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The umbilical cord and the blood left in it at birth contain a broad diversity of pristine newborn stem cells that have demonstrated the ability to help other tissues and organs heal themselves after injury or disease. Hematopoietic stem cells found in cord blood used for 20 years to help regenerate the body's blood and immune system. Mesenchymal stem cells, found primarily in the umbilical cord tissue itself, have the ability to help from bone or connective tissues like cartilage and ligaments.
Stem cells from the umbilical cord and cord blood have distinct benefits compared to adult stems cells from bone marrow. They're younger, have greater ability to multiply, and have had minimal exposure to environmental factors like viruses or chemicals that can interfere with cell structure and function.
Cord blood stem cells are not embryonic stem cells. Collecting and using them is not controversial.
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all laboratories should now be using a creatinine method that has been standardized or traceable to isotope dilution mass spectrometry (IDMS). The way creatinine levels are calibrated affects the GFR estimating equation slightly.
to properly estimate GFR, the serum creatinine must be measured accurately. When a laboratory calibrates their method to the single standardized serum creatinine using reference materials traceable to the primary reference material at the National Institute of Standards, we say that value is traceable to IDMS because the test is based on isotope dilution mass spectrometry (IDMS).
with the exception of the Cockcroft-Gault formula, all other calculators in this Smartphone application are designed for use with standardized creatinine values that are traceable to IDMS. Also, only standardized cystatin C values are used.
your laboratory can confirm whether or not it uses standardized creatinine values that are traceable to IDMS. It can also confirm whether it uses cystatin C values that are standardized.
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Normal GFR varies according to age, sex, and body size; in young adults it is approximately 120-130 mL/min/1.73m2 and declines normally with age. However, a decrease in GFR may also be a marker of kidney disease and precedes the onset of kidney failure; therefore a persistently reduced GFR is a specific diagnostic criterion for chronic kidney disease. Below 60 mL/min/1.73sq.m, the prevalence of complications of CKD increases, as does the risk of cardiovascular disease (CVD).
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GFR is equal to the total of the filtration rates of the functioning nephrons in the kidney. In most healthy people, the normal GFR is 90 mL/min/1.73m2 or higher.
a result of 60-89 mL/min/1.73m2 without kidney damage may be normal in some people such as the elderly or infants (if, for example, there are no other findings indicative of kidney disease, such as protein in the urine).
a result of 60-89 mL/min/1.73m2 for => 3 months, along with kidney damage (such as persistent protein in the urine), means the person has early kidney disease.
When GFR is < 60 for => 3 months, chronic kidney disease (CKD) is present.
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GFR is measured using plasma or urinary clearance of an exogenous filtration marker. However, this is a complex procedure and generally not routinely performed. Therefore, GFR is usually estimated from the person's serum creatinine level, in combination with demographic factor such as age, race, and gender using various formulas.
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GFR (glomerular filtration rate) is the optimal way to measure kidney function and determine a person's stage of kidney disease. The level of GFR and its magnitude of change over time are vital to :
the detection of kidney disease
understanding its severity
making decisions about diagnosis, prognosis and treatment
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Chronic kidney failure, also known as end stage renal disease or ESRD, is a condition where the kidneys lose their ability to filter waste from the bloodstream to convert into urine. Once the kidneys are so damaged that they cannot filter the blood, the patient will require dialysis or a kidney transplant in order to live. When the kidneys fail, dialysis -- a treatment where the blood is filtered and cleaned to do the work the kidneys cannot -- is performed. While dialysis can do the essential work of the kidneys, the treatment is expensive and time-consuming, requiring a minimum of three 3-hour treatments per week. Kidney transplant surgery is the only "cure" for end stage renal disease, as a functional kidney transplant will remove the need for dialysis. A transplant poses its own challenges, but provides a great improvement in overall health when the surgery is successful.
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Uncontrolled diabetes is the #1 cause of kidney failure in the worldwide countries, responsible for over 30% of the patients with the disease. The majority of kidney transplant recipients have either type 1 or type 2 diabetes.
Over time, high levels of glucose in the blood destroys the kidney’s ability to filter toxins and waste from the blood. The glucose molecule is larger than the molecules that the kidney is supposed to filter. The filtering mechanism is damaged as glucose is forced into the urine, and thus the kidney loses the ability to filter small molecules. The damage continues until it is so severe that waste begins to build up in the bloodstream.
