operation to stop cysts from bleeding. | NIDDK | Acquired Cystic Kidney Disease |
What is (are) Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List ? | MAGIC (Major Aspects of Growth in Children) Foundation is a national, nonprofit organization that provides support and education about growth disorders in children and growth hormone deficiency in adults. Staff will help connect people who have similar interests or concerns.
The Human Growth Foundation (HGF) is a nonprofit organization concerned with childrens growth disorders and adult growth hormone deficiency. The HGF offers a brochure about adult growth hormone deficiency. The foundation also sponsors adult and pediatric Internet discussion forums to support the exchange of information about growth hormone deficiency and growth hormone replacement therapy. To subscribe, follow the instructions at www.hgfound.org.
The Creutzfeldt-Jakob Disease (CJD) Foundation, Inc. was created in 1993 by two families who lost relatives to CJD and the neurologist who treated the patients. This nonprofit corporation seeks to promote awareness of CJD through research and education and to reach out to people who have lost loved ones to this illness. | NIDDK | Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List |
What is (are) Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List ? | Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated with Human Growth Hormone
National Hormone and Pituitary Program (NHPP): Information for People Treated with Pituitary Human Growth Hormone (Summary)
National Hormone and Pituitary Program (NHPP): Information for People Treated with Pituitary Human Growth Hormone (Comprehensive Report)
Creutzfeldt-Jakob Disease. Fact sheet of the National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH)
NIH and Italian Scientists Develop Nasal Test for Human Prion Disease
What is a prion?from Scientific American: Ask the Experts | NIDDK | Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List |
What is (are) Simple Kidney Cysts ? | Simple kidney cysts are abnormal, fluid-filled sacs that form in the kidneys. Simple kidney cysts are different from the cysts that develop when a person has polycystic kidney disease (PKD), which is a genetic disorder. Simple kidney cysts do not enlarge the kidneys, replace their normal structure, or cause reduced kidney function like cysts do in people with PKD.
Simple kidney cysts are more common as people age. An estimated 25 percent of people 40 years of age and 50 percent of people 50 years of age have simple kidney cysts.1 | NIDDK | Simple Kidney Cysts |
What is (are) Simple Kidney Cysts ? | The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every day, the two kidneys process about 200 quarts of blood to filter out about 1 to 2 quarts of urine, composed of waste products and extra water. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. | NIDDK | Simple Kidney Cysts |
What causes Simple Kidney Cysts ? | The cause of simple kidney cysts is not fully understood. Obstruction of tubulestiny structures within the kidneys that collect urineor deficiency of blood supply to the kidneys may play a role. Diverticulasacs that form on the tubulesmay detach and become simple kidney cysts. The role of genetic factors in the development of simple kidney cysts has not been studied. | NIDDK | Simple Kidney Cysts |
What are the symptoms of Simple Kidney Cysts ? | Simple kidney cysts usually do not cause symptoms or harm the kidneys. In some cases, however, pain can occur between the ribs and hips when cysts enlarge and press on other organs. Sometimes cysts become infected, causing fever, pain, and tenderness. Simple kidney cysts are not thought to affect kidney function, but one study found an association between the presence of cysts and reduced kidney function in hospitalized people younger than 60 years of age.1 Some studies have found a relationship between simple kidney cysts and high blood pressure. For example, high blood pressure has improved in some people after a large cyst was drained. However, this relationship is not well understood.2 | NIDDK | Simple Kidney Cysts |
How to diagnose Simple Kidney Cysts ? | Most simple kidney cysts are found during imaging tests done for other reasons. When a cyst is found, the following imaging tests can be used to determine whether it is a simple kidney cyst or another, more serious condition. These imaging tests are performed at an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Ultrasound may also be performed in a health care providers office. Anesthesia is not needed though light sedation may be used for people with a fear of confined spaces who undergo magnetic resonance imaging (MRI).
- Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract. The images can be used to distinguish harmless cysts from other problems. - Computerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create three-dimensional (3-D) images. A CT scan may include the injection of a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. CT scans can show cysts and tumors in the kidneys. - MRI. MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. An MRI may include the injection of contrast medium. With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some newer machines are designed to allow the person to lie in a more open space. Like CT scans, MRIs can show cysts and tumors. | NIDDK | Simple Kidney Cysts |
What are the treatments for Simple Kidney Cysts ? | Treatment is not needed for simple kidney cysts that do not cause any symptoms. Simple kidney cysts may be monitored with periodic ultrasounds.
Simple kidney cysts that are causing symptoms or blocking the flow of blood or urine through the kidney may need to be treated using a procedure called sclerotherapy. In sclerotherapy, the doctor punctures the cyst using a long needle inserted through the skin. Ultrasound is used to guide the needle to the cyst. The cyst is drained and then filled with a solution containing alcohol to make the kidney tissue harder. The procedure is usually performed on an outpatient basis with a local anesthetic.
If the cyst is large, surgery may be needed. Most surgeries can be performed using a laparoscopea special tool with a small, lighted video camera. The procedure is usually done under general anesthesia in a hospital. The surgeon drains the cyst and then removes or burns away its outer tissue. This type of surgery allows for a smaller incision and quicker recovery. | NIDDK | Simple Kidney Cysts |
What to do for Simple Kidney Cysts ? | Eating, diet, and nutrition have not been shown to play a role in causing or preventing simple kidney cysts. | NIDDK | Simple Kidney Cysts |
What to do for Simple Kidney Cysts ? | - Simple kidney cysts are abnormal, fluid-filled sacs that form in the kidneys. - Simple kidney cysts usually do not cause symptoms or harm the kidneys. - Most simple kidney cysts are found during imaging tests done for other reasons. - Treatment is not needed for simple kidney cysts that do not cause any symptoms. - Simple kidney cysts that are causing symptoms or blocking the flow of blood or urine through the kidney may need to be treated using sclerotherapy or surgery. | NIDDK | Simple Kidney Cysts |
How to diagnose Kidney Disease of Diabetes ? | People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are eGFR and urine albumin.
- eGFR. eGFR stands for estimated glomerular filtration rate. Each kidney contains about 1 million tiny filters made up of blood vessels. These filters are called glomeruli. Kidney function can be checked by estimating how much blood the glomeruli filter in a minute. The calculation of eGFR is based on the amount of creatinine, a waste product, found in a blood sample. As the level of creatinine goes up, the eGFR goes down. Kidney disease is present when eGFR is less than 60 milliliters per minute. The American Diabetes Association (ADA) and the National Institutes of Health (NIH) recommend that eGFR be calculated from serum creatinine at least once a year in all people with diabetes. - Urine albumin. Urine albumin is measured by comparing the amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amounts of creatinine but almost no albumin. Even a small increase in the ratio of albumin to creatinine is a sign of kidney damage. Kidney disease is present when urine contains more than 30 milligrams of albumin per gram of creatinine, with or without decreased eGFR. The ADA and the NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have had type 1 diabetes for 5 years or more.
If kidney disease is detected, it should be addressed as part of a comprehensive approach to the treatment of diabetes. | NIDDK | Kidney Disease of Diabetes |
How to diagnose Kidney Disease of Diabetes ? | People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are eGFR and urine albumin.
- eGFR. eGFR stands for estimated glomerular filtration rate. Each kidney contains about 1 million tiny filters made up of blood vessels. These filters are called glomeruli. Kidney function can be checked by estimating how much blood the glomeruli filter in a minute. The calculation of eGFR is based on the amount of creatinine, a waste product, found in a blood sample. As the level of creatinine goes up, the eGFR goes down. Kidney disease is present when eGFR is less than 60 milliliters per minute. The American Diabetes Association (ADA) and the National Institutes of Health (NIH) recommend that eGFR be calculated from serum creatinine at least once a year in all people with diabetes. - Urine albumin. Urine albumin is measured by comparing the amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amounts of creatinine but almost no albumin. Even a small increase in the ratio of albumin to creatinine is a sign of kidney damage. Kidney disease is present when urine contains more than 30 milligrams of albumin per gram of creatinine, with or without decreased eGFR. The ADA and the NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have had type 1 diabetes for 5 years or more.
If kidney disease is detected, it should be addressed as part of a comprehensive approach to the treatment of diabetes. | NIDDK | Kidney Disease of Diabetes |
How to prevent Kidney Disease of Diabetes ? | Blood Pressure Medicines
Scientists have made great progress in developing methods that slow the onset and progression of kidney disease in people with diabetes. Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more drugs to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic can also be useful. Beta blockers, calcium channel blockers, and other blood pressure drugs may also be needed.
An example of an effective ACE inhibitor is lisinopril (Prinivil, Zestril), which doctors commonly prescribe for treating kidney disease of diabetes. The benefits of lisinopril extend beyond its ability to lower blood pressure: it may directly protect the kidneys' glomeruli. ACE inhibitors have lowered proteinuria and slowed deterioration even in people with diabetes who did not have high blood pressure.
An example of an effective ARB is losartan (Cozaar), which has also been shown to protect kidney function and lower the risk of cardiovascular events.
Patients with even mild hypertension or persistent microalbuminuria should consult a health care provider about the use of antihypertensive medicines.
Moderate-protein Diets
In people with diabetes, excessive consumption of protein may be harmful. Experts recommend that people with kidney disease of diabetes consume the recommended dietary allowance for protein, but avoid high-protein diets. For people with greatly reduced kidney function, a diet containing reduced amounts of protein may help delay the onset of kidney failure. Anyone following a reduced-protein diet should work with a dietitian to ensure adequate nutrition.
Intensive Management of Blood Glucose
Antihypertensive drugs and low-protein diets can slow CKD. A third treatment, known as intensive management of blood glucose or glycemic control, has shown great promise for people with diabetes, especially for those in the early stages of CKD.
The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body's cells. To enter cells, glucose needs the help of insulin, a hormone produced by the pancreas. When a person does not make enough insulin, or the body does not respond to the insulin that is present, the body cannot process glucose, and it builds up in the bloodstream. High levels of glucose in the blood lead to a diagnosis of diabetes.
Intensive management of blood glucose is a treatment regimen that aims to keep blood glucose levels close to normal. The regimen includes testing blood glucose frequently, administering insulin throughout the day on the basis of food intake and physical activity, following a diet and activity plan, and consulting a health care team regularly. Some people use an insulin pump to supply insulin throughout the day.
A number of studies have pointed to the beneficial effects of intensive management of blood glucose. In the Diabetes Control and Complications Trial supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), researchers found a 50 percent decrease in both development and progression of early diabetic kidney disease in participants who followed an intensive regimen for controlling blood glucose levels. The intensively managed patients had average blood glucose levels of 150 milligrams per deciliterabout 80 milligrams per deciliter lower than the levels observed in the conventionally managed patients. The United Kingdom Prospective Diabetes Study, conducted from 1976 to 1997, showed conclusively that, in people with improved blood glucose control, the risk of early kidney disease was reduced by a third. Additional studies conducted over the past decades have clearly established that any program resulting in sustained lowering of blood glucose levels will be beneficial to patients in the early stages of CKD. | NIDDK | Kidney Disease of Diabetes |
How to prevent Kidney Disease of Diabetes ? | Blood Pressure Medicines
Scientists have made great progress in developing methods that slow the onset and progression of kidney disease in people with diabetes. Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more drugs to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic can also be useful. Beta blockers, calcium channel blockers, and other blood pressure drugs may also be needed.
An example of an effective ACE inhibitor is lisinopril (Prinivil, Zestril), which doctors commonly prescribe for treating kidney disease of diabetes. The benefits of lisinopril extend beyond its ability to lower blood pressure: it may directly protect the kidneys' glomeruli. ACE inhibitors have lowered proteinuria and slowed deterioration even in people with diabetes who did not have high blood pressure.
An example of an effective ARB is losartan (Cozaar), which has also been shown to protect kidney function and lower the risk of cardiovascular events.
Patients with even mild hypertension or persistent microalbuminuria should consult a health care provider about the use of antihypertensive medicines.
Moderate-protein Diets
In people with diabetes, excessive consumption of protein may be harmful. Experts recommend that people with kidney disease of diabetes consume the recommended dietary allowance for protein, but avoid high-protein diets. For people with greatly reduced kidney function, a diet containing reduced amounts of protein may help delay the onset of kidney failure. Anyone following a reduced-protein diet should work with a dietitian to ensure adequate nutrition.
Intensive Management of Blood Glucose
Antihypertensive drugs and low-protein diets can slow CKD. A third treatment, known as intensive management of blood glucose or glycemic control, has shown great promise for people with diabetes, especially for those in the early stages of CKD.
The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body's cells. To enter cells, glucose needs the help of insulin, a hormone produced by the pancreas. When a person does not make enough insulin, or the body does not respond to the insulin that is present, the body cannot process glucose, and it builds up in the bloodstream. High levels of glucose in the blood lead to a diagnosis of diabetes.
Intensive management of blood glucose is a treatment regimen that aims to keep blood glucose levels close to normal. The regimen includes testing blood glucose frequently, administering insulin throughout the day on the basis of food intake and physical activity, following a diet and activity plan, and consulting a health care team regularly. Some people use an insulin pump to supply insulin throughout the day.
A number of studies have pointed to the beneficial effects of intensive management of blood glucose. In the Diabetes Control and Complications Trial supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), researchers found a 50 percent decrease in both development and progression of early diabetic kidney disease in participants who followed an intensive regimen for controlling blood glucose levels. The intensively managed patients had average blood glucose levels of 150 milligrams per deciliterabout 80 milligrams per deciliter lower than the levels observed in the conventionally managed patients. The United Kingdom Prospective Diabetes Study, conducted from 1976 to 1997, showed conclusively that, in people with improved blood glucose control, the risk of early kidney disease was reduced by a third. Additional studies conducted over the past decades have clearly established that any program resulting in sustained lowering of blood glucose levels will be beneficial to patients in the early stages of CKD. | NIDDK | Kidney Disease of Diabetes |
What to do for Kidney Disease of Diabetes ? | - Diabetes is the leading cause of chronic kidney disease (CKD) and kidney failure in the United States. - People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are estimated glomerular filtration rate (eGFR) and urine albumin. - Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. - In people with diabetes, excessive consumption of protein may be harmful. - Intensive management of blood glucose has shown great promise for people with diabetes, especially for those in the early stages of CKD. | NIDDK | Kidney Disease of Diabetes |
What to do for Kidney Disease of Diabetes ? | - Diabetes is the leading cause of chronic kidney disease (CKD) and kidney failure in the United States. - People with diabetes should be screened regularly for kidney disease. The two key markers for kidney disease are estimated glomerular filtration rate (eGFR) and urine albumin. - Drugs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. - In people with diabetes, excessive consumption of protein may be harmful. - Intensive management of blood glucose has shown great promise for people with diabetes, especially for those in the early stages of CKD. | NIDDK | Kidney Disease of Diabetes |
What is (are) Hepatitis B: What Asian and Pacific Islander Americans Need to Know ? | Hepatitis B is a liver disease spread through contact with blood, semen, or other body fluids from a person infected with the hepatitis B virus. The disease is most commonly spread from an infected mother to her infant at birth. Hepatitis B is also spread through sex, wound-to-wound contact, and contact with items that may have blood on them, such as shaving razors, toothbrushes, syringes, and tattoo and body piercing needles.
