INTRODUCTION TO KIDNEY
Kidney is a paired organ whose functions include removing waste products from the blood and regulating the amount of fluid in the body. The basic units of the kidneys are microscopically thin structures called nephrons, which filter the blood and cause wastes to be removed in the form of urine. Together with the bladder, two ureters, and the single urethra, the kidneys make up the body’s urinary system. Human beings, as well as members of all other vertebrate species, typically have two kidneys.
KIDNEY DESEASES
Diseases of the kidney range from mild infection to life-threatening kidney failure. The most common form of kidney disease is an inflammation of the kidney, called pyelonephritis. Most such inflammations are caused by a bacterial infection that starts in the bladder and spreads to the kidney. Sometimes an obstruction that interferes with the flow of urine in the urinary tract can cause the disease. Symptoms of pyelonephritis include fever, chills, and back pain. Antibiotic drugs are usually given to fight the infection, which can scar the kidneys and impair their function if left untreated.
Glomerulonephritis, another common kidney disease, is characterized by inflammation of some of the kidney's glomeruli (glomerulus is a round cluster of interconnected capillaries found in the cortex of a kidney, which remove body waste to be excreted as urine). This condition may occur when the body’s immune system is impaired. Antibodies and other substances form large particles in the bloodstream that become trapped in the glomeruli. This causes inflammation and prevents the glomeruli from working properly. Symptoms may include blood in the urine, swelling of body tissues, and the presence of protein in the urine, as determined by laboratory tests. Glomerulonephritis often clears up without treatment. When treatment is necessary, it may include a special diet, immunosuppressant drugs, or plasmapheresis, a procedure that removes the portion of the blood that contains antibodies.
Other common kidney disorders include kidney stones, which are small, crystallized substances, such as calcium, that form in the kidney or other parts of the urinary tract. Smaller kidney stones can pass out of the body on their own, although this can be painful. Larger stones may require surgery, or they may be broken into smaller pieces with sound waves in a procedure called ultrasonic lithotripsy. The kidneys may be harmed whenever injury or disease affects the rest of the body. For example, diabetes mellitus (a disease caused by a malfunctioning pancreas that produces little or no insulin) can result in impaired blood flow through the kidneys. The bacteria that cause tuberculosis can travel from the lungs and infect the kidneys. Injured muscles can release large amounts of protein into the bloodstream, blocking the nephrons. Drug use, including long-term use of some prescription medications as well as illegal drugs, can also cause kidney damage. Certain birth defects may cause the kidneys to have abnormal shapes or to function improperly.
Treatment of severe kidney disease may include kidney dialysis, a procedure in which blood is circulated through a machine that removes wastes and excess fluid from the bloodstream. Some patients use dialysis for a short time, while their kidneys recover from injury or disease. Others must use dialysis for their entire lives or until they undergo a kidney transplant. Kidney transplants are the most common of all transplant operations and have excellent success rates. Unfortunately, there are not enough kidneys available for the people who need them. More than 38,000 people in the United States alone wait for a kidney transplant each year, and fewer than 12,000 of them receive this life-sustaining organ . As one kidney is enough to survive, it is worthwhile to donate to a relation or any other person for God’s sake. This is particularly if the recipient is still economically viable. Can any member of Unilorin forum afford to be so generous? As stated below, you may want to will your kidney to someone who might need it immediately after your death.
Since medication to prevent rejection is so effective, donors do not need to be genetically similar to their recipient. Most donated kidneys come from deceased donors; however, the utilization of living donors in the United States is on the rise. In 2006, 47% of donated kidneys were from living donors. This varies by country: for example, only 3% of kidneys transplanted during 2006 in Spain came from living donors.
More than one in three donations in the UK is now from a live donor and nearly that in Israel. The percentage of transplants from living donors is increasing. Potential donors are carefully evaluated on medical and psychological grounds. This ensures that the donor is fit for surgery and has no disease which brings undue risk or likelihood of a poor outcome for either the donor or recipient. The psychological assessment is to ensure the donor gives informed consent and is not coerced. In countries where paying for organs is illegal, the authorities may also seek to ensure that a donation has not resulted from a financial transaction. In the UK, the Human Tissue Act 2004 (HTA) dictated that donors must prove a familiar or long-term relationship or enduring friendship, for instance by providing photographs of themselves together spread over a period of time or a birth or wedding certificate. Purely altruistic donation to strangers has recently been accepted by the Human Tissue Authority in the United Kingdom, but as of December 2007 only four people had been given permission to do this under the HTA. The decision must be approved by a panel, whereas the typical donation based on relationship is required only to go through an executive.
There is good evidence that kidney donation is not associated with long-term harm to the donor. In some cases of male living donors a hydrocele may occur in the scrotum related to the side of the nephrectomy. As an example, a living donor who had a left side laproscopic nephrectomy, the left side of the scrotum can develop a hydrocele that envelopes the left testicle and enlarges the left side of the scrotum. This condition is typically non threatening and can disappear over time.
So called "daisy chain" transplants in the US involve one altruistic donor who donates a kidney to someone who has a family member willing to donate, who isn't a match. That family member then donates to a recipient who is a match. This "chain" can be continued with several more pairs of donors/recipients.
Traditionally, the donor procedure has been through a single incision of 4–7 inches (10–18 cm), but live donation is being increasingly performed by laparoscopic surgery. This reduces pain and accelerates recovery for the donor. Operative time and complications decreased significantly after a surgeon performed 150 cases. Live donor kidney grafts have higher long-term success rates than those from deceased donors. Since the increase in the use of laparoscopic surgery, the number of live donors has increased. Any advance which leads to a decrease in pain and scarring and swifter recovery has the potential to boost donor numbers. In January 2009, the first all-robotic kidney transplant was performed at Saint Barnabas Medical Center through a two-inch incision. In the following six months, the same team performed eight more robotic-assisted transplants.
In the developing world some people sell their organs. Such people are often in grave poverty or are exploited by salespersons. The people who travel to make use of these kidneys are often known as "transplant tourists." This practice is opposed by a variety of human rights groups, including Organs Watch, a group established by medical anthropologists, which was instrumental in exposing illegal international organ selling rings. These patients may have increased complications owing to poor infection control and lower medical and surgical standards. One surgeon has said that organ trade could be legalized in the UK to prevent such tourism, but this is not seen by the National Kidney Research Fund as the answer to a deficit in donors.
Looking for a living donor?
If you (or someone you know) needs a transplant:
