The main job of the kidneys is to filter the blood and remove all of the waste that we don't want. The main waste product you need to know about is urea which is made in the liver during the process of deamination which is where excess amino acids that we don't need anymore, are converted to fats and carbohydrates for storage the kidneys.
Each kidney receives blood through a branch of the aorta called the Renal artery. This blood is then filtered through nephrons to produce urine. There are about 1 million nephrons in each kidney. Each nephron contains a small tangle of porous blood vessels called a glomerulus fluid, that is to become urine leaks. Out of these blood vessels into a thin bowl shaped structure called the Bauman capsule. The glomeruli are located in the outer part of the kidney or the cortex. From here urine drains into tubules in the inner layer of the kidney called the medulla, and then into the collecting ducts. Urine drains through the ureter the tubes connecting each kidney to the bladder, and then through the urethra the tube that leads outside of the body. The kidneys and urinary tract can be affected by many different disorders. Stones are hard masses, usually composed of calcium that begin to form in the kidney and may enlarge throughout the urinary tract, causing pain, bleeding or an infection and are more common in older adults and men.
Dysuria is a sensation of pain described as a burning sensation while urinating. So as an individual is urinating, they have a burning sensation. We call this dysuria, and this is because there is irritation of the bladder and lower segments of the urinary tract caused by infective organisms. So there's inflammation, and there is this burning sensation when someone is urinating. so that is one of the symptoms of a UTI.
This is the sensation of feeling like needing to urinate more quickly. so you feel like you have to very quickly get to the bathroom and urinate. And again this is due to bladder irritation as well.
So increased frequency of urination, so urinating more frequently, than normal is a symptom of UTI. And this increased frequency of urination is due to irritation of the bladder as well, so that irritation makes the patient feel like they have to go to the washroom more often, and they often feel like they need to urinate even when the bladder is empty. So they'll go back to the washroom and try to urinate even when they don't have to.
Those three symptoms we just mentioned:
Those are the three major cardinal symptoms of a UTI.
Urine may smell more foul than usual, and this can be due to piuria or pus in the urine, so white blood cells and bacteria. So just the presence of bacteria in the urine can change the smell of the urine, making it more foul in nature.
Superpubic pain pain in the Pelvic area or pain in the super Pubic area. This is due to irritation of the bladder. Again we call the Cystitis.
Hematuria is blood in the urine. You can imagine, that if there are bacteria in the bladder and the urinary tract, they can cause irritation and some trauma of the urinary tract even at a microscopic level, causing some bleeding to occur. And this hematuria is most often microscopic hematuria, which means we don't see it with the naked eye. We can only see it on a urinalysis or urine dipstick, and this is due to again organism irritation. Some other symptoms of UTI include urinary hesitation. So urinary hesitation is a difficulty initiating urination or maintaining a urine stream.
So difficulty starting and difficulty maintaining urine stream called post void dribbling. Post-avoid dribbling is where there's some residual urine after voiding. After voiding has completed, there can be some residual urine.
Pylonephritis is a complication of a UTI where that UTI has ascended up to lead to an infection of the kidneys. So those bacteria that have caused a UTI can travel up the ureters and infect the kidneys, causing pylon nephritis. This can be a complication of a urinary tract infection. So in a pylonephritis we can see those symptoms we talked about before dysuria urgency frequency.
But we can see these other symptoms. Some of these include flank pain. So flank pain is where there is pain at the lower side of the back. so usually around in this area, here at the bottom of the Ribcage, and that is where your kidneys are located so pain in the back toward one side at the bottom of the Rib cage. And then, if you were to pound on that area, the patient jumps due to pain from that area. and that is what we call Costo vertebral angle or Cva tenderness. So that is a very critical clinical sign of a pyelonephritis. And then, because the kidney is infected, there can be fever and chills. So this occurs with flank pain and is actually one of the most common signs and symptoms of pyelonephritis. So along with flying pain there can be fever and chills. And again this is due to an infected kidney. You can imagine, that if an organ is infected with bacteria, the body is going to mount a fever. Now some other signs and symptoms of pylonephritis include nausea and vomiting. So because the patient is very ill, their kidney is infected, they can have nausea and vomiting. This is a relatively common symptom of pyelonephritis.
People typically notice this when they have severe back pain that can radiate into the abdomen. They may see blood in their urine. It's very, very uncomfortable. When I talk to people about risk factors for stones typically. They don't drink very much in the way of water. And so our goal is to get them to drink more and more fluids to prevent the stones. And soda's a bad thing, Particularly the colas. Most of the stones in this country are calcium oxalate stones.
Calcium oxalate stones are the most common, and they're caused by excess consumption of either calcium or oxalate. Food, that contains a lot of oxalate, includes chocolate nuts and vegetables. Calcium phosphate stones are a bit different as they're mainly caused by genetic conditions and migraine and seizure communications.
Steroid stones are the result of urinary tract infection, and these are significantly sharper, than calcium stones, and so they cause much more pain and they normally require surgical excision.
Uric acid stones are caused by well excess of uric acid and cysteine.
Stones are the rarest and they're caused by cysteine urea, which is a genetic condition. The biggest risk factor for developing kidney stones is previous history. So if someone developed a stone at one point, it's likely they will have another. Dehydration is the second most common cause. Obesity is also very common and, of course, certain medications and diet. This includes vitamin C, tablets, laxatives and calcium anti-acids.
Symptoms regarding kidney stones are very straightforward. You will have colicky pain severe pain that you're not able to even withstand, nor even you can stand or sit. It will be associated with vomiting, sometimes with fever and burning in urination. That may be symptoms like hematuria, which may be mild or severe. Hematuria means blood in urine. These are the symptoms which you should identify and you should meet your nearest urologist as early as possible and take proper treatment.