Hepatitis B is not spread through casual contact such as shaking hands or hugging; nor is it spread by sharing food or beverages, by sneezing and coughing, or through breastfeeding. | NIDDK | Hepatitis B: What Asian and Pacific Islander Americans Need to Know |
What is (are) Hepatitis B: What Asian and Pacific Islander Americans Need to Know ? | Hepatitis B may start as a brief, flu-like illness. Most healthy adults and children older than 5 completely recover after the bodys immune system gets rid of the virus.
Hepatitis B becomes chronic when the bodys immune system cant get rid of the virus. Over time, having the virus can lead to inflammation of the liver; scar tissue in the liver, called cirrhosis; or liver cancer. Inflammation is the painful red swelling that results when tissues of the body become infected. Young children and people with weakened immune systems are especially at risk. People who were infected as infants have a 90 percent chance of developing chronic hepatitis B.1 | NIDDK | Hepatitis B: What Asian and Pacific Islander Americans Need to Know |
Who is at risk for Hepatitis B: What Asian and Pacific Islander Americans Need to Know? ? | Since 1986, a hepatitis B vaccine has been available and should be given to newborns and children in the United States. The vaccine, however, is unavailableor has only recently become availablein many parts of the world. You are at higher risk for hepatitis B if you or your mother was born in a region of the world where hepatitis B is common, meaning 2 percent or more of the population is chronically infected with the hepatitis B virus.1 In most Asian and Pacific Island nations, 8 to 16 percent of the population is chronically infected.2 | NIDDK | Hepatitis B: What Asian and Pacific Islander Americans Need to Know |
What are the symptoms of Hepatitis B: What Asian and Pacific Islander Americans Need to Know ? | Hepatitis B is called a silent killer because many people have no symptoms, so the disease often progresses unnoticed for years. Unfortunately, many people first learn they have chronic hepatitis B when they develop symptoms of severe liver damage, which include
- yellowish eyes and skin, called jaundice - a swollen stomach or ankles - tiredness - nausea - weakness - loss of appetite - weight loss - spiderlike blood vessels, called spider angiomas, that develop on the skin | NIDDK | Hepatitis B: What Asian and Pacific Islander Americans Need to Know |
Who is at risk for Hepatitis B: What Asian and Pacific Islander Americans Need to Know? ? | Anyone can get hepatitis B, but some people are at higher risk, including
- people who were born to a mother with hepatitis B - people who have close household contact with someone infected with the hepatitis B virus - people who have lived in parts of the world where hepatitis B is common, including most Asian and Pacific Island nations - people who are exposed to blood or body fluids at work - people on hemodialysis - people whose sex partner(s) has hepatitis B - people who have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease - injection drug users - men who have sex with men | NIDDK | Hepatitis B: What Asian and Pacific Islander Americans Need to Know |
What is (are) Solitary Kidney ? | When a person has only one kidney or one working kidney, this kidney is called a solitary kidney. The three main causes of a solitary kidney are
- birth defects. People with kidney agenesis are born with only one kidney. People born with kidney dysplasia have both kidneys; however, one kidney does not function. Many people with kidney agenesis or kidney dysplasia do not discover that they have a solitary kidney until they have an x ray, an ultrasound, or surgery for an unrelated condition. - surgical removal of a kidney. Some people must have a kidney removed to treat cancer or another disease or injury. When a kidney is removed surgically due to disease or for donation, both the kidney and ureter are removed. - kidney donation. A growing number of people are donating a kidney to be transplanted into a family member or friend whose kidneys have failed.
In general, people with a solitary kidney lead full, healthy lives. However, some people are more likely to develop kidney disease. | NIDDK | Solitary Kidney |
What is (are) Solitary Kidney ? | The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. | NIDDK | Solitary Kidney |
What to do for Solitary Kidney ? | People with a solitary kidney do not need to eat a special diet. However, people with reduced kidney function may need to make changes to their diet to slow the progression of kidney disease. More information about recommended dietary changes is provided in the NIDDK health topics, Nutrition for Early Chronic Kidney Disease in Adults and Nutrition for Advanced Chronic Kidney Disease in Adults, and on the National Kidney Disease Education Program website. People should talk with their health care provider about what diet is right for them.
Controlling Blood Pressure
People can control their blood pressure by not smoking, eating a healthy diet, and taking certain medications. Medications that lower blood pressure can also significantly slow the progression of kidney disease. Two types of blood pressurelowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or ARB, a diuretica medication that helps the kidneys remove fluid from the bloodmay be prescribed. Beta-blockers, calcium channel blockers, and other blood pressure medications may also be needed.
Preventing Injury
For people with a solitary kidney, loss of the remaining working kidney results in the need for dialysis or kidney transplant. People should make sure their health care providers know they have a solitary kidney to prevent injury from medications or medical procedures. People who participate in certain sports may be more likely to injure the kidney; this risk is of particular concern with children, as they are more likely to play sports. The American Academy of Pediatrics recommends individual assessment for contact, collision, and limited-contact sports. Protective equipment may reduce the chance of injury to the remaining kidney enough to allow participation in most sports, provided that such equipment remains in place during activity. Health care providers, parents, and patients should consider the risks of any activity and decide whether the benefits outweigh those risks. | NIDDK | Solitary Kidney |
What to do for Solitary Kidney ? | - When a person has only one kidney or one working kidney, this kidney is called a solitary kidney. The three main causes of a solitary kidney are birth defects, surgical removal of a kidney, and kidney donation. - In general, people with a solitary kidney lead full, healthy lives. However, some people are more likely to develop kidney disease. - People with a solitary kidney should be tested regularly for the following signs of kidney damage: - albuminuria - decreased glomerular filtration rate (GFR) - high blood pressure - People with a solitary kidney can protect their health by eating a nutritious diet, keeping their blood pressure at the appropriate level, and preventing injury to the working kidney. | NIDDK | Solitary Kidney |
What is (are) What I need to know about Hepatitis B ? | Hepatitis* B is a virus, or infection, that causes liver disease and inflammation of the liver. Viruses can cause sickness. For example, the flu is caused by a virus. People can pass viruses to each other.
Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can cause organs to not work properly. | NIDDK | What I need to know about Hepatitis B |
What is (are) What I need to know about Hepatitis B ? | The liver is an organ that does many important things. You cannot live without a liver.
*See the Pronunciation Guide for tips on how to say the words in bold type.
The liver
- removes harmful chemicals from your blood - fights infection - helps digest food - stores nutrients and vitamins - stores energy | NIDDK | What I need to know about Hepatitis B |
Who is at risk for What I need to know about Hepatitis B? ? | Anyone can get hepatitis B, but those more likely to are people who
- were born to a mother with hepatitis B - are in contact with blood, needles, or body fluids at work - live with someone who currently has an active hepatitis B infection - have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease - are on kidney dialysisthe process of filtering wastes and extra water from the body by means other than the kidneys - are taking medicines that suppress the immune system, such as steroids or chemotherapy medicines - have lived in or travel often to parts of the world where hepatitis B is common - are from Asian and Pacific Island nations - are infected with HIV or hepatitis C - have injected illegal drugs - work or live in a prison - had a blood transfusion or organ transplant before the mid-1980s
Also, men who have sex with men are more likely to get hepatitis B. | NIDDK | What I need to know about Hepatitis B |
What are the symptoms of What I need to know about Hepatitis B ? | Most people do not have any symptoms of hepatitis B. Adults and children ages 5 and older may have one or more of the following symptoms:
- feeling tired - muscle soreness - upset stomach - stomach pain - fever - loss of appetite - diarrhea - dark-yellow urine - light-colored stools - yellowish eyes and skin, called jaundice
When symptoms occur, they can begin 2 to 5 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis B. | NIDDK | What I need to know about Hepatitis B |
What is (are) What I need to know about Hepatitis B ? | Acute hepatitis B is a short-term infection with the hepatitis B virus. Symptoms usually last several weeks but they can last up to 6 months. The infection sometimes clears up because your body is able to fight off the infection and get rid of the virus. Most healthy adults and children older than 5 who have hepatitis B get better without treatment. | NIDDK | What I need to know about Hepatitis B |
What is (are) What I need to know about Hepatitis B ? | Chronic hepatitis B is a long-lasting infection with the hepatitis B virus. Chronic hepatitis B occurs when the body cant get rid of the hepatitis B virus. Children, especially infants, are more likely to get chronic hepatitis B, which usually has no symptoms until signs of liver damage appear.
Without treatment, chronic hepatitis B can cause liver cancer or severe liver damage that leads to liver failure. Liver failure occurs when the liver stops working properly. | NIDDK | What I need to know about Hepatitis B |
How to diagnose What I need to know about Hepatitis B ? | A blood test will show if you have hepatitis B. Blood tests are done at a doctors office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis B.
If you are at higher risk of getting hepatitis B, get tested. If you are pregnant, you should also get tested. Many people with hepatitis B do not know they are infected. Early diagnosis and treatment can help prevent liver damage.
Your doctor may suggest getting a liver biopsy if chronic hepatitis B is suspected. A liver biopsy is a test to take a small piece of your liver to look for liver damage. The doctor may ask you to stop taking certain medicines before the test. You may be asked to fast for 8 hours before the test.
During the test, you lie on a table with your right hand resting above your head. Medicine is applied to numb the area where the biopsy needle will be inserted. If needed, sedatives and pain medicine are also given. The doctor uses a needle to take a small piece of liver tissue. After the test, you must lie on your right side for up to 2 hours. You will stay 2 to 4 hours after the test before being sent home.
A liver biopsy is performed at a hospital or outpatient center by a doctor. The liver tissue is sent to a special lab where a doctor looks at the tissue with a microscope and sends a report to your doctor. | NIDDK | What I need to know about Hepatitis B |
What are the treatments for What I need to know about Hepatitis B ? | Hepatitis B is not usually treated unless it becomes chronic. Chronic hepatitis B is treated with medicines that slow or stop the virus from damaging the liver.
Medicines for Chronic Hepatitis B
Your doctor will choose medicines or a combination of medicines that are likely to work for you. The doctor will closely watch your symptoms and schedule regular blood tests to make sure treatment is working.
Medicines given by shots include
- interferon - peginterferon
Medicines taken by mouth include
- adefovir - entecavir - lamivudine - telbivudine - tenofovir
The length of treatment varies. Talk with your doctor before taking other prescription medicines and over-the-counter medicines.
Liver Transplant
A liver transplant may be necessary if chronic hepatitis B causes severe liver damage that leads to liver failure. Symptoms of severe liver damage include the symptoms of hepatitis B and
- generalized itching - a longer than usual amount of time for bleeding to stop - easy bruising - swollen stomach or ankles - spiderlike blood vessels, called spider angiomas, that develop on the skin
Liver transplant is surgery to remove a diseased or injured liver and replace it with a healthy one from another person, called a donor. If your doctors tell you that you need a transplant, you should talk with them about the long-term demands of living with a liver transplant.
A team of surgeonsdoctors who specialize in surgeryperforms a liver transplant in a hospital. You will learn how to take care of yourself after you go home and about the medicines youll need to take to protect your new liver. Medicines taken after liver transplant surgery can prevent hepatitis B from coming back.
Testing for Liver Cancer
Having hepatitis B increases your risk for getting liver cancer, so your doctor may suggest an ultrasound test of the liver every 6 to 12 months. Finding cancer early makes it more treatable. Ultrasound is a machine that uses sound waves to create a picture of your liver. Ultrasound is performed at a hospital or radiology center by a specially trained technician. The image, called a sonogram, can show the livers size and the presence of cancerous tumors. | NIDDK | What I need to know about Hepatitis B |
What to do for What I need to know about Hepatitis B ? | If you have chronic hepatitis B, you should do things to take care of yourself, including eating a healthy diet. Avoid drinking alcohol, which can harm the liver. Talk with your doctor before taking vitamins and other supplements. | NIDDK | What I need to know about Hepatitis B |
What to do for What I need to know about Hepatitis B ? | - Hepatitis B is a virus, or infection, that causes liver disease and inflammation of the liver. - Anyone can get hepatitis B, but some people are more likely to than others. - You could get hepatitis B through contact with an infected persons blood, semen, or other body fluid. - Most people do not have any symptoms of hepatitis B. Adults and children ages 5 and older may have symptoms. - See a doctor right away if you or a child in your care has symptoms of hepatitis B. - Acute hepatitis B is a short-term infection with the hepatitis B virus. - Chronic hepatitis B is a long-lasting infection with the hepatitis B virus. Chronic hepatitis B occurs when the body cant get rid of the hepatitis B virus. - Children, especially infants, are more likely to get chronic hepatitis B. - A blood test will show if you have hepatitis B. - If you are at higher risk of getting hepatitis B, get tested. If you are pregnant, you should also get tested. - Many people with hepatitis B do not know they are infected. Early diagnosis and treatment can help prevent liver damage. - Hepatitis B is usually not treated unless it becomes chronic. Chronic hepatitis B is treated with medicines that slow or stop the virus from damaging the liver. - You can avoid getting hepatitis B by receiving the hepatitis B vaccine. - Tell your doctor and your dentist if you have hepatitis B. - If you are pregnant and have hepatitis B, tell the doctor and staff who deliver your baby. - See your doctor right away if you think you have been in contact with the hepatitis B virus. | NIDDK | What I need to know about Hepatitis B |
What are the treatments for Kidney Failure: Choosing a Treatment That's Right for You ? | If you have advanced chronic kidney disease (CKD), you may soon need treatment to do the work your kidneys can no longer do. Learning about your treatment options for kidney failure will help you make the best choice for you. Each treatment has pros and cons. Your choice of treatment will have a big effect on your daily life, such as continuing to work if you do so currently. Talking with your doctor ahead of time about your options can help you take control of your care. Understanding the treatment you choose and getting used to the idea that you need to have this treatment takes time. If you find your choice of treatment does not fit your lifestyle, talk with your doctor about picking another treatment that fits your needs better. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What is (are) Kidney Failure: Choosing a Treatment That's Right for You ? | The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of the bladder. The bladder stores urine. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men the urethra is long, while in women it is short. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What is (are) Kidney Failure: Choosing a Treatment That's Right for You ? | Chronic kidney disease means you have damaged kidneys that cannot filter blood normally. Wastes then build up in your blood, harming your body. Kidney disease usually does not get better and may lead to kidney failure. If your kidneys fail, current treatment options can help you live a longer, healthier life. Some people live with kidney disease for years without needing treatment. Others progress quickly to kidney failure. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What are the treatments for Kidney Failure: Choosing a Treatment That's Right for You ? | You have three treatment options to choose from to filter your blood. A fourth option offers care without replacing the work of the kidneys. None of these treatments helps the kidneys get better. However, they all can help you feel better.
