Treatments for Kidney conditions
Kidney conditions: Is the Diagnosis Correct?
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Differential diagnosis list for Kidney conditions may include:
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Drugs and Medications used to treat Kidney conditions:
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or change in treatment plans.
Some of the different medications used in the treatment of Kidney conditions include:
- Minoxidil - kidney failure
- Kresse - kidney failure
- Loniten - kidney failure
- Med-Minoxidil - kidney failure
- Minocalve 5 - kidney failure
- Minodyl - kidney failure
- Minoximen - kidney failure
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Treatments of Kidney conditions: Online Medical Books
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Hematuria:
Treatment
(In a Page: Signs and Symptoms)
-
Older patients with transient hematuria should always be evaluated due to increased risk of urinary tract cancers; refer to urologist for further evaluation and treatment
-
UTI: Start appropriate antibiotics and follow up with urinalysis to see if hematuria resolves
-
Glomerular sources (RBC casts, protein excretion >500 mg/dL, dysmorphic RBCs): Follow BUN/creatinine, blood pressure, creatinine clearance, and 24-hour urine protein, and refer for biopsy if worsening
-
Nonglomerular source (no RBC casts or dysmorphic RBCs in the urine): Urologic consult if imaging indicates a lesion (renal, bladder, or urethral)
-
Stones: Increase hydration, analgesics, urology referral for large or persistent stones
-
Myoglobinuria/hemoglobinuria: Treat underlying cause
-
Beeturia: Evaluate for iron deficiency or achlorhydria due to pernicious anemia, as treating these disorders may eliminate beeturia; eating foods high in oxalate (spinach, oysters) with beets can also cause beeturia
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hematuria:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
UTI: Empiric antibiotic (e.g., co-trimoxazole)
-
Manage hypertension
–ACE inhibitors or calcium channel blockers
–Consider diuretics if edematous
-
Suspected acute glomerulonephritis
–Low C3, evidence of recent strep or other infection
–Monitor urine output, weight, BP closely
–Daily outpatient visits until stable
–Inpatient admission if oliguria/edema is severe
–Once acute phase is over, monitor every 1–2 weeks and recheck C3 in 6–8 weeks
-
Nephrolithiasis: Increase fluid intake
–Sodium-restrict (do not calcium-restrict)
–Consult urology for severe pain or obstruction
-
Consult nephrology if hematuria persists or is associated with proteinuria, hypertension, persistently decreased C3, or abnormal creatinine
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Acute renal failure:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Strict fluid management, supportive care (electrolyte replacement; high-calorie, low-
protein diet), hemodialysis or peritoneal dialysis
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Polycystic kidney disease:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Polycystic kidney disease can’t be cured. The primary goal of treatment is preserving renal parenchyma and preventing infectious complications. Management of secondary hypertension will also help prevent rapid deterioration in function. Progressive renal failure requires treatment similar to that for other types of renal disease, including dialysis or, rarely, kidney transplantation.
When adult polycystic kidney disease is discovered in the asymptomatic stage, careful monitoring is required, including urine cultures and creatinine clearance tests every 6 months. Prompt and vigorous antibiotic treatment is needed when a urine culture reveals infection — even when the patient is asymptomatic. As renal impairment progresses, selected patients may undergo dialysis, transplantation, or both. Cystic abscess or retroperitoneal bleeding may require surgical drainage; intractable pain (a rare symptom) may also require surgery. However, because this disease affects both kidneys, nephrectomy usually isn’t recommended because it increases the risk of infection in the remaining kidney.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Kidney cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Radical nephrectomy, with or without regional lymph node dissection, offers the only chance of cure. Because the disease is radiation resistant, radiation is used only if the cancer spreads to the perinephric region or the lymph nodes or if the primary tumor or metastatic sites can't be fully excised. In these cases, high radiation doses are used.
Chemotherapy has been only erratically effective against kidney cancer. Fluorouracil, cyclophosphamide, vinblastine, vincristine, cisplatin, tamoxifen, teniposide, interferons, and hormones such as medroxyprogesterone and testosterone have been used, usually with poor results. Biotherapy (interferon and interleukins), commonly used in advanced disease, has produced few durable remissions.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Medullary sponge kidney:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment focuses on preventing or treating complications caused by stones and infection. Specific measures include increasing fluid intake and monitoring renal function and urine. New symptoms necessitate immediate evaluation.
Because medullary sponge kidney is a benign condition, surgery is seldom necessary, except to remove stones during acute obstruction. Only serious, uncontrollable infection or hemorrhage requires nephrectomy.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Chronic renal failure:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease. Associated diseases that cause or result from chronic renal failure must be controlled such as hypertension. Conservative treatment aims to correct specific symptoms. A low-protein diet reduces the production of end products of protein metabolism that the kidneys can’t excrete. (A patient receiving continuous peritoneal dialysis should have a high-protein diet.) A high-calorie diet prevents ketoacidosis and the negative nitrogen balance that results in catabolism and tissue atrophy, and restricts sodium and potassium.
