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August 6, 2013

Signs of kidney disease cont.

Over the last three weeks I have looked at the signs and symptoms of kidney disease. I looked at pain in the flanks, swelling of the feet and body, and blood in the urine. There are other symptoms that most people are not even aware of, like weight loss, loss of the appetite, itching of the skin, darkening of the skin, nausea and vomiting, pallor and shortness of breath.{{more}}

The symptoms mentioned in the first two articles are the ones you will find in acute kidney disease. The ones just mentioned you would mainly find in chronic kidney disease caused by other diseases like diabetes (sugar) or hypertension (pressure), chronic kidney infection or following an acute process like blockage of the kidneys or acute viral or medication or toxin induced kidney swelling. If you look at the symptoms mentioned above, they look like any other disease process, e.g. itching of the skin can be cause by a rash or by an allergy or by jaundice. Likewise 20 or 30 different things may cause nausea and vomiting.

Let’s look at the symptoms:

Weight loss and loss of appetite: When the kidney fails, the patient loses appetite, due to a build up of waste substances and the body starts to break down its own tissues to provide energy to stay alive. This leads to weight loss. This will be reversed when the patient gets a transplant or if he goes on effective dialysis.

Itching of the skin: The build-up of waste substances, especially urea and potassium, as well as some acids in the blood and under the skin causes itching. Urea is the waste substance that comes out in the urine that makes the urine smell like it does. This is the waste substance that builds up in the body that causes a lot of symptoms like itching of the skin, confusion and eventually coma. This is not the only substance that causes it. There are other “nitrogenous wastes” from the breakdown of proteins apart from urea that cause the above.

Nausea and vomiting: One of the substances the kidney excretes is acid. This acid accumulates with kidney failure. The excess acid is “breathed off” and the stomach excretes some. The stomach also has increased gastric acid secretion from the accumulation of substances that cause increased gastric acid secretion. This excess acid causes heartburn, nausea and vomiting. The condition is caused uremic gastritis.

Pallor and shortness of breath: Pallor means paleness or the patient’s eyes and fingers look white. They are supposed to look pink. The whiteness is due to the lack of blood in the tissues. To be exact, the patient’s blood count is low or he is anemic. Anemia also causes shortness of breath. The patient is usually severely anemic because the blood making substance that comes from the kidney is not produced. This causes a drop in the blood count. The count can drop to as low as 4-6 units. It is usually 12-16 units!

Darkening of the skin: There is a substance that causes darkening of the skin in pregnancy and other conditions called melatonin. This substance is increased in renal failure. We still do not know exactly why, but it is increased and causes skin darkening. The skin also looked ashen grey and may be scaly from the constant itching. There are many more non-specific symptoms and signs of kidney disease, but they are too numerous and infrequent in occurrence to mention.

Next week, I will be looking at the popular diagnosis of kidney stones.

For comments or question contact:

Dr Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com