- Hemodialysis uses a machine to move your blood through a filter outside your body, removing wastes. - Peritoneal dialysis uses the lining of your belly to filter your blood inside your body, removing wastes. - Kidney transplantation is surgery to place a healthy kidney from a person who has just died or a living person, usually a family member, into your body to take over the job of filtering your blood. - Conservative management is the choice not to treat kidney failure with dialysis or a transplant. Instead, the focus is on using medicines to keep you comfortable, preserving kidney function through diet, and treating the problems of kidney failure, such as anemiaa shortage of red blood cells that can make you tiredand weak bones. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What is (are) Kidney Failure: Choosing a Treatment That's Right for You ? | Purpose of Hemodialysis
The purpose of hemodialysis is to filter your blood. This type of dialysis uses a machine to remove harmful wastes and extra fluid, as your kidneys did when they were healthy. Hemodialysis helps control blood pressure and balance important minerals, such as potassium, sodium, calcium, and bicarbonate, in your blood. Hemodialysis is not a cure for kidney failure; however, it can help you feel better and live longer.
How Hemodialysis Works
Before you can begin dialysis, a surgeon will create a vascular access, usually in your arm. A vascular access lets high volumes of blood flow continuously during hemodialysis treatments to filter the largest possible amounts of blood per treatment.
Hemodialysis uses a machine to move your blood through a filter, called a dialyzer, outside your body. A pump on the hemodialysis machine draws your blood through a needle into a tube, a few ounces at a time. Your blood then travels through the tube, which takes it to the dialyzer. Inside the dialyzer, your blood flows through thin fibers that filter out wastes and extra fluid. After the dialyzer filters your blood, another tube carries your blood back to your body. You can do hemodialysis at a dialysis center or in your home.
Hemodialysis can replace part of your kidney function. You will also need dietary changes, medicines, and limits on water and other liquids you drink and get from food. Your dietary changes, the number of medicines you need, and limits on liquid will depend on where you receive your treatmentsat a dialysis center or at homeand how often you receive treatmentsthree or more times a week.
Pros and Cons of Hemodialysis
The pros and cons of hemodialysis differ for each person. What may be bad for one person may be good for another. Following is a list of the general pros and cons of dialysis center and home hemodialysis.
Dialysis Center Hemodialysis
Pros
- Dialysis centers are widely available. - Trained health care providers are with you at all times and help administer the treatment. - You can get to know other people with kidney failure who also need hemodialysis. - You dont have to have a trained partner or keep equipment in your home.
Cons
- The center arranges everyones treatments and allows few exceptions to the schedule. - You need to travel to the center for treatment. - This treatment has the strictest diet and limits on liquids because the longer time between treatments means wastes and extra fluid can build up in your body. - You may have more frequent ups and downs in how you feel from day to day because of the longer time between sessions. - Feeling better after a treatment may take a few hours.
Home Hemodialysis
Pros
- You can do the treatment at the times you choose; however, you should follow your doctors orders about how many times a week you need treatment. - You dont have to travel to a dialysis center. - You gain a sense of control over your treatment. - You will have fewer ups and downs in how you feel from day to day because of more frequent sessions. - You can do your treatments at times that will let you work outside the home. - You will have a more manageable diet and fewer limits on liquids because the shorter time between sessions prevents the buildup of wastes and extra fluid. - You can take along a hemodialysis machine when traveling. - You can spend more time with your loved ones because you dont have to go to the dialysis center three times a week.
Cons
- Not all dialysis centers offer home hemodialysis training and support. - You and a family member or friend will have to set aside a week or more at the beginning for training. - Helping with treatments may be stressful for your family or friend. - You need space for storing the hemodialysis machine and supplies at home. - You will need to learn to put dialysis needles into your vascular access. - Medicare and private insurance companies may limit the number of treatments they will pay for when you use home hemodialysis. Few people can afford the costs for additional treatments.
Questions to Ask My Doctor
You may want to ask your doctor these questions:
- Is hemodialysis the best treatment choice for me? Why? - If Im treated at a dialysis center, can I go to the center of my choice? - What should I look for in a dialysis center? - Will my kidney doctor see me at the dialysis center? - What does hemodialysis feel like? - How will hemodialysis affect my ____ [blood pressure, diabetes, other conditions]? - Is home hemodialysis available in my area? What type of training will I need? Who will train my partner and me? - Will I be able to keep working? Can I have treatments at night? Will I be able to care for my children? - How much should I exercise? - Whom do I contact if I have problems? - Who will be on my health care team? How can the members of my health care team help me? - If I do home hemodialysis, will my insurance pay for more than three sessions a week? - With whom can I talk about finances, sex, or family concerns? - How/where can I talk with other people who have faced this decision?
More information about Hemodialysis and Home Hemodialysis is provided in the NIDDK health topics, Treatment Methods for Kidney Failure: Hemodialysis and Home Hemodialysis. See also the Kidney Failure Treatment Comparison Chart in this booklet, which compares hemodialysis, peritoneal dialysis, and transplantation. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What is (are) Kidney Failure: Choosing a Treatment That's Right for You ? | Purpose of Peritoneal Dialysis
The purpose of peritoneal dialysis is to filter wastes and extra fluid from your body. This type of dialysis uses the lining of your bellythe space in your body that holds your stomach, bowels, and liverto filter your blood. This lining, called the peritoneum, acts to do the work of your kidneys.
How Peritoneal Dialysis Works
A doctor will place a soft tube, called a catheter, in your belly a few weeks before you start treatment. The catheter stays in your belly permanently. When you start peritoneal dialysis, you will empty a kind of salty water, called dialysis solution, from a plastic bag through the catheter into your belly. When the bag is empty, you can disconnect your catheter from the bag so you can move around and do your normal activities. While the dialysis solution is inside your belly, it soaks up wastes and extra fluid from your body. After a few hours, you drain the used dialysis solution through another tube into a drain bag. You can throw away the used dialysis solution, now filled with wastes and extra fluid, in a toilet or tub. Then you start over with a fresh bag of dialysis solution. The process of emptying the used dialysis solution and refilling your belly with fresh solution is called an exchange. The process goes on continuously, so you always have dialysis solution in your belly soaking up wastes and extra fluid from your body.
Types of Peritoneal Dialysis
Two types of peritoneal dialysis are available. After you have learned about the types of peritoneal dialysis, you can choose the type that best fits your life. If one schedule or type of peritoneal dialysis does not suit you, talk with your doctor about trying the other type.
- Continuous ambulatory peritoneal dialysis does not require a machine and you can do it in any clean, well-lit place. The time period that the dialysis solution is in your belly is the dwell time. With continuous ambulatory peritoneal dialysis, the dialysis solution stays in your belly for a dwell time of 4 to 6 hours, or more. The process of draining the used dialysis solution and replacing it with fresh solution takes about 30 to 40 minutes. Most people change the dialysis solution at least four times a day and sleep with solution in their belly at night. With continuous ambulatory peritoneal dialysis, you do not have to wake up and perform dialysis tasks during the night. - Continuous cycler-assisted peritoneal dialysis uses a machine called a cycler to fill and empty your belly three to five times during the night while you sleep. In the morning, you begin one exchange with a dwell time that lasts the entire day. You may do an additional exchange in the middle of the afternoon without the cycler to increase the amount of waste removed and to reduce the amount of fluid left behind in your body.
You may need a combination of continuous ambulatory peritoneal dialysis and continuous cycler-assisted peritoneal dialysis if you weigh more than 175 pounds or if your peritoneum filters wastes slowly. For example, some people use a cycler at night and perform one exchange during the day. Others do four exchanges during the day and use a minicycler to perform one or more exchanges during the night. Youll work with your health care team to find the best schedule for you.
Pros and Cons of Peritoneal Dialysis
Each type of peritoneal dialysis has pros and cons.
Continuous Ambulatory Peritoneal Dialysis
Pros
- You can do continuous ambulatory peritoneal dialysis alone. - You can do continuous ambulatory peritoneal dialysis at the times you choose, as long as you perform the required number of exchanges each day. - You can do continuous ambulatory peritoneal dialysis in many locations. - You can travel as long as you bring dialysis bags with you or have them delivered to your destination. - You dont need a machine for continuous ambulatory peritoneal dialysis. - You gain a sense of control over your treatment.
Cons
- Continuous ambulatory peritoneal dialysis can disrupt your daily schedule. - Continuous ambulatory peritoneal dialysis is a continuous treatment, and you should do all exchanges 7 days a week. - Boxes of dialysis solution will take up space in your home.
Continuous Cycler-assisted Peritoneal Dialysis
Pros
- You can do exchanges at night, while you sleep. - You may not have to perform exchanges during the day.
Cons
- You need a machine. - Your connection to the cycler limits your movement at night.
Questions to Ask My Doctor
- Is peritoneal dialysis the best treatment choice for me? Why? If yes, which type is best? - What type of training do I need, and how long will it take? - What does peritoneal dialysis feel like? - How will peritoneal dialysis affect my ____ [blood pressure, diabetes, other conditions]? - Will I be able to keep working? Will I be able to care for my children? - How much should I exercise? - Where do I store supplies? - How often do I see my doctor? - Who will be on my health care team? How can the members of my health care team help me? - Whom do I contact if I have problems? - With whom can I talk about finances, sex, or family concerns? - How/where can I talk with other people who have faced this decision?
More information about Peritoneal Dialysis is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Peritoneal Dialysis. See also the Kidney Failure Treatment Comparison Chart, which compares peritoneal dialysis, hemodialysis, and transplantation. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What is (are) Kidney Failure: Choosing a Treatment That's Right for You ? | What should I know about kidney transplantation?
The purpose of kidney transplantation is to surgically place a healthy kidney from a donora person who has just died or a living person, most often a family memberinto your body. A kidney from someone who has just died is a deceased donor kidney. A kidney from a living person is a living donor kidney. A functioning kidney transplant does a better job of filtering wastes and keeping you healthy than dialysis.
How Kidney Transplantation Works
Surgeonsdoctors who specialize in surgeryplace most transplanted kidneys in the lower front part of your abdomen. The kidney is connected to an artery, which brings unfiltered blood into the kidney, and a vein, which takes filtered blood out of the kidney. The surgeon also transplants the ureter from the donor to let urine from the new kidney flow to your bladder. Unless your damaged kidneys cause problems such as infection, they can remain in their normal position. The transplanted kidney takes over the job of filtering your blood. Your body normally attacks anything it sees as foreign, so to keep your body from attacking the kidney you need to take medicines called immunosuppressants for as long as the transplanted kidney functions.
Pros and Cons of Kidney Transplantation
Following is a list of the pros and cons of kidney transplantation.
Kidney Transplantation
Pros
- A transplanted kidney works like a healthy kidney. - If you have a living donor, you can choose the time of your operation. - You may feel healthier and have an improved quality of life. - You have fewer dietary restrictions. - You wont need dialysis. - People who receive a donated kidney have a greater chance of living a longer life than those who stay on dialysis.
Cons
- Transplantation requires surgery. - You will go through extensive medical testing at the transplant clinic. - You may need to wait years for a deceased donor kidney. - Your body may reject the new kidney, so one transplant may not last a lifetime. - Youll need to take immunosuppressants, which may cause other health problems, for as long as the transplanted kidney functions.
Questions to Ask My Doctor
You may want to ask your doctor these questions:
- Is transplantation the best treatment choice for me? Why? - What are my chances of having a successful transplant? - How do I find out whether a family member or friend can donate? - What are the risks to a family member or friend who donates? - If a family member or friend does not donate, who will place me on a waiting list for a kidney? How long will I have to wait? - How will I know if my donor kidney is working? - How long does a transplanted kidney function? - What side effects do immunosuppressants cause? - Who will be on my transplant team? How can the members of my transplant team help me? - With whom can I talk about finances, sex, or family concerns? - How/where can I talk with other people who have faced this decision?
More information about Transplantation is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Transplantation. See also the Kidney Failure Treatment Comparison Chart, which compares peritoneal dialysis, hemodialysis, and transplantation. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What are the treatments for Kidney Failure: Choosing a Treatment That's Right for You ? | Conservative management for kidney failure is the choice to say no to or stop dialysis treatments. For many people, dialysis not only extends life, it also improves the quality of life. For others who have serious conditions in addition to kidney failure, dialysis may seem like a burden that only prolongs suffering. If you have serious conditions in addition to kidney failure, dialysis may not prolong your life or improve the quality of your life.
You have the right to say no to or stop dialysis. You may want to speak with your doctor, spouse, family, counselor, or renal social worker, who helps people with kidney disease, to help you make this decision.
If you stop dialysis treatments or say you do not want to begin them, you may live for a few weeks or for several months, depending on your health and your remaining kidney function. You may choose to receive care from a hospicea facility or home program designed to meet the physical and emotional needs of the terminally illduring this time. Hospice care focuses on relief of pain and other symptoms. Whether or not you choose to use a hospice, your doctor can give you medicines to make you more comfortable. Your doctor can also give you medicines to treat the problems of kidney failure, such as anemia or weak bones. You may restart dialysis treatment if you change your mind.
Advance Directives
An advance directive is a statement or document in which you give instructions either to withhold certain treatments, such as dialysis, or to provide them, depending on your wishes and the specific circumstances. Even if you are happy with your quality of life on dialysis, you should think about circumstances that might make you want to stop dialysis treatments. At some point in a medical crisis, you might lose the ability to tell your health care team and loved ones what you want. Advance directives may include
- a living will - a durable power of attorney for health care decisions - a do not resuscitate (DNR) ordera legal form that tells your health care team you do not want cardiopulmonary resuscitation (CPR) or other life-sustaining treatment if your heart were to stop or if you were to stop breathing.