Maintaining fluid balance requires careful monitoring of vital signs, weight changes, and urine volume (if present). If some renal function remains, administration of loop diuretics such as furosemide, and fluid restriction can reduce fluid retention. Cardiac glycosides may be used to mobilize edema fluids; antihypertensives, to control blood pressure and associated edema. Antiemetics taken before meals may relieve nausea and vomiting; cimetidine or ranitidine may decrease gastric irritation. Methylcellulose or docusate can help prevent constipation.
Treatment may also include regular stool analysis (guaiac test) to detect occult blood and, as needed, cleaning enemas to remove blood from the GI tract. Anemia necessitates iron and folate supplements; severe anemia requires infusion of fresh frozen packed cells or washed packed cells. However, transfusions relieve anemia only temporarily. Epoetin alpha (erythropoietin) increases RBC production.
Drug therapy often relieves associated symptoms: an antipruritic, such as trimeprazine or diphenhydramine, for itching and aluminum hydroxide gel to lower serum phosphate levels. The patient may also benefit from supplementary vitamins (particularly B vitamins and vitamin D) and essential amino acids.
Careful monitoring of serum potassium levels is necessary to detect hyperkalemia. Emergency treatment for severe hyperkalemia includes dialysis therapy and administration of 50% hypertonic glucose I.V., regular insulin, calcium gluconate I.V., sodium bicarbonate I.V., and cation exchange resins such as sodium polystyrene sulfonate.
Alert Cardiac tamponade resulting from pericardial effusion may require emergency pericardial tap or surgery.
Blood gas measurements may indicate acidosis; intensive dialysis and thoracentesis can relieve pulmonary edema and pleural effusions.
Hemodialysis or peritoneal dialysis (particularly continuous ambulatory peritoneal dialysis and continuous cyclic peritoneal dialysis) can help control most manifestations of end-stage renal disease; altering dialyzing bath fluids can correct fluid and electrolyte disturbances. (See Comparing peritoneal dialysis and hemodialysis, page 806. Also see Continuous ambulatory peritoneal dialysis, page 807.) But anemia, peripheral neuropathy, cardiopulmonary and GI complications, sexual dysfunction, and skeletal defects may persist. Maintenance dialysis itself may produce complications, such as protein wasting, refractory ascites, and dialysis dementia. Kidney transplantation may eventually be the treatment of choice for some patients with end-stage renal disease.
PEDIATRIC TIP Children require more dialysis in relation to their body weight than adults because their metabolic rates and, therefore, food intake, are higher.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hematuria:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Teach the patient how to collect serial urine specimens using the three-glass technique. This technique helps determine whether hematuria marks the beginning, end, or entire course of urination.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Polycystic kidney disease:
Treatment
(Handbook of Diseases)
Polycystic kidney disease can’t be cured. The primary goal of treatment is to preserve renal parenchyma and prevent infectious complications. Management of secondary hypertension will also help prevent rapid deterioration in function. Progressive renal failure requires treatment similar to that for other types of renal disease, including dialysis or, rarely, a kidney transplant.
Asymptomatic stage
When adult polycystic kidney disease is discovered in the asymptomatic stage, careful monitoring is required, including urine cultures and creatinine clearance tests every 6 months. When a urine culture detects infection, prompt and vigorous antibiotic treatment is needed (even when the patient is asymptomatic).
Progressive renal impairment
As renal impairment progresses, selected patients may undergo dialysis, transplantation, or both. Cystic abscess or retroperitoneal bleeding may require surgical drainage; intractable pain (a rare symptom) may also require surgery. Anemia is treated with iron and other supplements, erythropoietin, or blood transfusions. However, because this disease affects both kidneys, nephrectomy usually isn’t recommended because it increases the risk of infection in the remaining kidney.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Kidney cancer:
Treatment
(Handbook of Diseases)
Radical nephrectomy, with or without regional lymph node dissection, offers the only chance of cure. Because the disease is radiation-resistant, radiation is used only if the cancer spreads to the perinephric region or the lymph nodes or if the primary tumor or metastatic sites can’t be fully excised. In such cases, high doses of radiation are used.
Chemotherapy has been only erratically effective against kidney cancer and includes various drugs. Interferons and hormones, such as medroxyprogesterone and testosterone, have also been used. Biotherapy (lymphokine-activated killer cells with recombinant interleukin-2) shows promise, but causes adverse reactions. Interferon is somewhat effective in advanced disease. Hormone therapy may be tried in advanced cases.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Renal failure, acute:
Treatment
(Handbook of Diseases)
The goals of treatment include identifying and treating reversible causes, such as nephrotoxic drug therapy, obstructive uropathy, and volume depletion. Supportive measures include a diet high in calories and low in protein, sodium, and potassium, with supplemental vitamins and restricted fluids. Meticulous electrolyte monitoring is essential to detect hyperkalemia.
