Kidney health

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Post by Ahead of Time: A practical guide to growing older with HIV08 Apr 2010

Kidney function gradually declines as you get older, but this rarely causes serious problems.

Diabetes (high sugar levels) and hypertension (high blood pressure) are the most common causes of chronic kidney disease. The rates of both of these conditions are usually significantly higher in people with HIV, and as a result, as people with HIV get older, chronic kidney disease may become more common.

Some HIV treatments have been linked to kidney disease:

    • that link has been confirmed with indinavir—a drug now rarely used
    • Tenofovir has the very rare side effect of Fanconi syndrome, a disorder of the kidney tubes in which certain substances normally absorbed into the bloodstream by the kidneys are released into the urine instead.

Kidney disease has often been called a ‘silent disease’ because there are often few symptoms until the disease is severe.

Urinary infection, can also lead to kidney infection and kidney disease, particularly if it keeps recurring or is left untreated.

Urinary Tract Infections (UTIs)

Urine is normally sterile, which means it doesn’t contain any bacteria, fungus orviruses (micro organisms or germs).

Urinary tract infections (UTIs) are caused by these microorganisms, which infect the urinary system by entering through the urethra or, rarely, from the bloodstream. The most common culprit is a bacterium common to the digestive tract called E. coli (Escherichia coli)—which is usually spread to the urethra from the anus.

Other micro-organisms, such as Mycoplasma and chlamydia can cause urethritis in both men and women. These micro-organisms are sexually transmitted so, when these infections are detected, both partners need medical treatment to avoid re-infection.

The different types of urinary tract infection can include:

      • urethritis — infection of the urethra
      • cystitis — infection of the bladder
      • pyelonephritis — infection of the kidneys.

Some of the symptoms of urinary tract infection include:

      • wanting to urinate more often, if only a few drops (urgency)
      • burning pain or a ‘scalding’ sensation on urination
      • a feeling that the bladder is still full after urination
      • pain above the pubic bone
      • blood in the urine.

Kidney infections are serious.
If infection reaches the kidneys, prompt medical attention is needed. In addition to the general symptoms, a person with a kidney infection can also experience:

      • chills
      • fever
      • loin (lower abdominal) pain
      • pain in the back.

What can you do?

You can decrease the risk of getting kidney disease by:

Living a healthy life style.
All the usual things reduce the risk of kidney disease:

      • not smoking
      • a healthy diet
      • staying fit
      • keeping a good body weight
      • drinking lots of water — at least 6–8 glasses a day is recommended by kidney health organisations.

Getting blood pressure tested and high blood pressure treated.
As well as lifestyle changes, there are many successful drug treatments for hypertension .Some anti-hypertensive medications also reduce any progression of kidney disease.

Minimising your risk of getting diabetes and controlling blood glucose if you have diabetes .
Your doctor is often able to diagnose pre-diabetes . f it is diagnosed, it is sort of like the last stop café: both a warning and a great chance to make the lifestyle changes you need to make in order to avoid progressing to diabetes and all of the complications which follow from diabetes .
Try to avoid urinary tract infections (UTIs), which can lead to kidney infection.
Urinary tract infections do occur in men, but are much more common in women, and may lead to kidney disease if they keep recurring—especially if they are not treated. Some suggestions for avoiding UTIs in men and women include:

      • drinking lots of water and other fluids to flush the urinary system
      • treat vaginal infections quickly (such as Thrush or Trichomonas)
      • avoiding spermicidal products, particularly with a diaphragm contraceptive device
      • avoiding constipation where possible
      • practice good hygiene
      • going to the toilet as soon as you feel the urge to urinate, rather than holding on
      • emptying your bladder after sex.

Getting kidney function monitored.
Because kidney disease often doesn’t have symptoms, it needs to be monitored on a regular basis—particularly if you have risk factors for kidney disease.

It is beyond the scope of this resource to provide detailed information on the treatment of advanced kidney disease. More detailed information can be found at Kidney Health Australia