A living will is a document that details the conditions under which you would want to refuse treatment. You may state that you want your health care team to use all available means to sustain your life, or you may direct that you be withdrawn from dialysis if you fall into a coma from which you most likely wont wake up. In addition to dialysis, you may choose or refuse the following life-sustaining treatments:
- CPR - feedings through a tube in your stomach - mechanical or artificial means to help you breathe - medicines to treat infections - surgery - receiving blood
Refusing to have CPR is the same as a DNR order. If you choose to have a DNR order, your doctor will place the order in your medical chart.
A durable power of attorney for health care decisions or a health care proxy is a document you use to assign a person to make health care decisions for you in the event you cannot make them for yourself. Make sure the person you name understands your values and will follow your instructions.
Each state has its own laws on advance directives. You can obtain a form for an advance medical directive thats valid in your state from the National Hospice and Palliative Care Organizationsee For More Information. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What to do for Kidney Failure: Choosing a Treatment That's Right for You ? | All of the treatment options for kidney failure require changes and restrictions in your diet.
Hemodialysis
Hemodialysis has the most restrictions. You should watch how much water and other liquids you get from food and drinks and avoid getting too much sodium, often from salt; potassium; and phosphorus. You may find it difficult to limit phosphorus because many foods that are high in phosphorus also provide the protein you need. Hemodialysis can remove protein from the body, so you should eat foods with high-quality protein, such as meat, fish, and eggs. Limit your phosphorus by avoiding foods such as beans, peas, nuts, tea, and colas. You may also need to take a pill called a phosphate binder that keeps phosphorus in your food from entering your bloodstream. Talk with your dialysis centers dietitian to find a hemodialysis meal plan that works for you.
More information about nutrition for people who are on hemodialysis is provided in the NIDDK health topic, Eat Right to Feel Right on Hemodialysis.
Peritoneal Dialysis
Like hemodialysis, peritoneal dialysis requires limits on sodium and phosphorus. You may need to take a phosphate binder. The liquid limitations in peritoneal dialysis may not be as strict as those for hemodialysis. In fact, you may need to drink more water and other liquids if your peritoneal dialysis treatments remove too much fluid from your body. Peritoneal dialysis removes potassium from the body, so you may need to eat potassium-rich foods such as potatoes, tomatoes, oranges, and bananas. However, be careful not to eat too much potassium because it can cause an unsteady heartbeat. Peritoneal dialysis removes even more protein than hemodialysis, so eating foods with high-quality protein is important. You may need to limit calories because your body absorbs sugar from the dialysis solution.
Kidney Transplantation
Kidney transplantation has the fewest restrictions on your diet. You should limit sodium because it can raise your blood pressure. Medicines that you take after the transplant can cause you to gain weight, so you may need to limit calories.
Conservative Management
The diet for conservative management limits protein. Protein breaks down into waste products the kidneys must remove. Limiting protein may reduce the amount of work the kidneys have to do so they will last longer.
Hemodialysis Peritoneal Dialysis Kidney Transplantation In Center Home CAPD CCPD Deceased Living Schedule Three treatments a week for 3 to 5 hours or more. More flexibility in determining your schedule of treatments. Four to six exchanges a day, every day. Three to five exchanges a night, every night, with an additional exchange begun first thing in the morning. You may wait several years before a suitable kidney is available. If a friend or family member is donating, you can schedule the operation when you're both ready. After the operation, you'll have regular checkups with your doctor. Location Dialysis center. Home. Any clean environment that allows solution exchanges. The transplant operation takes place in a hospital. Availability Available in most communities; may require travel in some rural areas. Generally available, but not widely used because of equipment requirements. Widely available. Widely available. Transplant centers are located throughout the country. However, the demand for kidneys is far greater than the supply. Equipment and Supplies No equipment or supplies in the home. Hemodialysis machine connected to plumbing; chair. Bags of dialysis solution take up storage space. Cycling machine; bags of dialysis solution. No equipment or supplies needed. Training Required Little training required; clinic staff perform most tasks. You and a helper must attend several training sessions. You'll need to attend several training sessions. You'll need to learn about your medications and when to take them. Diet Must limit fluids, sodium, potassium, and phosphorus. Must limit sodium and calories. Fewer dietary restrictions. Level of Freedom Little freedom during treatments. Greater freedom on non-treatment days. More freedom to set your own schedule. You're still linked to a machine for several hours a week. You can move around, exercise, work, drive, etc., with solution in your abdomen. You're linked to a machine during the night. You're free from exchanges during the day. Offers the greatest amount of freedom. Level of Responsibility Some patients prefer to let clinic staff perform all tasks. You and your helper are responsible for cleaning and setting up equipment and monitoring vital signs. Can be stressful on family helpers. You must perform exchanges four to six times a day, every day. You must set up your cycler every night. You must take immunosuppressants every day for as long as the transplanted kidney functions.
More information about the treatments for kidney failure is provided in the NIDDK health communication program, National Kidney Disease Education Program. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What to do for Kidney Failure: Choosing a Treatment That's Right for You ? | - You have three treatment options to choose from to filter your blood. A fourth option offers care without replacing the work of the kidneys. - Hemodialysis - Peritoneal dialysis - Kidney transplantation - Conservative management - None of these treatments helps the kidneys get better. However, they all can help you feel better. - Hemodialysis uses a machine to move your blood through a filter outside your body, removing wastes. - Peritoneal dialysis uses the lining of your belly to filter your blood inside your body, removing wastes. - Kidney transplantation is surgery to place a healthy kidney from a person who has just died or a living person, usually a family member, into your body to take over the job of filtering your blood. - Conservative management is the choice not to treat kidney failure with dialysis or a transplant. - All of the treatment options for kidney failure require changes and restrictions in your diet. | NIDDK | Kidney Failure: Choosing a Treatment That's Right for You |
What is (are) Monitor Your Diabetes ? | Sometimes, no matter how hard you try to keep your blood glucose levels in your target range, they will be too high or too low. Blood glucose thats too high or too low can make you feel sick. If you try to control your high or low blood glucose and cant, you may become even sicker and need help. Talk with your doctor to learn how to handle these emergencies.
Learn about High Blood Glucose Levels
If your blood glucose levels stay above 180 for more than 1 to 2 hours, they may be too high. See the "Daily Diabetes Record Page." High blood glucose, also called hyperglycemia, means you dont have enough insulin in your body. High blood glucose can happen if you
- miss taking your diabetes medicines - eat too much - dont get enough physical activity - have an infection - get sick - are stressed - take medicines that can cause high blood glucose
Be sure to tell your doctor about other medicines you take. When youre sick, be sure to check your blood glucose levels and keep taking your diabetes medicines. Read more about how to take care of yourself when youre sick in the section Take Care of Your Diabetes during Special Times or Events.
Signs that your blood glucose levels may be too high are the following:
- feeling thirsty - feeling weak or tired - headaches - urinating often - having trouble paying attention - blurry vision - yeast infections
Very high blood glucose may also make you feel sick to your stomach.
If your blood glucose levels are high much of the time, or if you have symptoms of high blood glucose, call your doctor. You may need a change in your healthy eating plan, physical activity plan, or medicines.
Learn about Low Blood Glucose Levels
If your blood glucose levels drop below 70, you have low blood glucose, also called hypoglycemia. Low blood glucose can come on fast and can be caused by
- taking too much diabetes medicine - missing or delaying a meal - being more physically active than usual - drinking alcoholic beverages
Sometimes, medicines you take for other health problems can cause your blood glucose levels to drop.
Signs your blood glucose levels may be too low are the following:
- hunger - dizziness or shakiness - confusion - being pale - sweating more - weakness - anxiety or moodiness - headaches - a fast heartbeat
If your blood glucose levels drop lower, you could have severe hypoglycemia, where you pass out or have a seizure. A seizure occurs when cells in the brain release a rush of energy that can cause changes in behavior or muscle contractions. Some seizures are life threatening.
If you have any of these symptoms, check your blood glucose levels. If your blood glucose levels are less than 70, have one of the following right away:
- three or four glucose tablets - one serving of glucose gelthe amount equal to 15 grams of carbohydrates - 1/2 cup, or 4 ounces, of fruit juice - 1/2 cup, or 4 ounces, of a regularnondietsoft drink - 1 cup, or 8 ounces, of milk - five or six pieces of hard candy - 1 tablespoon of sugar, syrup, or honey
After 15 minutes, check your blood glucose levels again. Repeat these steps until your blood glucose levels are 70 or above. If it will be at least 1 hour before your next meal, eat a snack.
If you take diabetes medicines that can cause low blood glucose, always carry food for emergencies. You should also wear a medical identification bracelet or necklace that says you have diabetes.
If you take insulin, keep a prescription glucagon kit at home and at other places where you often go. A glucagon kit has a vial of glucagon, a syringe, and a needle to inject the glucagon. Given as a shot, the glucagon quickly raises blood glucose. If you have severe hypoglycemia, youll need someone to help bring your blood glucose levels back to normal by giving you a glucagon shot. Show your family, friends, and coworkers how to give you a glucagon shot when you have severe hypoglycemia. Someone should call 911 for help if a glucagon kit is not available.
Action Steps If You Take Insulin - Tell your doctor if you have low blood glucose, especially at the same time of the day or night, several times in a row. - Tell your doctor if youve passed out from low blood glucose. - Ask your doctor about glucagon. Glucagon is a medicine that raises blood glucose. - Show your family, friends, and coworkers how to give you a glucagon shot when you have severe hypoglycemia. - When you have severe hypoglycemia, someone should call 911 for help if a glucagon shot is not available.
Action Steps If You Don't Take Insulin - Tell your doctor if you have low blood glucose, especially at the same time of the day or night, several times in a row. - Tell your doctor about other medicines you are taking. - Ask your doctor whether your diabetes medicines might cause low blood glucose.
More information is provided in the NIDDK health topic, Hypoglycemia.
Go to Prevent Diabetes Problems
Return to Take Care of Your Diabetes Each Day
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank: Michael L. Parchman, M.D., M.P.H., F.A.A.F.P., MacColl Center for Health Care Innovation, Group Health Research Institute; Marion J. Franz, M.S., R.D., L.D., C.D.E., Minneapolis, Minnesota
This information is not copyrighted. The NIDDK encourages people to share this content freely.
February 2014 | NIDDK | Monitor Your Diabetes |
What is (are) Diarrhea ? | Diarrhea is loose, watery stools. Having diarrhea means passing loose stools three or more times a day. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own.
Diarrhea lasting more than 2 days may be a sign of a more serious problem. Chronic diarrheadiarrhea that lasts at least 4 weeksmay be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual or they may come and go.
Diarrhea of any duration may cause dehydration, which means the body lacks enough fluid and electrolyteschemicals in salts, including sodium, potassium, and chlorideto function properly. Loose stools contain more fluid and electrolytes and weigh more than solid stools.
People of all ages can get diarrhea. In the United States, adults average one bout of acute diarrhea each year,1 and young children have an average of two episodes of acute diarrhea each year.2 | NIDDK | Diarrhea |
What causes Diarrhea ? | Acute diarrhea is usually caused by a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to a functional disorder such as irritable bowel syndrome or an intestinal disease such as Crohns disease.
The most common causes of diarrhea include the following:
- Bacterial infections. Several types of bacteria consumed through contaminated food or water can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli (E. coli). - Viral infections. Many viruses cause diarrhea, including rotavirus, norovirus, cytomegalovirus, herpes simplex virus, and viral hepatitis. Infection with the rotavirus is the most common cause of acute diarrhea in children. Rotavirus diarrhea usually resolves in 3 to 7 days but can cause problems digesting lactose for up to a month or longer. - Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium. - Functional bowel disorders. Diarrhea can be a symptom of irritable bowel syndrome. - Intestinal diseases. Inflammatory bowel disease, ulcerative colitis, Crohns disease, and celiac disease often lead to diarrhea. - Food intolerances and sensitivities. Some people have difficulty digesting certain ingredients, such as lactose, the sugar found in milk and milk products. Some people may have diarrhea if they eat certain types of sugar substitutes in excessive quantities. - Reaction to medicines. Antibiotics, cancer drugs, and antacids containing magnesium can all cause diarrhea.
Some people develop diarrhea after stomach surgery, which may cause food to move through the digestive system more quickly.
People who visit certain foreign countries are at risk for travelers diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Travelers diarrhea can be a problem for people traveling to developing countries in Africa, Asia, Latin America, and the Caribbean. Visitors to Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for travelers diarrhea.
In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own within 1 to 2 days, finding the cause is not usually necessary. | NIDDK | Diarrhea |
What are the symptoms of Diarrhea ? | Diarrhea may be accompanied by cramping, abdominal pain, nausea, an urgent need to use the bathroom, or loss of bowel control. Some infections that cause diarrhea can also cause a fever and chills or bloody stools.
Dehydration
Diarrhea can cause dehydration. Loss of electrolytes through dehydration affects the amount of water in the body, muscle activity, and other important functions.
Dehydration is particularly dangerous in children, older adults, and people with weakened immune systems. Dehydration must be treated promptly to avoid serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.
Signs of dehydration in adults include
- thirst - less frequent urination than usual - dark-colored urine - dry skin - fatigue - dizziness - light-headedness
Signs of dehydration in infants and young children include
- dry mouth and tongue - no tears when crying - no wet diapers for 3 hours or more - sunken eyes, cheeks, or soft spot in the skull - high fever - listlessness or irritability
Also, when people are dehydrated, their skin does not flatten back to normal right away after being gently pinched and released.
Anyone with signs of dehydration should see a health care provider immediately. Severe dehydration may require hospitalization.
Although drinking plenty of water is important in preventing dehydration, water does not contain electrolytes. Adults can prevent dehydration by also drinking liquids that contain electrolytes, such as fruit juices, sports drinks, caffeine-free soft drinks, and broths. Children with diarrhea should be given oral rehydration solutions such as Pedialyte, Naturalyte, Infalyte, and CeraLyte to prevent dehydration. | NIDDK | Diarrhea |
How to diagnose Diarrhea ? | If acute diarrhea lasts 2 days or less, diagnostic tests are usually not necessary. If diarrhea lasts longer or is accompanied by symptoms such as fever or bloody stools, a doctor may perform tests to determine the cause.
