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The Genitourinary System / The Kidneys - Basic Version
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submitted by Dr. Gary Farr - Contact the author here.
Last Updated July, 17, 2003
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Not everyone with a urinary tract infection has symptoms, but most people get at least some. These may include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad all over—tired, shaky, washed out—and to feel pain even when not urinating. Often, women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum. It is common for a person with a urinary infection to complain that, despite the urge to urinate, only a small amount of urine is passed. The urine itself may look milky or cloudy, even reddish if blood is present. A fever may mean that the infection has reached the kidneys. Other symptoms of a Kidney Infection include pain in the back or side below the ribs, nausea, or vomiting.
In children, symptoms of a urinary infection may be overlooked or attributed to another disorder. A urinary tract infection should be considered when a child or infant seems irritable, is not eating normally, has an unexplained fever that does not go away, has incontinence or loose bowels, or is not thriving. The child should be seen by a doctor if there are any questions about these symptoms, especially if there is a change in the child's urinary pattern.
Kidney stones symptoms can result in pain (severe at times), chills, acidosis, fever, nausea, vomiting and loss of appetite.
Normal urine is sterile. It contains fluids, salts, and waste products, but it is free of bacteria, viruses, and fungi. An infection occurs when microorganisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon.
In most cases, bacteria first begin growing in the urethra. An infection limited to the urethra is called urethritis. From there bacteria often move on to the bladder, causing a bladder Infection (cystitis). If the infection is not treated promptly, bacteria may then go up the ureters to infect the kidneys (pyelonephritis).
Microorganisms called Chlamydia and Mycoplasma may also cause urinary tract infections in both men and women, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coli, Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.
The urinary system is structured in a way that helps ward off infection. The ureters and bladder normally prevent urine from backing up toward the kidneys, and the flow of urine from the bladderhelps wash bacteria out of the body. In men, the prostate gland produces secretions that slow bacterial growth. In both sexes, immune defenses also prevent infection. Despite these safeguards, though, infections still occur.
Who Is at Risk?
Some people are more prone to getting a urinary tract infection than others. Any abnormality of the urinary tract that obstructs the flow of urine (a Kidney stone, for example) sets the stage for an infection. An enlarged prostate gland also can slow the flow of urine, thus raising the risk of infection.
A common source of infection is catheters, or tubes, placed in the bladder. A person who cannot void or who is unconscious or critically ill often needs a catheter that stays in place for a long time. Some people, especially the elderly or those with nervous system disorders who lose bladder control, may need a catheter for life. Bacteria on the catheter can infect the bladder, so hospital staff take special care to keep the catheter sterile and remove it as soon as possible.
People with diabetes have a higher risk of a urinary tract infection because of changes in the immune system. Any disorder that suppresses the immune system raises the risk of a urinary infection.
Urinary tract infections may occur in infants who are born with abnormalities of the urinary tract, which sometimes need to be corrected with surgery. urinary tract infections are rarely seen in boys and young men. In women, though, the rate of urinary tract infections gradually increases with age. The author's thought regarding this is simply that these women have increasingly weaker immune systems. Another factor may be that a woman's urethra is short, allowing bacteria quick access to the bladder. Also, a woman's urethral opening is near sources of bacteria from the anus and vagina. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.
According to several studies, women who use a diaphragm are more likely to develop a urinary tract infection than women who use other forms of birth control. Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the vagina.
Recurrent Infections
Many women suffer from frequent urinary tract infections. Nearly 20 percent of women who have a urinary tract infection will have another, and 30 percent of those will have yet another. Of the last group, 80 percent will have recurrences.
Usually, the latest infection stems from a strain or type of bacteria that is different from the infection before it, indicating a separate infection. (Even when several urinary tract infections in a row are due to E. coli, slight differences in the bacteria indicate distinct infections.)
Research funded by the National Institutes of Health (NIH) suggests that one factor behind recurrent urinary tract infections may be the ability of bacteria to attach to cells lining the urinary tract. A recent NIH-funded study has also shown that women with recurrent urinary tract infections tend to have certain blood types. Some scientists speculate that women with these blood types are more prone to urinary tract infections because the cells lining the vagina and urethra may allow bacteria to attach more easily. Further research will show whether this association is sound and proves useful in identifying women at high risk for urinary tract infections.
Infections in Pregnancy
Pregnant women seem no more prone to urinary tract infections than other women. However, when a urinary tract infection does occur, it is more likely to travel to the kidneys. According to some reports, about 2 to 4 percent of pregnant women develop a urinary infection. Scientists think that hormonal changes and shifts in the position of the urinary tract during pregnancy make it easier for bacteria to travel up the ureters to the kidneys. For this reason, many doctors recommend periodic testing of urine.
1) Symptoms of kidney dysfunction can include tiredness, weight loss, edema, flank pain, abnormal blood pressure, nausea, bad taste in mouth, blurred vision, acidosis, puffy face.
2) In kidney dysfunction urine output can be decreased or increased. The urine can be cloudy or contain blood, and you may wake up several times nightly to urinate.
3) Chills and fever often accompany kidney infections.
4) Kidney stone symptoms can include pain (very severe at times), loss of appetite, nausea, vomiting, paleness, sweating, chills, fever, blood in urine.
Imaging techniques are used to determine the anatomical site, configuration, and level of functioning of the kidneys, pelvis, and ureters. A plain X ray nearly always precedes any other more elaborate investigation, so that the size, outline, and position of the two kidneys, as well as information about the presence or absence of calcium-containing renal stones or zones of calcification can be ascertained. Excretion urography is one of the simplest methods of defining these aspects more precisely, though this radiological method is giving way to noninvasive imaging methods such as ultrasonography and nuclear magnetic resonance (NMR). In excretion urography, the kidneys are observed in X rays after intravenous injection of a radiopaque iodine-containing compound that is excreted largely by glomerular filtration within one hour of the injection. A series of X-ray images (nephrograms) then indicates when the contrast substance first appears and reveals the increasing radiographic density of the renal tissue. The X rays also indicate the position, size, and presence of scarring or tumours in the organs and provide an approximate comparison of function in the two kidneys. Finally the dye collects in the bladder, revealing any rupture or tumour in this organ.
Obstruction to the flow of urine also may be revealed by distension of the calyceal system above the site of obstruction. This is more clearly detected by urography, in which contrast medium is injected through a fine catheter introduced either directly into the pelvis of the kidney or into the ureteral orifice visualized during cystoscopy. A micturating cystogram involves the injection of contrast substance into the bladder and is of importance in the investigation of urinary tract infection in childhood. It may show the reflux of urine from the bladder upward into the ureters or kidneys on micturition. Because of the risk of radiation to the gonads this test should be conducted only on certain patients.
A radioactive renogram involves the injection of radioactive compounds that are concentrated and excreted by the kidney. The radiation can be detected by placing gamma scintillation counters externally over the kidneys at the back; the counts, transcribed on moving graph paper, yield characteristic time curves for normal and disordered function.
A picture of renal circulation can be obtained by introducing a radiopaque substance directly into the abdominal aorta just above the origin of the renal arteries, or directly into the renal arteries themselves. The contrast material yields a renal angiogram, showing the renal vascular tree. The technique is especially valuable in demonstrating the presence of localized narrowing or obstructions in the circulation or of localized dilatations (aneurysms). Tumours, which tend to be well vascularized, are also distinguishable from cysts, which are not well supplied with blood.
Ultrasound and Nuclear Magnetic Resonance Imaging or MRI have the advantage of being noninvasive and apparently free from risk to the patient. They are useful in detecting tumours of the kidney or adjacent structures and in distinguishing tumours from cysts. Ultrasound techniques are comparatively simple and have replaced other methods in detecting the presence of polycystic kidneys.
The visual, usually microscopic, examination of a specimen of kidney tissue removed from a living patient (renal biopsy) is the only investigative method that yields exact histological data on renal structure. The material for examination is usually obtained by inserting a special needle through the skin of the back into the kidney substance and withdrawing a fragment of tissue. A general anesthetic is not usually required, the procedure occupying only a few minutes. Renal biopsy has been valuable in clarifying several renal disorders, notably those affecting the glomeruli, and in revealing their prognosis and natural course. The only serious potential complication is excessive bleeding, but this is rare. The procedure is not justified, however, if the patient possesses only one kidney or suffers from a bleeding disorder or from severe, uncontrolled high blood pressure.
General Rules
- Drink plenty of water every day.
- See your chiropractor if you suspect nerve irritation.
- Urinate when you feel the need; don't resist the urge to urinate.
- Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
- Take showers instead of tub baths.
- Avoid sugar, alcohol, white flour, milk, and birth control pills.
- Cleanse the genital area before sexual intercourse.
- Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
- Drink unsweetened cranberry juice.
The following reflexes may be active when the ovaries are involved:
These reflexes should be tested and treated with the proper supplementation.
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