Blood tests will typically show both elevated creatinine and BUN levels. When the waste begins to build up, dialysis or a kidney transplant is the next step for treatment.
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Hypertension, or high blood pressure, causes scarring of the kidney tissues. As the blood pressure rises, the kidneys try to compensate for the increasing pressure. Scar tissue accumulates over the course of months and years until the kidneys' ability to filter the blood is impaired.
Left untreated, high blood pressure continues to cause scarring in the kidneys until they fail and dialysis or a kidney transplant becomes necessary.
Causes of Kidney Failure : 26.8% caused by high blood pressure.
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Chronic kidney infections cause scarring of the kidneys, similar to the scarring caused by high blood pressure and diabetes. With each infection, the damage is increased, until the kidneys lose the ability to filter small particles from the bloodstream.
The more frequent and more serious the infections, the greater the likelihood that kidney failure will result. Urinary tract infections that are ignored can lead to kidney infections that persist until treated with antibiotics.
If enough infections are severe enough, or ignored and untreated, the result can be the need for dialysis or a kidney transplant.
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There are two types of polycystic kidney disease (PKD). The first, Autosomal Dominant PKD (ADPKD), is a very common inherited disease -- a child has a 50% chance of inheriting the disease if either parent carries it. One in 500 newborns has ADPKD, which causes cysts to grow on the kidneys and leads to kidney failure in 50% of cases.
Autosomal Recessive PKD (ARPKD) is less common, but is a far more severe form of the disease. Both parents must be a carrier for the disease, and their children have a 25% chance of having ARPKD. Approximately 1 in 20,000 newborns have the disease.
In this form of the disease, cysts grow inside the kidney, causing such severe damage that many patients die in the first month of life.
For those who survive, one-third will require dialysis by the age of 10. To make matters worse, children with ARPKD also have associated liver disease that can also cause life-threatening problems.
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The growth of a tumor in the kidney, either cancerous or benign, can cause tremendous damage to the structures of the kidney. A typical adult kidney measures approximately 10 centimeters by 5 centimeters, yet tumors within the kidney can reach 10 centimeters in diameter or larger before the patient feels the slightest effects.
By the time the tumor is found, even if it is non-cancerous, the kidney may no longer be functioning. In some cases, the damage is so severe that the kidney must be removed to prevent damage to other organs, including the heart. If the remaining kidney is also not functioning well, dialysis or a kidney transplant may be required.
You may have no symptoms at first. They may appear as the cancer grows. See your health care provider if you notice :
Blood in your urine
A lump in your abdomen and pain in your side that does not go away
Loss of appetite and weight loss
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A congenital kidney abnormality is a problem with the kidney that is present at birth. Abnormalities range from abnormal structures, blocked urine flow, unusual position of the kidneys that impairs function, or even being born with only one kidney. If the problem is severe enough, kidney failure may result.
Types of congenital abnormalities of kidneys
Absence of one kidney: Also called agenesis when there is absence of one kidney the corresponding ureter is also absent. In this case the single kidney increases to almost twice its normal size and takes over the function of two kidneys
Supernumary kidney: There may be more than one kidney on one or both sides.
Hypoplasia: When a kidney attains a smaller size than normal or functions less it is called hypoplasia.
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Kidney stones, problems with the ureters (the tubes that allow urine to flow out of the kidney and into the bladder), and other conditions can prevent urine from draining from the kidneys. Typically, the problem begins in the kidney, but in some rare cases, the bladder cannot empty and urine will back up into the ureters, then into the kidneys.
Once the blockage is severe, the kidney become damaged as urine continues to be produced, but cannot flow out of the kidney. This condition can be extremely painful and may result in surgery to release the build-up of urine.
If the problem is left untreated, the kidney may no longer function and may even need to be surgically removed. In most cases, the undamaged kidney will be able to compensate; however, if the other kidney is also damaged, dialysis or a kidney transplant may be necessary.
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Lupus nephritis is a kidney disorder that is a complication of systemic lupus erythematosus.
Systemic lupus erythematosus (SLE, or lupus) is an autoimmune disease. This means there is a problem with the body's immune system. Normally, the immune system helps protect the body from infection or harmful substances. But in patients with an autoimmune disease, the immune system cannot tell the difference between harmful substances and healthy ones. As a result, the immune system attacks otherwise healthy cells and tissue.
SLE may damage different parts of the kidney, leading to interstitial nephritis, nephrotic syndrome, and membranous GN. It may rapidly worsen to kidney failure.
Lupus nephritis affects approximately 3 out of every 10,000 people. In children with SLE, about half will have some form or degree of kidney involvement.
More than half of patients have not had other symptoms of SLE when they are diagnosed with lupus nephritis. SLE is most common in women ages 20 - 40.
Symptoms of lupus nephritis include:
Blood in the urine
Foamy appearance to urine
High blood pressure
Swelling of any area of the body
Medicines may include corticosteroids or other medications that suppress the immune system, such as cyclophosphamide, mycophenolate mofetil, or azathioprine.
You may need dialysis to control symptoms of kidney failure, sometimes for only a while. A kidney transplant may be recommended. People with active lupus should not have a transplant because the condition can occur in the transplanted kidney.
Possible Complications
Acute renal failure
Chronic renal failure
End-stage renal disease
Nephrotic syndrome
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The blood pressure in your body depends upon the following conditions:
The force of contraction of the heart -- related to how much the heart muscle gets stretched by the incoming blood.
The degree to which the arteries and arterioles constrict -- increases the resistance to blood flow, thus requiring a higher blood pressure.
The circulating blood volume -- the higher the circulating blood volume, the more the heart muscle gets stretched by the incoming blood.
The kidney influences blood pressure by:
Causing the arteries and veins to constrict
Increasing the circulating blood volume
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The kidney can correct any imbalances by:
Removing excess acid (hydrogen ion) or bases (bicarbonate) in the urine and
Restoring the bicarbonate concentration in the blood to normal
The kidney cells produce a constant amount of hydrogen ion and bicarbonate because of their own cellular metabolism (production of carbon dioxide). Through a carbonic anhydrase reaction similar to the red blood cells, hydrogen ions get produced and secreted into the lumen of the nephron. Also, bicarbonate ions get produced and secreted into the blood. In the lumen of the nephron, filtered bicarbonate combines with secreted hydrogen ions to form carbon dioxide and water (carbonic anhydrase is also present on the luminal surface of the kidney cells). Whether the kidney removes hydrogen ions or bicarbonate ions in the urine depends upon the amount of bicarbonate filtered in the glomerulus from the blood relative to the amount of hydrogen ions secreted by the kidney cells. If the amount of filtered bicarbonate is greater than the amount of secreted hydrogen ions, then bicarbonate will be lost in the urine. Likewise, If the amount of secreted hydrogen ion is greater than the amount of filtered bicarbonate, then hydrogen ions will be lost in the urine (i.e. acidic urine).
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When you drink a large glass of water, the water gets absorbed into the blood and the following happens:
The absorbed water increases the amount of water filtered in the glomerulus.
The absorbed water in the blood reduces the Na concentration a little.
The reduced Na concentration lowers the amount of Na filtered in the glomerulus.
The nephron reabsorbs all of the reduced Na load and some of the accompanying water, leaving excess water in the filtrate.
The reduced Na concentration is sensed by the osmoreceptors.
The osmoreceptors do not secrete as much ADH.
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Your kidneys have the ability to conserve or waste water. For example, if you drink a large glass of water, you'll find that you will have the urge to urinate within an hour or so. In contrast, if you don't drink for a while, such as overnight, you will not produce much urine and it will usually be very concentrated (i.e. darker). How does your kidney know the difference? The answer to this question involves two mechanisms:
The structure and transport properties of the loop of Henle in the nephron.
The anti-diuretic hormone (ADH), also called vasopressin, secreted by the pituitary gland.
The loop of Henle has a descending limb and an ascending limb. As filtrate moves down the loop of Henle, water is reabsorbed, but ions (Na,Cl) aren't.
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Some substances are secreted from the plasma into the lumen by the cells of the nephron. Examples of such substances are ammonia (NH3). As in reabsorption, there are transporters on the cells that can move these specific substances into the lumen.
Now let's put all of these processes -- filtration, reabsorption and secretion -- together to understand how the kidneys maintain a constant composition of the blood. Let's say that you decide to eat several bags of salty (NaCl) potato chips at one sitting. The Na will be absorbed into your blood by your intestines, increasing the concentration of Na in your blood.
