Kidney Problems - Treatment
The doctor can determine if you have a kidney infection by examining your urine for bacteria and pus cells. A kidney infection is usually treated by plenty of fluids and antibiotics. If the infection is severe, you may need to be hospitalized to receive intravenous antibiotics and fluids.
Sometimes drinking a large volume of electrolyte balanced fluid and taking pain medication will help you pass the stone. The success of this treatment depends mainly on stone size and location. Smaller stones have an excellent chance of passing themselves. Other times, under general anesthesia kidney stones can be broken up with an ultrasonic shock wave technique (ESWL) or with a laser fiber through a small camera placed within a natural orifice (ureteroscopy). This grinds the stones into a powder to be passed more easily. Additionally, the stones can be removed with small baskets during ureteroscopy. Both of these procedures are generally considered day surgery procedures and can be performed at outpatient surgery centers. For larger stones, a tract through the flank is made into the kidney to allow the passage of a larger camera and the use of an instrument that both breaks up the stone and aspirates the fragments. This procedure is performed at a hospital and usually requires a short hospital stay.
Acute kidney failure - This is sometimes a reversible condition. The disease that is causing the failure must be treated. Examples of this are controlling diabetes, better control of blood pressure, and intravenous fluids and transfusions for kidney failure associated with severe blood loss. If the failure is a result of an enlarged prostate or a kidney stone, then surgery may be required to remove the obstruction.
Chronic kidney failure - Possible treatments include better control of disease causing the failure, intravenous fluids, transfusions, surgery, or transplant.
End-stage kidney failure or renal disease - Permanent damage cannot be reversed. Dialysis or a kidney transplant is required.
Dialysis is an artificial means of removing wastes in the blood when the kidneys can not do it anymore.
Kidney transplants are another option. The United Network for Organ Sharing reported that as of 2016 there were 99,852 people waiting for a kidney transplant. In 2015, there were 12,250 deceased donor kidney transplants and 5,628 living donor transplants done in the United States. The living donors are usually relatives of the patient who volunteer to donate one of their own kidneys. The chance of the body rejecting a kidney from a relative is less than with an unrelated donor.
For localized kidney cancer, it was previously believed that the only curative therapy was radical removal of the kidney. While complete removal of the kidney has long been the standard of care, increasing attention is being paid to nephron-sparing procedures such as partial nephrectomy (removal of the tumor only), cryotherapy (freezing) of the tumor, or radio frequency ablation of the tumor are now viable alternatives in selected cases. For small tumors, which are peripherally located, ablative techniques are excellent options for appropriately selected patients. The tendency for renal cell carcinoma to be multifocal and metachronous demands careful long-term surveillance in those patients treated with nephron-sparing techniques.
Innovations in the management of these tumors have included robot assisted (Davinci platform) laparoscopic (minimally invasive through small incisions or ports) partial nephrectomy for selected cases of renal cell carcinoma. Patient who undergo a robotic partial nephrectomy or a laparoscopic radical nephrectomy typically spend 24-48 hours in the hospital.
Currently, there are no curative therapies for metastatic kidney cancer. Historically, Immunotherapy in the form of Interleukin-II was used for advanced kidney cancer. Targeted therapies are now the standard of care for metastatic renal cell carcinoma and newer immunotherapy agents have been recently been approved.