Diagnostic tests to find the cause of diarrhea may include the following:
- Medical history and physical examination. The doctor will ask about eating habits and medication use and will perform a physical examination to look for signs of illness. - Stool culture. A sample of stool is analyzed in a laboratory to check for bacteria, parasites, or other signs of disease and infection. - Blood tests. Blood tests can be helpful in ruling out certain diseases. - Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask a person to avoid foods with lactose, carbohydrates, wheat, or other ingredients to see whether the diarrhea responds to a change in diet. - Sigmoidoscopy or colonoscopy. These tests may be used to look for signs of intestinal diseases that cause chronic diarrhea. For sigmoidoscopy, the doctor uses a thin, flexible, lighted tube with a lens on the end to look at the inside of the rectum and lower part of the colon. Colonoscopy is similar to sigmoidoscopy, but it allows the doctor to view the entire colon. | NIDDK | Diarrhea |
What are the treatments for Diarrhea ? | In most cases of diarrhea, the only treatment necessary is replacing lost fluids and electrolytes to prevent dehydration.
Over-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol and Kaopectate) may help stop diarrhea in adults. However, people with bloody diarrheaa sign of bacterial or parasitic infectionshould not use these medicines. If diarrhea is caused by bacteria or parasites, over-the-counter medicines may prolong the problem, so doctors usually prescribe antibiotics instead.
Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given with a doctors guidance. | NIDDK | Diarrhea |
What to do for Diarrhea ? | Until diarrhea subsides, avoiding caffeine and foods that are greasy, high in fiber, or sweet may lessen symptoms. These foods can aggravate diarrhea. Some people also have problems digesting lactose during or after a bout of diarrhea. Yogurt, which has less lactose than milk, is often better tolerated. Yogurt with active, live bacterial cultures may even help people recover from diarrhea more quickly.
As symptoms improve, soft, bland foods can be added to the diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the health care provider may also recommend a bland diet. Once the diarrhea stops, the health care provider will likely encourage children to return to a normal and healthy diet if it can be tolerated. Infants with diarrhea should be given breast milk or full-strength formula as usual, along with oral rehydration solutions. Some children recovering from viral diarrheas have problems digesting lactose for up to a month or more. | NIDDK | Diarrhea |
How to prevent Diarrhea ? | Two types of diarrhea can be preventedrotavirus diarrhea and travelers diarrhea.
Rotavirus Diarrhea
Two oral vaccines have been approved by the U.S. Food and Drug Administration to protect children from rotavirus infections: rotavirus vaccine, live, oral, pentavalent (RotaTeq); and rotavirus vaccine, live, oral (Rotarix). RotaTeq is given to infants in three doses at 2, 4, and 6 months of age. Rotarix is given in two doses. The first dose is given when infants are 6 weeks old, and the second is given at least 4 weeks later but before infants are 24 weeks old.
Parents of infants should discuss rotavirus vaccination with a health care provider. For more information, parents can visit the Centers for Disease Control and Prevention rotavirus vaccination webpage at www.cdc.gov/vaccines/vpd-vac/rotavirus.
Travelers Diarrhea
To prevent travelers diarrhea, people traveling from the United States to developing countries should avoid
- drinking tap water, using tap water to brush their teeth, or using ice made from tap water - drinking unpasteurized milk or milk products - eating raw fruits and vegetables, including lettuce and fruit salads, unless they peel the fruits or vegetables themselves - eating raw or rare meat and fish - eating meat or shellfish that is not hot when served - eating food from street vendors
Travelers can drink bottled water, soft drinks, and hot drinks such as coffee or tea.
People concerned about travelers diarrhea should talk with a health care provider before traveling. The health care provider may recommend that travelers bring medicine with them in case they develop diarrhea during their trip. Health care providers may advise some peopleespecially people with weakened immune systemsto take antibiotics before and during a trip to help prevent travelers diarrhea. Early treatment with antibiotics can shorten a bout of travelers diarrhea. | NIDDK | Diarrhea |
What to do for Diarrhea ? | - Diarrhea is loose, watery stools. Having diarrhea means passing loose stools three or more times a day. - Diarrhea is a common problem that usually goes away on its own. - The most common causes of diarrhea include bacterial, viral, and parasitic infections; functional bowel disorders; intestinal diseases; food intolerances and sensitivities; and reactions to medicines. - Diarrhea can cause dehydration, which is particularly dangerous in children, older adults, and people with weakened immune systems. - Treatment involves replacing lost fluids and electrolytes. Depending on the cause of the problem, medication may also be needed to stop the diarrhea or treat an infection. - Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes. - Adults with any of the following symptoms should see a health care provider: signs of dehydration, diarrhea for more than 2 days, severe pain in the abdomen or rectum, a fever of 102 degrees or higher, stools containing blood or pus, or stools that are black and tarry. - Children with any of the following symptoms should see a health care provider: signs of dehydration, diarrhea for more than 24 hours, a fever of 102 degrees or higher, stools containing blood or pus, or stools that are black and tarry. - People can take steps to prevent two types of diarrhearotavirus diarrhea and travelers diarrhea. | NIDDK | Diarrhea |
What is (are) 4 Steps to Manage Your Diabetes for Life ? | What is diabetes?
There are three main types of diabetes:
- Type 1 diabetes Your body does not make insulin. This is a problem because you need insulin to take the sugar (glucose) from the foods you eat and turn it into energy for your body. You need to take insulin every day to live. - Type 2 diabetes Your body does not make or use insulin well. You may need to take pills or insulin to help control your diabetes. Type 2 is the most common type of diabetes. - Gestational (jest-TAY-shun-al) diabetes Some women get this kind of diabetes when they are pregnant. Most of the time, it goes away after the baby is born. But even if it goes away, these women and their children have a greater chance of getting diabetes later in life.
You are the most important member of your health care team.
You are the one who manages your diabetes day by day. Talk to your doctor about how you can best care for your diabetes to stay healthy. Some others who can help are:
- dentist - diabetes doctor - diabetes educator - dietitian - eye doctor - foot doctor - friends and family - mental health counselor - nurse - nurse practitioner - pharmacist - social worker
How to learn more about diabetes.
- Take classes to learn more about living with diabetes. To find a class, check with your health care team, hospital, or area health clinic. You can also search online. - Join a support group in-person or online to get peer support with managing your diabetes. - Read about diabetes online. Go to National Diabetes Education Program.
Take diabetes seriously.
You may have heard people say they have a touch of diabetes or that their sugar is a little high. These words suggest that diabetes is not a serious disease. That is not correct. Diabetes is serious, but you can learn to manage it.
People with diabetes need to make healthy food choices, stay at a healthy weight, move more every day, and take their medicine even when they feel good. Its a lot to do. Its not easy, but its worth it!
Why take care of your diabetes?
Taking care of yourself and your diabetes can help you feel good today and in the future. When your blood sugar (glucose) is close to normal, you are likely to:
- have more energy - be less tired and thirsty - need to pass urine less often - heal better - have fewer skin or bladder infections
You will also have less chance of having health problems caused by diabetes such as:
- heart attack or stroke - eye problems that can lead to trouble seeing or going blind - pain, tingling, or numbness in your hands and feet, also called nerve damage - kidney problems that can cause your kidneys to stop working - teeth and gum problems
Actions you can take
- Ask your health care team what type of diabetes you have. - Learn where you can go for support. - Learn how caring for your diabetes helps you feel good today and in the future. | NIDDK | 4 Steps to Manage Your Diabetes for Life |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | CKD usually takes a long time to develop and does not go away. In CKD, the kidneys continue to workjust not as well as they should. Wastes may build up so gradually that the body becomes used to having those wastes in the blood. Salts containing phosphorus and potassium may rise to unsafe levels, causing heart and bone problems. Anemialow red blood cell countcan result from CKD because the kidneys stop making enough erythropoietin, a hormone that causes bone marrow to make red blood cells. After months or years, CKD may progress to permanent kidney failure, which requires a person to have a kidney transplant or regular blood filtering treatments called dialysis. | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | MNT is the use of nutrition counseling by a registered dietitian to help promote a medical or health goal. A health care provider may refer a patient to a registered dietitian to help with the patient's food plan. Many insurance policies cover MNT when recommended by a health care provider. Anyone who qualifies for Medicare can receive a benefit for MNT from a registered dietitian or nutrition professional when a health care provider provides a referral indicating that the person has diabetes or kidney disease.
One way to locate a qualified dietitian is to contact the Academy of Nutrition and Dietetics at www.eatright.organd click on "Find a Registered Dietitian." Users can enter their address or ZIP code for a list of dietitians in their area. A person looking for dietary advice to prevent kidney damage should click on "Renal (Kidney) Nutrition" in the specialty field. Dietitians who specialize in helping people with CKD are called renal dietitians.
Top | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | As CKD progresses, people often lose their appetites because they find that foods do not taste the same. As a result, they consume fewer caloriesimportant units of energy in foodand may lose too much weight. Renal dietitians can help people with advanced CKD find healthy ways to add calories to their diet if they are losing too much weight.
Top | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | Protein is an essential part of any diet. Proteins help build and maintain muscle, bone, skin, connective tissue, internal organs, and blood. They help fight disease and heal wounds. But proteins also break down into waste products that must be removed from the blood by the kidneys. Eating more protein than the body needs may put an extra burden on the kidneys and cause kidney function to decline faster.
Health care providers recommend that people with CKD eat moderate or reduced amounts of protein. However, restricting protein could lead to malnutrition, so people with CKD need to be careful. The typical American diet contains more than enough protein. Learning about portion sizes can help people limit protein intake without endangering their health. | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | Most peoplewith or without CKDcan get the daily protein they need by eating two 3-ounce servings of meat or meat substitute. A 3-ounce serving of meat is about the size of a deck of cards or the palm of a persons hand.
A renal dietitian can help people learn about the amount and sources of protein in their diet. Animal protein in egg whites, cheese, chicken, fish, and red meats contain more of the essential nutrients a body needs. With careful meal planning, a well-balanced vegetarian diet can also provide these nutrients. A renal dietitian can help people with advanced CKD make small adjustments in their eating habits that can result in significant protein reduction. For example, people can lower their protein intake by making sandwiches using thinner slices of meat and adding lettuce, cucumber slices, apple slices, and other garnishes. The following table lists some higher-protein foods and suggestions for lower-protein alternatives that are better choices for people with CKD trying to limit their protein intake.
Higher- and Lower-protein Foods
Based on about a 3 oz. portion Higher-Protein Foods Lower-protein Alternatives Ground beef Halibut Shrimp Salmon Tuna Chicken breast Roasted chicken Chili con carne Beef stew Egg substitutes Tofu Imitation crab meat
When kidney function declines to the point where dialysis becomes necessary, patients should include more protein in their diet because dialysis removes large amounts of protein from the blood. | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | Everyone should know about fat sources because eating the wrong kinds of fat and too much fat increases the risk of clogged blood vessels and heart problems. Fat provides energy, helps produce hormonelike substances that regulate blood pressure and other heart functions, and carries fat-soluble vitamins. Everyone needs dietary fat, but some fats are healthier than others. People with CKD are at higher risk of having a heart attack or stroke. Therefore, people with CKD should be especially careful about how dietary fat affects their heart health.
People with advanced CKD should talk with a dietitian about healthy and unhealthy sources of fat. Saturated fats and trans-fatty acids can raise blood cholesterol levels and clog blood vessels. Saturated fats are found in animal products such as red meat, poultry, whole milk, and butter. These fats are usually solid at room temperature. Trans-fatty acids are often found in commercially baked goods such as cookies and cakes and in fried foods like doughnuts and french fries.
A dietitian can suggest healthy ways to include fat in the diet, especially if more calories are needed. Vegetable oils such as corn or safflower oil are healthier than animal fats such as butter or lard. Hydrogenated vegetable oils should be avoided because they are high in trans-fatty acids. Monounsaturated fatsolive, peanut, and canola oilsare healthy alternatives to animal fats. The table below shows the sources of fats, broken down into three types of fats that should be eaten less often and good fats that can be eaten more often.
Sources of Fats
Eat Less Often Eat More Often Saturated fats - red meat - poultry - whole milk - butter - lard Monounsaturated fats - corn oil - safflower oil - olive oil - peanut oil - canola oil Trans-fatty acids - commercial baked goods - french fries - doughnuts Hydrogenated vegetable oils - margarine - shortening | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | Too much sodium in a person's diet can be harmful because it causes blood to hold fluid. People with CKD need to be careful not to let too much fluid build up in their bodies. The extra fluid raises blood pressure and puts a strain on the heart and kidneys. A dietitian can help people find ways to reduce the amount of sodium in their diet. Nutrition labels provide information about the sodium content in food. The U.S. Food and Drug Administration advises that healthy people should limit their daily sodium intake to no more than 2,300 milligrams (mg), the amount found in 1 teaspoon of table salt. People who are at risk for a heart attack or stroke because of a condition such as high blood pressure or kidney disease should limit their daily sodium intake to no more than 1,500 mg. Choosing sodium-free or low-sodium food products will help them reach that goal.
Sodium is found in ordinary table salt and many salty seasonings such as soy sauce and teriyaki sauce. Canned foods, some frozen foods, and most processed meats have large amounts of salt. Snack foods such as chips and crackers are also high in salt.
Alternative seasonings such as lemon juice, salt-free seasoning mixes, and hot pepper sauce can help people reduce their salt intake. People with advanced CKD should avoid salt substitutes that use potassium, such as AlsoSalt or Nu-Salt, because CKD limits the body's ability to eliminate potassium from the blood. The table below provides some high-sodium foods and suggestions for low-sodium alternatives that are healthier for people with any level of CKD who have high blood pressure.
High- and Low-sodium Foods
High-sodium Foods Low-sodium Alternatives Salt Regular canned vegetables Hot dogs and canned meat Packaged rice with sauce Packaged noodles with sauce Frozen vegetables with sauce Frozen prepared meals Canned soup Regular tomato sauce Snack foods Salt-free herb seasonings Low-sodium canned foods Frozen vegetables without sauce Fresh, cooked meat Plain rice without sauce Plain noodles without sauce Fresh vegetables without sauce Homemade soup with fresh ingredients Reduced-sodium tomato sauce Unsalted pretzels Unsalted popcorn | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | Keeping the proper level of potassium in the blood is essential. Potassium keeps the heart beating regularly and muscles working right. Problems can occur when blood potassium levels are either too low or too high. Damaged kidneys allow potassium to build up in the blood, causing serious heart problems. Potassium is found in many fruits and vegetables, such as bananas, potatoes, avocados, and melons. People with advanced CKD may need to avoid some fruits and vegetables. Blood tests can indicate when potassium levels have climbed above normal range. A renal dietitian can help people with advanced CKD find ways to limit the amount of potassium they eat. The potassium content of potatoes and other vegetables can be reduced by boiling them in water. The following table gives examples of some high-potassium foods and suggestions for low-potassium alternatives for people with advanced CKD.