If hyperkalemia occurs, acute therapy may include dialysis, hypertonic glucose and insulin infusions, and calcium — all administered I.V. — and oral or rectal administration of potassium exchange resin to remove potassium from the body.
If measures fail to control uremic symptoms, hemodialysis or peritoneal dialysis may be necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Renal failure, chronic:
Treatment
(Handbook of Diseases)
Conservative treatment aims to correct specific symptoms, minimize complications, and slow progression of the disease. Underlying conditions that cause chronic renal failure must be controlled.
Diet
A low-protein diet reduces the production of end products of protein metabolism that the kidneys can’t excrete. (A patient receiving continuous peritoneal dialysis should receive a high-protein diet.)
A high-calorie diet prevents ketoacidosis and the negative nitrogen balance that results in catabolism and tissue atrophy. Such a diet also restricts sodium and potassium.
Fluid status
Maintaining fluid balance requires careful monitoring of vital signs, weight changes, and urine volume (if present). Loop diuretics, such as furosemide (if some renal function remains), and fluid restriction can reduce fluid retention. A cardiac glycoside may be used to mobilize edema fluids; an antihypertensive, especially an angiotensin-converting enzyme inhibitor, to control blood pressure and associated edema.
Treatment of GI and blood problems
An antiemetic taken before meals may relieve nausea and vomiting; cimetidine, omeprazole, or ranitidine may decrease gastric irritation. Methylcellulose or docusate can help prevent constipation.
Treatment may also include regular stool analysis (guaiac test) to detect occult blood and, as needed, cleansing enemas to remove blood from the GI tract.
Anemia necessitates iron and folate supplements; severe anemia requires infusion of fresh frozen packed cells or washed packed cells. However, transfusions relieve anemia only temporarily. Synthetic erythropoietin (epoetin alfa) may be given to stimulate the division and differentiation of cells within the bone marrow to produce RBCs. An-drogen therapy (testosterone or nandrolone) may increase RBC production.
Drug therapy, surgery, and dialysis
Drug therapy can help relieve associated symptoms: an antipruritic, such as trimeprazine or diphenhydramine, to relieve itching and aluminum hydroxide gel to lower serum phosphate levels.
CLINICAL TIP: Be alert for aluminum toxicity, an adverse reaction to aluminum hydroxide.
The patient may also benefit from supplementary vitamins (particularly B vitamins and vitamin D) and essential amino acids.
Careful monitoring of serum potassium levels is necessary to detect hyperkalemia. Emergency treatment for severe hyperkalemia includes dialysis therapy and administration of 50% hypertonic glucose I.V., regular insulin, calcium gluconate I.V., sodium bicarbonate I.V., and cation exchange resins such as sodium polystyrene sulfonate. Cardiac tamponade resulting from pericardial effusion may require emergency pericardial tap or surgery.
Blood gas measurements may indicate acidosis; intensive dialysis and thoracentesis can relieve pulmonary edema and pleural effusions.
Hemodialysis or peritoneal dialysis (particularly continuous ambulatory peritoneal dialysis and continuous cyclic peritoneal dialysis) can help control most manifestations of end-stage renal disease. (See Continuous ambulatory peritoneal dialysis, page 718.) Altering dialyzing bath fluids can correct fluid and electrolyte disturbances. However, anemia, peripheral neuropathy, cardiopulmonary and GI complications, sexual dysfunction, and skeletal defects may persist.
Maintenance dialysis may produce complications, such as protein wasting, refractory ascites, and dialysis dementia. A kidney transplant may eventually be the treatment of choice for some patients with end-stage renal disease.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hematuria:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient how to collect serial urine specimens using the three-glass technique. This technique helps determine whether hematuria marks the beginning, end, or entire course of urination. Encourage the patient to drink plenty of fluids, unless contraindicated.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hematuria:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Check vital signs frequently.
▪ Monitor intake and output, including the amount and pattern of hematuria.
▪ If the patient has an indwelling urinary catheter in place, ensure its patency and irrigate it if necessary to remove clots and tissue that may impede urine drainage.
▪ Administer prescribed analgesics, and enforce bed rest as indicated.
▪ Prepare the patient for diagnostic tests, such as blood and urine studies, cystoscopy, and renal X-rays or biopsy.
▪ Monitor hemoglobin level and hematocrit; administer blood products as ordered.
Patient teaching
▪ Show the patient how to collect urine specimens.
▪ Emphasize the need to increase fluid intake.
▪ Explain the underlying cause of hematuria and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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