High- and Low-potassium Foods
High-potassium Foods Low-potassium Alternatives Oranges and orange juice Melons Apricots Bananas Potatoes Tomatoes Sweet potatoes Cooked spinach Cooked broccoli Beans (baked, kidney, lima, pinto) Apples and apple juice Cranberries and cranberry juice Canned pears Strawberries, blueberries, raspberries Plums Pineapple Cabbage Boiled Cauliflower | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | Damaged kidneys allow phosphorus, a mineral found in many foods, to build up in the blood. Too much phosphorus in the blood pulls calcium from the bones, making the bones weak and likely to break. Too much phosphorus may also make skin itch. Foods such as milk and cheese, dried beans, peas, colas, canned iced teas and lemonade, nuts, and peanut butter are high in phosphorus. A renal dietitian can help people with advanced CKD learn how to limit phosphorus in their diet.
As CKD progresses, a person may need to take a phosphate binder such as sevelamer hydrochloride (Renagel), lanthanum carbonate (Fosrenol), calcium acetate (PhosLo), or calcium carbonate (Tums) to control the phosphorus in the blood. These medications act like sponges to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into the blood. Instead, it is removed from the body in the stool.
The table below lists some high-phosphorus foods and suggestions for low-phosphorus alternatives that are healthier for people with advanced CKD.
High- and Low-phosphorus Foods
High-phosphorus Foods Low-phosphorus Alternatives Dairy foods (milk, cheese, yogurt) Beans (baked, kidney, lima, pinto) Nuts and peanut butter Processed meats (hot dogs, canned meat) Cola Canned iced teas and lemonade Bran cereals Egg yolks Liquid non-dairy creamer Sherbet Cooked rice Rice, wheat, and corn cereals Popcorn Peas Lemon-lime soda Root beer Powdered iced tea and lemonade mixes | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What to do for Nutrition for Advanced Chronic Kidney Disease in Adults ? | - A person may prevent or delay some health problems from chronic kidney disease (CKD) by eating the right foods and avoiding foods high in sodium, potassium, and phosphorus. - The kidneys remove wastes and extra water from the blood and make urine. - Medical nutrition therapy (MNT) is the use of counseling by a registered dietitian to help promote a medical or health goal. - Dietitians who specialize in helping people with CKD are called renal dietitians. - People with advanced CKD often lose their appetites and consume fewer caloriesimportant units of energy in foodand may lose too much weight. - Eating more protein than the body needs may put an extra burden on the kidneys and cause kidney function to decline faster. Most peoplewith or without CKDcan get the daily protein they need by eating two 3-ounce servings of meat or meat substitute. - People with CKD are at higher risk of having a heart attack or stroke. - Everyone needs dietary fat, but some fats are healthier than others. - Too much sodium in a persons diet can be harmful because it causes blood to hold fluid. People with CKD need to be careful not to let too much fluid build up in their bodies. - People with advanced CKD should avoid salt substitutes that use potassium because CKD limits the bodys ability to eliminate potassium from the blood. - Damaged kidneys allow potassium to build up in the blood, causing serious heart problems. Potassium is found in many fruits and vegetables, such as bananas, potatoes, avocados, and melons. - Too much phosphorus in the blood pulls calcium from the bones, making the bones weak and likely to break. - People with advanced CKD may need to limit how much they drink because damaged kidneys can't remove extra fluid. - Many patients find that keeping track of their test results helps them see how their treatment is working. Patients can ask their health care provider for copies of their lab reports and ask to have them explained, noting any results out of the normal range. | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Nutrition for Advanced Chronic Kidney Disease in Adults ? | The NIDDK Nutrition for Chronic Kidney Disease Series includes three fact sheets:
- Nutrition for Early Chronic Kidney Disease in Adults - Nutrition for Advanced Chronic Kidney Disease in Adults - Nutrition for Chronic Kidney Disease in Children | NIDDK | Nutrition for Advanced Chronic Kidney Disease in Adults |
What is (are) Wilson Disease ? | Wilson disease is a genetic disease that prevents the body from removing extra copper. The body needs a small amount of copper from food to stay healthy; however, too much copper is poisonous. Normally, the liver filters extra copper and releases it into bile. Bile is a fluid made by the liver that carries toxins and wastes out of the body through the gastrointestinal tract. In Wilson disease, the liver does not filter copper correctly and copper builds up in the liver, brain, eyes, and other organs. Over time, high copper levels can cause life-threatening organ damage. | NIDDK | Wilson Disease |
What is (are) Wilson Disease ? | The liver is the bodys largest internal organ. The liver is called the bodys metabolic factory because of the important role it plays in metabolismthe way cells change food into energy after food is digested and absorbed into the blood. The liver has many important functions, including
- taking up, storing, and processing nutrients from foodincluding fat, sugar, and proteinand delivering them to the rest of the body when needed. - making new proteins, such as clotting factors and immune factors. - producing bile. In addition to carrying toxins and waste products out of the body, bile helps the body digest fats and the fat-soluble vitamins A, D, E, and K. - removing waste products the kidneys cannot remove, such as fats, cholesterol, toxins, and medications.
A healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete and the liver creates scar tissue. | NIDDK | Wilson Disease |
What causes Wilson Disease ? | Wilson disease is caused by an inherited autosomal recessive mutation, or change, in the ATP7B gene. In an autosomal recessive disease, the child has to inherit the gene mutation from both parents to have an increased likelihood for the disease. The chance of a child inheriting autosomal recessive mutations from both parents with a gene mutation is 25 percent, or one in four. If only one parent carries the mutated gene, the child will not get the disease, although the child may inherit one copy of the gene mutation. The child is called a carrier of the disease and can pass the gene mutation to the next generation. Genetic testing is a procedure that identifies changes in a patients genes and can show whether a parent or child is a carrier of a mutated gene. Autosomal recessive diseases are typically not seen in every generation of an affected family.
The following chart shows the chance of inheriting an autosomal recessive mutation from parents who both carry the mutated gene.
Genetic Diseases Each cell contains thousands of genes that provide the instructions for making proteins for growth and repair of the body. If a gene has a mutation, the protein made by that gene may not function properly. Not all gene mutations cause a disease. People have two copies of most genes; they inherit one copy from each parent. A genetic disease occurs when one or both parents pass a mutated gene to a child at conception. A genetic disease can also occur through a spontaneous gene mutation, meaning neither parent carries a copy of the mutated gene. Once a spontaneous gene mutation has occurred in a person, that person can pass the gene mutation on to a child. Read more about genes and genetic conditions in the U.S. National Library of Medicines Genetics Home Reference at www.ghr.nlm.nih.gov. | NIDDK | Wilson Disease |
What are the symptoms of Wilson Disease ? | The signs and symptoms of Wilson disease vary, depending on what organs of the body are affected. Wilson disease is present at birth; however, the signs and symptoms of the disease do not appear until the copper builds up in the liver, the brain, or other organs.
When people have signs and symptoms, they usually affect the liver, the central nervous system, or both. The central nervous system includes the brain, the spinal cord, and nerves throughout the body. Sometimes a person does not have symptoms and a health care provider discovers the disease during a routine physical exam or blood test, or during an illness. Children can have Wilson disease for several years before any signs and symptoms occur. People with Wilson disease may have
- liver-related signs and symptoms - central nervous system-related signs and symptoms - mental health-related signs and symptoms - other signs and symptoms
Liver-related Signs and Symptoms
People with Wilson disease may develop signs and symptoms of chronic, or long lasting, liver disease:
- weakness - fatigue, or feeling tired - loss of appetite - nausea - vomiting - weight loss - pain and bloating from fluid accumulating in the abdomen - edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face - itching - spiderlike blood vessels, called spider angiomas, near the surface of the skin - muscle cramps - jaundice, a condition that causes the skin and whites of the eyes to turn yellow
Some people with Wilson disease may not develop signs or symptoms of liver disease until they develop acute liver failurea condition that develops suddenly.
Central Nervous System-related Signs and Symptoms
Central nervous system-related symptoms usually appear in people after the liver has retained a lot of copper; however, signs and symptoms of liver disease may not be present. Central nervous system-related symptoms occur most often in adults and sometimes occur in children.1 Signs and symptoms include
- tremors or uncontrolled movements - muscle stiffness - problems with speech, swallowing, or physical coordination
A health care provider may refer people with these symptoms to a neurologista doctor who specializes in nervous system diseases.
Mental Health-related Signs and Symptoms
Some people will have mental health-related signs and symptoms when copper builds up in the central nervous system. Signs and symptoms may include
- personality changes - depression - feeling anxious, or nervous, about most things - psychosiswhen a person loses contact with reality
Other Signs and Symptoms
Other signs and symptoms of Wilson disease may include
- anemia, a condition in which red blood cells are fewer or smaller than normal, which prevents the bodys cells from getting enough oxygen - arthritis, a condition in which a person has pain and swelling in one or more joints - high levels of amino acids, protein, uric acid, and carbohydrates in urine - low platelet or white blood cell count - osteoporosis, a condition in which the bones become less dense and more likely to fracture | NIDDK | Wilson Disease |
What are the complications of Wilson Disease ? | People who have Wilson disease that is not treated or diagnosed early can have serious complications, such as
- cirrhosisscarring of the liver - kidney damageas liver function decreases, the kidneys may be damaged - persistent nervous system problems when nervous system symptoms do not resolve - liver cancerhepatocellular carcinoma is a type of liver cancer that can occur in people with cirrhosis - liver failurea condition in which the liver stops working properly - death, if left untreated | NIDDK | Wilson Disease |
How to diagnose Wilson Disease ? | A health care provider may use several tests and exams to diagnose Wilson disease, including the following:
- medical and family history - physical exam - blood tests - urine tests - liver biopsy - imaging tests
Health care providers typically see the same symptoms of Wilson disease in other conditions, and the symptoms of Wilson disease do not occur together often, making the disease difficult to diagnose.
Medical and Family History
A health care provider may take a medical and family history to help diagnose Wilson disease.
Physical Exam
A physical exam may help diagnose Wilson disease. During a physical exam, a health care provider usually
- examines a patients body - uses a stethoscope to listen to sounds related to the abdomen
A health care provider will use a special light called a slit lamp to look for Kayser-Fleischer rings in the eyes.
Blood Tests
A nurse or technician will draw blood samples at a health care providers office or a commercial facility and send the samples to a lab for analysis. A health care provider may
- perform liver enzyme or function testsblood tests that may indicate liver abnormalities. - check copper levels in the blood. Since the copper is deposited into the organs and is not circulating in the blood, most people with Wilson disease have a lower-than-normal level of copper in the blood. In cases of acute liver failure caused by Wilson disease, the level of blood copper is often higher than normal. - check the level of ceruloplasmina protein that carries copper in the bloodstream. Most people with Wilson disease have a lower-than-normal ceruloplasmin level. - conduct genetic testing. A health care provider may recommend genetic testing in cases of a known family history of Wilson disease.
Urine Tests
24-hour urine collection. A patient will collect urine at home in a special container provided by a health care providers office or a commercial facility. A health care provider sends the sample to a lab for analysis. A 24-hour urine collection will show increased copper in the urine in most patients who have symptoms due to Wilson disease.
Liver Biopsy
A liver biopsy is a procedure that involves taking a small piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to stop taking certain medications temporarily before the liver biopsy. He or she may also ask the patient to fasteat or drink nothingfor 8 hours before the procedure.
During the procedure, the patient lies on a table, right hand resting above the head. The health care provider applies a local anesthetic to the area where he or she will insert the biopsy needle. If needed, a health care provider will also give sedatives and pain medication. The health care provider uses the needle to take a small piece of liver tissue. He or she may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home.
A pathologista doctor who specializes in diagnosing diseasesexamines the liver tissue in a lab. The test can show cirrhosis of the liver. Sometimes the liver biopsy will show copper buildup in the liver cells; however, the results can vary because the copper does not always deposit evenly into the liver. Therefore, health care providers often find it more useful to analyze a piece of liver tissue for copper content. Most patients with Wilson disease have high levels of copper in the liver tissue when compared with carriers or with people who do not have Wilson disease.
More information is provided in the NIDDK health topic, Liver Biopsy.
Imaging Tests
A health care provider may order imaging tests to evaluate brain abnormalities in patients who have nervous system symptoms often seen with Wilson disease, or in patients diagnosed with Wilson disease. Health care providers do not use brain imaging tests to diagnose Wilson disease, though certain findings may suggest the patient has the disease.
Magnetic resonance imaging (MRI). An MRI is a test that takes pictures of the bodys internal organs and soft tissues without using x rays. A specially trained technician performs the procedure in an outpatient center or a hospital, and a radiologista doctor who specializes in medical imaginginterprets the images. The patient does not need anesthesia, though people with a fear of confined spaces may receive light sedation, taken by mouth. An MRI may include the injection of a special dye, called contrast medium. With most MRI machines, the patient will lie on a table that slides into a tunnel-shaped device that may be open ended or closed at one end. Some machines allow the patient to lie in a more open space. The technician will take a sequence of images from different angles to create a detailed picture of the brain. During sequencing, the patient will hear loud mechanical knocking and humming noises. MRI can show if other diseases or conditions are causing the patients neurological symptoms.
Computerized tomography (CT) scan. A CT scan uses a combination of x rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where a technician takes the x rays. An x-ray technician performs the procedure in an outpatient center or a hospital. A radiologist interprets the images. The patient does not need anesthesia. A CT scan can show if other diseases or conditions are causing the patients neurological symptoms. | NIDDK | Wilson Disease |
What are the treatments for Wilson Disease ? | A health care provider will treat Wilson disease with a lifelong effort to reduce and control the amount of copper in the body. Treatment may include
- medications - changes in eating, diet, and nutrition - a liver transplant
Medications
A health care provider will prescribe medications to treat Wilson disease. The medications have different actions that health care providers use during different phases of the treatment.
Chelating agents. Chelating agents are medications that remove extra copper from the body by releasing it from organs into the bloodstream. Once the cooper is in the bloodstream, the kidneys then filter the copper and pass it into the urine. A health care provider usually recommends chelating agents at the beginning of treatment. A potential side effect of chelating agents is that nervous system symptoms may become worse during treatment. The two medications available for this type of treatment include
- trientine (Syprine)the risk for side effects and worsening nervous system symptoms appears to be lower with trientine than d-penicillamine. Researchers are still studying the side effects; however, some health care providers prefer to prescribe trientine as the first treatment of choice because it appears to be safer. - d-penicillaminepeople taking d-penicillamine may have other reactions or side effects, such as - fever - a rash - kidney problems - bone marrow problems
A health care provider will prescribe a lower dose of a chelating agent to women who are pregnant to reduce the risk of birth defects. A health care provider should consider future screening on any newborn whose parent has Wilson disease.
Zinc. A health care provider will prescribe zinc for patients who do not have symptoms, or after a person has completed successful treatment using a chelating agent and symptoms begin to improve. Zinc, taken by mouth as zinc salts such as zinc acetate (Galzin), blocks the digestive tracts absorption of copper from food. Although most people taking zinc usually do not experience side effects, some people may experience stomach upset. A health care provider may prescribe zinc for children with Wilson disease who show no symptoms. Women may take the full dosage of zinc safely during pregnancy.
Maintenance, or long term, treatment begins when symptoms improve and tests show that copper is at a safe level. Maintenance treatment typically includes taking zinc or a lower dose of a chelating agent. A health care provider closely monitors the person and reviews regular blood and urine tests to ensure maintenance treatment controls the copper level in the body.
Treatment for people with Wilson disease who have no symptoms may include a chelating agent or zinc in order to prevent symptoms from developing and stop or slow disease progression.
People with Wilson disease will take medications for the rest of their lives. Follow-up and adherence to the health care providers treatment plan is necessary to manage symptoms and prevent organ damage. | NIDDK | Wilson Disease |
What to do for Wilson Disease ? | People with Wilson disease should reduce their dietary copper intake by avoiding foods that are high in copper, such as
- shellfish - liver - mushrooms - nuts - chocolate
People should not eat these foods during the initial treatment and talk with the health care provider to discuss if they are safe to eat in moderation during maintenance treatment.
People with Wilson disease whose tap water runs through copper pipes or comes from a well should check the copper levels in the tap water. Water that sits in copper pipes may pick up copper residue, but running water lowers the level to within acceptable limits. People with Wilson disease should not use copper containers or cookware to store or prepare food or drinks.
To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of vitamins and dietary supplements, with their health care provider. Read more at www.nccam. nih.gov/health. If the health care provider recommends taking any type of supplement or vitamin, a pharmacist can recommend types that do not contain copper.
People should talk with a health care provider about diet changes to reduce copper intake.
Liver Transplant
A liver transplant may be necessary in people when
- cirrhosis leads to liver failure - acute liver failure happens suddenly - treatment is not effective
A liver transplant is an operation to remove a diseased or an injured liver and replace it with a healthy one from another person, called a donor. A successful transplant is a life-saving treatment for people with liver failure.
Most liver transplants are successful. About 85 percent of transplanted livers are functioning after 1 year.2 Liver transplant surgery provides a cure for Wilson disease in most cases. More information is provided in the NIDDK health topic, Liver Transplantation. | NIDDK | Wilson Disease |
How to prevent Wilson Disease ? | A person cannot prevent Wilson disease; however, people with a family history of Wilson disease, especially those with an affected sibling or parent, should talk with a health care provider about testing. A health care provider may be able to diagnose Wilson disease before symptoms appear. Early diagnosis and treatment of Wilson disease can reduce or even prevent organ damage.
People with a family history of the disease may also benefit from genetic testing that can identify one or more gene mutations. A health care provider may refer a person with a family history of Wilson disease to a geneticista doctor who specializes in genetic diseases. | NIDDK | Wilson Disease |
What to do for Wilson Disease ? | - Wilson disease is a genetic disease that prevents the body from removing extra copper. - Normally, the liver filters extra copper and releases it into bile. In Wilson disease, the liver does not filter copper correctly and copper builds up in the liver, brain, eyes, and other organs. - Wilson disease is caused by an inherited autosomal recessive mutation, or change, in the ATP7B gene. In an autosomal recessive disease, the child has to inherit the gene mutation from both parents to have an increased likelihood for the disease. - The signs and symptoms of Wilson disease vary, depending on what organs of the body are affected. People with Wilson disease may have - liver-related signs and symptoms - central nervous system-related signs and symptoms - mental health-related signs and symptoms - other signs and symptoms - A health care provider will treat Wilson disease with a lifelong effort to reduce and control the amount of copper in the body. Treatment may include - medications - changes in eating, diet, and nutrition - a liver transplant - People with Wilson disease should reduce their dietary copper intake by avoiding foods that are high in copper, such as - shellfish - liver - mushrooms - nuts - chocolate - A person cannot prevent Wilson disease; however, people with a family history of Wilson disease, especially those with an affected sibling or parent, should talk with a health care provider about testing. | NIDDK | Wilson Disease |
What is (are) Crohn's Disease ? | Crohn's disease is a chronic, or long lasting, disease that causes inflammationirritation or swellingin the gastrointestinal (GI) tract. Most commonly, Crohn's affects the small intestine and the beginning of the large intestine. However, the disease can affect any part of the GI tract, from the mouth to the anus.
Crohn's disease is a chronic inflammatory disease of the GI tract, called inflammatory bowel disease (IBD). Ulcerative colitis and microscopic colitis are the other common IBDs. More information is provided in the NIDDK health topics, Ulcerative Colitis and Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis.
Crohn's disease most often begins gradually and can become worse over time. Most people have periods of remissiontimes when symptoms disappearthat can last for weeks or years.
Some people with Crohn's disease receive care from a gastroenterologist, a doctor who specializes in digestive diseases. | NIDDK | Crohn's Disease |
What is (are) Crohn's Disease ? | The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anusa 1-inch-long opening through which stool leaves the body. The body digests food using the movement of muscles in the GI tract, along with the release of hormones and enzymes. Organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestinewhich includes the appendix, cecum, colon, and rectumand anus. The last part of the GI tractcalled the lower GI tractconsists of the large intestine and anus. The intestines are sometimes called the bowel. | NIDDK | Crohn's Disease |
What causes Crohn's Disease ? | The exact cause of Crohn's disease is unknown. Researchers believe the following factors may play a role in causing Crohn's disease:
- autoimmune reaction - genes - environment
Autoimmune reaction. Scientists believe one cause of Crohn's disease may be an autoimmune reactionwhen a person's immune system attacks healthy cells in the body by mistake. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Researchers believe bacteria or viruses can mistakenly trigger the immune system to attack the inner lining of the intestines. This immune system response causes the inflammation, leading to symptoms.
Genes. Crohn's disease sometimes runs in families. Research has shown that people who have a parent or sibling with Crohn's disease may be more likely to develop the disease. Researchers continue to study the link between genes and Crohn's disease.
Environment. Some studies suggest that certain things in the environment may increase the chance of a person getting Crohn's disease, although the overall chance is low. Nonsteroidal anti-inflammatory drugs,1 antibiotics,2 and oral contraceptives2 may slightly increase the chance of developing Crohn's disease. A high-fat diet may also slightly increase the chance of getting Crohn's disease.3
Some people incorrectly believe that eating certain foods, stress, or emotional distress can cause Crohn's disease. Emotional distress and eating certain foods do not cause Crohn's disease. Sometimes the stress of living with Crohn's disease can make symptoms worse. Also, some people may find that certain foods can trigger or worsen their symptoms. | NIDDK | Crohn's Disease |
What are the symptoms of Crohn's Disease ? | The most common signs and symptoms of Crohn's disease are
- diarrhea - abdominal cramping and pain - weight loss
Other general signs and symptoms include
- feeling tired - nausea or loss of appetite - fever - anemiaa condition in which the body has fewer red blood cells than normal
Signs and symptoms of inflammation outside of the intestines include
- joint pain or soreness - eye irritation - skin changes that involve red, tender bumps under the skin
The symptoms a person experiences can vary depending on the severity of the inflammation and where it occurs. | NIDDK | Crohn's Disease |
How to diagnose Crohn's Disease ? | A health care provider diagnoses Crohn's disease with the following:
- medical and family history - physical exam - lab tests - upper GI series - computerized tomography (CT) scan - intestinal endoscopy
The health care provider may perform a series of medical tests to rule out other bowel diseases, such as irritable bowel syndrome, ulcerative colitis, or celiac disease, that cause symptoms similar to those of Crohn's disease.
Medical and Family History
Taking a medical and family history can help a health care provider diagnose Crohn's disease and understand a patient's symptoms. He or she will ask the patient to describe his or her
- family history - symptoms - current and past medical conditions - current medications
Physical Exam
A physical exam may help diagnose Crohn's disease. During a physical exam, the health care provider most often
- checks for abdominal distension, or swelling - listens to sounds within the abdomen using a stethoscope - taps on the abdomen to check for tenderness and pain and establish if the liver or spleen is abnormal or enlarged
Lab Tests
A health care provider may order lab tests, including blood and stool tests.
Blood tests. A blood test involves drawing blood at a health care provider's office or a lab. A lab technologist will analyze the blood sample. A health care provider may use blood tests to look for changes in
- red blood cells. When red blood cells are fewer or smaller than normal, a patient may have anemia. - white blood cells. When the white blood cell count is higher than normal, a person may have inflammation or infection somewhere in his or her body.
Stool tests. A stool test is the analysis of a sample of stool. A health care provider will give the patient a container for catching and storing the stool at home. The patient returns the sample to the health care provider or to a lab. A lab technologist will analyze the stool sample. Health care providers commonly order stool tests to rule out other causes of GI diseases.
Upper Gastrointestinal Series
An upper GI series, also called a barium swallow, uses x-rays and fluoroscopy to help diagnose problems of the upper GI tract. Fluoroscopy is a form of x-ray that makes it possible to see the internal organs and their motion on a video monitor. An x-ray technician performs this test at a hospital or an outpatient center, and a radiologista doctor who specializes in medical imaginginterprets the images.
This test does not require anesthesia. A patient should not eat or drink before the procedure, as directed by the health care provider. Patients should ask their health care provider about how to prepare for an upper GI series.
During the procedure, the patient will stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats the esophagus, stomach, and small intestine so the radiologist and a health care provider can see the shape of these organs more clearly on x-rays.
A patient may experience bloating and nausea for a short time after the test. For several days afterward, barium liquid in the GI tract causes white or light-colored stools. A health care provider will give the patient specific instructions about eating and drinking after the test.
Computerized Tomography Scan
Computerized tomography scans use a combination of x-rays and computer technology to create images. For a CT scan, a health care provider may give the patient a solution to drink and an injection of a special dye, called contrast medium. CT scans require the patient to lie on a table that slides into a tunnel-shaped device where the x-rays are taken. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. The patient does not need anesthesia. CT scans can diagnose both Crohn's disease and the complications seen with the disease.
Intestinal Endoscopy
Intestinal endoscopies are the most accurate methods for diagnosing Crohn's disease and ruling out other possible conditions, such as ulcerative colitis, diverticular disease, or cancer. Intestinal endoscopies include
- upper GI endoscopy and enteroscopy - capsule endoscopy - colonoscopy
Upper GI endoscopy and enteroscopy. An upper GI endoscopy is a procedure that uses an endoscopea small, flexible tube with a lightto directly visualize the lining of the upper GI tract. A health care provider performs the procedure at a hospital or an outpatient center. A nurse or technician may give the patient a liquid anesthetic to gargle or will spray the anesthetic on the back of a patient's throat. The anesthetic numbs the throat and calms the gag reflex. The nurse or technician will then place an intravenous (IV) needle in the person's arm or hand to provide a sedative. The health care provider carefully feeds the endoscope down the patient's esophagus and into the stomach. A small camera on the endoscope sends a video image to a monitor, allowing close examination of the GI tract.
During an enteroscopy, the health care provider examines the small intestine with a special, longer endoscope. The health care provider carefully feeds the endoscope into the small intestine using one of the following procedures:
- push enteroscopy, which uses a long endoscope to examine the upper portion of the small intestine - single- or double-balloon enteroscopy, which use small balloons to help move the endoscope into the small intestine - spiral enteroscopy, which uses a tube attached to an endocope that acts as a cork screw to move the instrument into the small intestine
The procedure most often takes between 15 and 60 minutes. The endoscope does not interfere with the patient's breathing, and many patients fall asleep during the procedure.
Capsule endoscopy. Although this procedure can examine the entire digestive tract, health care providers use it mostly to examine the small intestine. The patient swallows a capsule containing a tiny camera. As the capsule passes through the GI tract, the camera will record and transmit images to a small receiver device worn by the patient. When the recording is done, the health care provider downloads the images and reviews them on a video monitor. The camera capsule leaves the patient's body during a bowel movement and is safely flushed down the toilet.
Colonoscopy. Colonoscopy is a test that uses a long, flexible, narrow tube with a light and tiny camera on one end, called a colonoscope or scope, to look inside a patient's rectum and entire colon. In most cases, light anesthesia and pain medication help patients relax for the test. The medical staff will monitor a patient's vital signs and try to make him or her as comfortable as possible. A nurse or technician will place an IV needle in a vein in the patient's arm or hand to give anesthesia.
For the test, the patient will lie on a table or stretcher while the gastroenterologist inserts a colonoscope into the patient's anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with air to give the gastroenterologist a better view. The camera sends a video image of the intestinal lining to a monitor, allowing the gastroenterologist to examine the tissues lining the colon and rectum. The gastroenterologist may move the patient several times and adjust the scope for better viewing. Once the scope has reached the opening to the small intestine, the gastroenterologist slowly withdraws it and examines the lining of the colon and rectum again.
A colonoscopy can show inflamed and swollen tissue, ulcers, and abnormal growths such as polypsextra pieces of tissue that grow on the inner lining of the intestine. If the gastroenterologist suspects Crohn's disease, he or she will biopsy the patient's colon and rectum. A biopsy is a procedure that involves taking small pieces of tissue for examination with a microscope.
A health care provider will give patients written bowel prep instructions to follow at home before the test. The health care provider will also give patients information about how to care for themselves following the procedure. | NIDDK | Crohn's Disease |
What are the treatments for Crohn's Disease ? | A health care provider treats Crohn's disease with
- medications - bowel rest - surgery
Which treatment a person needs depends on the severity of the disease and symptoms. Each person experiences Crohn's disease differently, so health care providers adjust treatments to improve the person's symptoms and induce, or bring about, remission.
Medications
While no medication cures Crohn's disease, many can reduce symptoms. The goals of medication therapy are
- inducing and maintaining remission - improving the person's quality of life
Many people with Crohn's disease require medication therapy. Health care providers will prescribe medications depending on the person's symptoms:
- aminosalicylates - corticosteroids - immunomodulators - biologic therapies - other medications
Aminosalicylates are medications that contain 5-aminosalicyclic acid (5-ASA), which helps control inflammation. Health care providers use aminosalicylates to treat people newly diagnosed with Crohn's disease who have mild symptoms. Aminosalicylates include
- balsalazide - mesalamine - olsalazine - sulfasalazinea combination of sulfapyridine and 5-ASA
Some of the common side effects of aminosalicylates include
- abdominal pain - diarrhea - headaches - heartburn - nausea and vomiting
Corticosteroids, also known as steroids, help reduce the activity of the immune system and decrease inflammation. Health care providers prescribe corticosteroids for people with moderate to severe symptoms. Corticosteroids include
- budesonide - hydrocortisone - methylprednisone - prednisone
Side effects of corticosteroids include
- acne - a higher chance of developing infections - bone mass loss - high blood glucose - high blood pressure - mood swings - weight gain
In most cases, health care providers do not prescribe corticosteroids for long-term use.
Immunomodulators reduce immune system activity, resulting in less inflammation in the GI tract. These medications can take several weeks to 3 months to start working. Immunomodulators include
- 6-mercaptopurine, or 6-MP - azathioprine - cyclosporine - methotrexate
Health care providers prescribe these medications to help people with Crohn's disease go into remission or to help people who do not respond to other treatments. People taking these medications may have the following side effects:
- a low white blood cell count, which can lead to a higher chance of infection - fatigue, or feeling tired - nausea and vomiting - pancreatitis
Health care providers most often prescribe cyclosporine only to people with severe Crohn's disease because of the medication's serious side effects. People should talk with their health care provider about the risks and benefits of cyclosporine.
Biologic therapies are medications that target a protein made by the immune system. Neutralizing this protein decreases inflammation in the intestine. Biologic therapies work quickly to bring on remission, especially in people who do not respond to other medications. Biologic therapies include
- adalimumab - certolizumab - infliximab - natalizumab - vedolizumab
Health care providers most often give patients infliximab every 6 to 8 weeks at a hospital or an outpatient center. Side effects may include a toxic reaction to the medication and a higher chance of developing infections, particularly tuberculosis.
Other medications to treat symptoms or complications may include
- acetaminophen for mild pain. People with Crohn's disease should avoid using ibuprofen, naproxen, and aspirin since these medications can make symptoms worse. - antibiotics to prevent or treat infections and fistulas. - loperamide to help slow or stop severe diarrhea. In most cases, people only take this medication for short periods of time since it can increase the chance of developing megacolon.
Bowel Rest
Sometimes Crohn's disease symptoms are severe and a person may need to rest his or her bowel for a few days to several weeks. Bowel rest involves drinking only clear liquids or having no oral intake. To provide the patient with nutrition, a health care provider will deliver IV nutrition through a special catheter, or tube, inserted into a vein in the patient's arm. Some patients stay in the hospital, while other patients are able to receive the treatment at home. In most cases, the intestines are able to heal during bowel rest.
Surgery
Even with medication treatments, up to 20 percent of people will need surgery to treat their Crohn's disease.1 Although surgery will not cure Crohn's disease, it can treat complications and improve symptoms. Health care providers most often recommend surgery to treat
- fistulas - bleeding that is life threatening - bowel obstructions - side effects from medications when they threaten a person's health - symptoms when medications do not improve a person's condition
A surgeon can perform different types of operations to treat Crohn's disease:
- small bowel resection - subtotal colectomy - proctocolectomy and ileostomy
Patients will receive general anesthesia. Most patients will stay in the hospital for 3 to 7 days after the surgery. Full recovery may take 4 to 6 weeks.
Small bowel resection. Small bowel resection is surgery to remove part of a patient's small intestine. When a patient with Crohn's disease has a blockage or severe disease in the small intestine, a surgeon may need to remove that section of intestine. The two types of small bowel resection are
- laparoscopicwhen a surgeon makes several small, half-inch incisions in the patient's abdomen. The surgeon inserts a laparoscopea thin tube with a tiny light and video camera on the endthrough the small incisions. The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the small intestine. While watching the monitor, the surgeon inserts tools through the small incisions and removes the diseased or blocked section of small intestine. The surgeon will reconnect the ends of the intestine. - open surgerywhen a surgeon makes one incision about 6 inches long in the patient's abdomen. The surgeon will locate the diseased or blocked section of small intestine and remove or repair that section. The surgeon will reconnect the ends of the intestine.
Subtotal colectomy. A subtotal colectomy, also called a large bowel resection, is surgery to remove part of a patient's large intestine. When a patient with Crohn's disease has a blockage, a fistula, or severe disease in the large intestine, a surgeon may need to remove that section of intestine. A surgeon can perform a subtotal colectomy by
- laparoscopic colectomywhen a surgeon makes several small, half-inch incisions in the abdomen. While watching the monitor, the surgeon removes the diseased or blocked section of the large intestine. The surgeon will reconnect the ends of the intestine. - open surgerywhen a surgeon makes one incision about 6 to 8 inches long in the abdomen. The surgeon will locate the diseased or blocked section of small intestine and remove that section. The surgeon will reconnect the ends of the intestine.
Proctocolectomy and ileostomy. A proctocolectomy is surgery to remove a patient's entire colon and rectum. An ileostomy is a stoma, or opening in the abdomen, that a surgeon creates from a part of the ileumthe last section of the small intestine. The surgeon brings the end of the ileum through an opening in the patient's abdomen and attaches it to the skin, creating an opening outside of the patient's body. The stoma is about three-fourths of an inch to a little less than 2 inches wide and is most often located in the lower part of the patient's abdomen, just below the beltline.
A removable external collection pouch, called an ostomy pouch or ostomy appliance, connects to the stoma and collects intestinal contents outside the patient's body. Intestinal contents pass through the stoma instead of passing through the anus. The stoma has no muscle, so it cannot control the flow of intestinal contents, and the flow occurs whenever peristalsis occurs. Peristalsis is the movement of the organ walls that propels food and liquid through the GI tract.
People who have this type of surgery will have the ileostomy for the rest of their lives. | NIDDK | Crohn's Disease |
What to do for Crohn's Disease ? | Researchers have not found that eating, diet, and nutrition cause Crohn's disease symptoms. Good nutrition is important in the management of Crohn's disease, however. Dietary changes can help reduce symptoms. A health care provider may recommend that a person make dietary changes such as
- avoiding carbonated drinks - avoiding popcorn, vegetable skins, nuts, and other high-fiber foods - drinking more liquids - eating smaller meals more often - keeping a food diary to help identify troublesome foods
Health care providers may recommend nutritional supplements and vitamins for people who do not absorb enough nutrients.
To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements and probiotics, with their health care provider. Read more at www.nccam.nih.gov/health/probiotics.
Depending on a person's symptoms or medications, a health care provider may recommend a specific diet, such as a
- high-calorie diet - lactose-free diet - low-fat diet - low-fiber diet - low-salt diet
People should speak with a health care provider about specific dietary recommendations and changes. | NIDDK | Crohn's Disease |
What are the complications of Crohn's Disease ? | Complications of Crohn's disease can include
- bowel obstruction. Crohn's disease can thicken the wall of the intestine. Over time, the thickened areas of the intestine can narrow, which can block the intestine. A partial or complete obstruction, also called a bowel blockage, can block the movement of food or stool through the intestines. A complete bowel obstruction is life threatening and requires immediate medical attention and often surgery. - fistulasabnormal passages, or tunnels, between two organs, or between an organ and the outside of the body. How a health care provider treats fistulas depends on their type and severity. For some people, fistulas heal with medication and diet changes, while other people will need to have surgery. - anal fissuressmall tears in the anus that may cause itching, pain, or bleeding. Most anal fissures heal with medical treatment, including ointments, warm baths, and dietary changes. - ulcers. Inflammation anywhere along the GI tract can lead to ulcers or open sores in a person's mouth, intestines, anus, and perineumthe area between the anus and the sex organs. In most cases, the treatment a health care provider prescribes for Crohn's disease will also treat the ulcers. - malnutritiona condition that develops when the body does not get the right amount of vitamins, minerals, and nutrients it needs to maintain healthy tissues and organ function. Some people may need IV fluids or feeding tubes to replace lost nutrients and fluids. - inflammation in other areas of the body. The immune system can trigger inflammation in the - joints - eyes - skin
Health care providers can treat inflammation by adjusting medications or prescribing new medications.
Crohn's Disease and Colon Cancer People with Crohn's disease in the large intestine may be more likely to develop colon cancer. People who receive ongoing treatment and remain in remission may reduce their chances of developing colon cancer. People with Crohn's disease should talk with their health care provider about how often they should get screened for colon cancer. Screening can include colonoscopy with biopsies. Such screening does not reduce a person's chances of developing colon cancer. Instead, screening can help diagnose cancer early and improve chances for recovery. | NIDDK | Crohn's Disease |
What to do for Crohn's Disease ? | - Crohn's disease is a chronic, or long lasting, disease that causes inflammationirritation or swellingin the gastrointestinal (GI) tract. - The exact cause of Crohn's disease is unknown. Researchers believe that factors such as an autoimmune reaction, genes, and environment may play a role in causing Crohn's disease. - Crohn's disease can occur in people of any age. However, it is more likely to develop in people - between the ages of 20 and 29 - who have a family member, most often a sibling or parent, with inflammatory bowel disease (IBD) - who smoke cigarettes - The most common signs and symptoms of Crohn's disease are diarrhea, abdominal cramping and pain, and weight loss. - A health care provider diagnoses Crohn's disease with the following: - medical and family history - physical exam - lab tests - upper GI series - computerized tomography (CT) scan - intestinal endoscopy - Which treatment a person needs depends on the severity of the disease and symptoms. - Good nutrition is important in the management of Crohn's disease. A health care provider may recommend that a person make dietary changes. - People with Crohn's disease should talk with their health care provider about how often they should get screened for colon cancer. | NIDDK | Crohn's Disease |
What is (are) What I need to know about Kidney Stones ? | A kidney* stone is a solid piece of material that forms in a kidney when there are high levels of certain substances in the urine. These substances are normally found in the urine and do not cause problems at lower levels.
A stone may stay in the kidney or travel down the urinary tract. Kidney stones vary in size. A small stone may pass on its own, causing little or no pain. A larger stone may get stuck along the urinary tract. A stone that gets stuck can block the flow of urine, causing severe pain or bleeding.
*See the Pronunciation Guide for tips on how to say the words in bold. | NIDDK | What I need to know about Kidney Stones |
What is (are) What I need to know about Kidney Stones ? | The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every day, the two kidneys process about 200 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra water. The urine flows from the kidneys to the bladder through tubes called ureters.
The bladder stores urine until releasing it through urination. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder. | NIDDK | What I need to know about Kidney Stones |
What causes What I need to know about Kidney Stones ? | Kidney stones are caused by high levels of calcium, oxalate, and phosphorus in the urine. Some foods may cause kidney stones in certain people. You may be more likely to get a kidney stone if you have
- a condition that affects levels of substances in your urine that can cause stones to form - a family history of kidney stones - repeating, or recurrent, urinary tract infections - blockage of your urinary tract - digestive problems
You may also be more likely to get a kidney stone if you dont drink enough fluids or if you take certain medicines. | NIDDK | What I need to know about Kidney Stones |
What is (are) What I need to know about Kidney Stones ? | Doctors have found four main types of kidney stones:
- The most common types of stones contain calcium. Calcium is a normal part of a healthy diet. Calcium that is not used by the bones and muscles goes to the kidneys. In most people, the kidneys flush out the extra calcium with the rest of the urine. People who have calcium stones keep the calcium in their kidneys. The calcium that stays behind joins with other waste products to form a stone. People can have calcium oxalate and calcium phosphate stones. Calcium oxalate stones are more common. - A uric acid stone may form when the urine contains too much acid. People who eat a lot of meat, fish, and shellfish may get uric acid stones. - A struvite stone may form after you have a kidney infection. - Cystine stones result from a genetic disorder, meaning a problem passed from parent to child. The disorder causes cystine to leak through the kidneys and into the urine. | NIDDK | What I need to know about Kidney Stones |
What are the symptoms of What I need to know about Kidney Stones ? | You may have a kidney stone if you
- have pain while urinating - see blood in your urine - feel a sharp pain in your back or lower abdomenthe area between your chest and hips
The pain may last for a short or long time. You may have nausea and vomiting with the pain.
If you have a small stone that passes on its own easily, you may not have symptoms at all. | NIDDK | What I need to know about Kidney Stones |
How to diagnose What I need to know about Kidney Stones ? | To diagnose kidney stones, your doctor will do a physical exam and ask about your medical history. The doctor may ask if you have a family history of kidney stones and about your diet, digestive problems, and other health problems. The doctor may perform urine, blood, and imaging tests to complete the diagnosis.
- Urine tests can show whether you have an infection or your urine contains substances that form stones. - Blood tests can show problems that lead to kidney stones. - Imaging tests are used to find the location of kidney stones in your body. The tests may also be able to show problems that caused a kidney stone to form. | NIDDK | What I need to know about Kidney Stones |
What are the treatments for What I need to know about Kidney Stones ? | The treatment for kidney stones usually depends on their size and what they are made of. Kidney stones may be treated by your regular doctor or by a urologista doctor who specializes in the urinary tract. You may need treatment if you have symptoms or if a kidney stone is blocking your urinary tract. Small stones dont usually need treatment. Still, you may need pain medicine. You should also drink lots of fluids to help move the stone along. If you are vomiting often or dont drink enough fluids, you may need to go to the hospital and get fluids through a needle in your arm.
If you have a large kidney stone or your urinary tract is blocked, the urologist can remove the stone or break it into small pieces with the following treatments: | NIDDK | What I need to know about Kidney Stones |
How to prevent What I need to know about Kidney Stones ? | To prevent kidney stones, you need to know what caused your kidney stone. Your doctor may ask you to try to catch the kidney stone as it passes in your urine. The kidney stone can then be sent to a lab to find out what type of stone it is. If you have treatment in the hospital and the doctor removes the stone, it will also be sent to a lab for testing.
Your doctor may ask you to collect your urine for 24 hours after the stone has passed or been removed. Your doctor can then measure how much urine you produce in a day and mineral levels in the urine. You are more likely to form stones if you dont make enough urine each day or have a problem with mineral levels.
Once you know what type of kidney stone you had, you can make changes in your eating, diet, and nutrition and take medicines to prevent future kidney stones. | NIDDK | What I need to know about Kidney Stones |