Nephrology Division

Nephrology Division

Overview

Diagnosis and treatment of hypertension, renal diseases of adult patients; dialysis (peritoneal or hemofialysis) and organ transplant for patients with renal failure are performed by specialized health personnel, primarily by academicians and physicians of our unit.

Kidney Transplant: Kidney transplant from deceased and living donors are performed in our unit, which is a part of the most advanced organ transplant team of Turkey, and preoperative preparations and postoperative follow-up are conducted in detail by experts on the subject.

  • Hypertension
  • Diabetic Renal Disease (Diabetic Nephropathy)
  • Glomerulonephritis
  • Renal Infections (Pyeolonephritis)
  • Acute Renal Failure.
  • Chronic Renal Failure.

Hypertension

It means high blood pressure. Today, accepted blood pressure for a normal adult at rest is 120/80 mmHg. Blood pressure is usually low, while a person is sleeping; on the other hand, it elevates during temper or excitement. Hypertension is considered if the blood pressure is continuously above 140/90 mmHg. Hypertension is a major risk factor for heart diseases. If it is not treated, it drastically increases risk of severe disease and mortality in severe cerebral, cardiovascular, ophthalmic and renal diseases. Elevated blood pressure can be lowered and risk of cardiovascular disease can be reduced once the diagnosis is made and treatment is started.

Diabetic Renal Disease (Diabetic Nephropathy)

Elevated blood glucose increases the filtering function kidney which causes stenosis in vessels leading to generalized dysfunction in kidneys. The kidney damage caused by diabetes is called “diabetic nephropathy”. It has been considered that the diabetes-related kidney damage is also related to genetic damage, not only vascular defect. Diabetic Nephropathy (DN) is one of the most critical complications of diabetes and the most common cause of end stage kidney failure.  End-stage kidney failure occurs in 30-40% of Type 1 diabetes and 5-10% of Type 2 diabetes. Kidney damage in diabetic patients can be verified by analyzing whether there is protein in urine and volume of protein, if any. Protein is not present in a normal urine sample. Microalbuminuria implies a concentration of protein in urine slightly above a certain threshold. “Microalbuminuria” screening in urine is performed 5 years after diagnosis for Type 1 diabetes patients and right after diagnosis for Type 2 diabetes patients. Diabetes-related kidney damage is a progressive condition. Progression of kidney damage accelerates, if the individual has elevated blood pressure (hypertension) or elevated triglyceride (hyperlipidemia). Therefore, it is also necessary to manage the diseases that accompany diabetes.

Glomerulonephritis

It is an inflammatory disease in internal structure of kidneys. Signs and symptoms may vary depending on type of glomerulonephritis. Diagnosis of glomerulonephritis is generally simple, including physical examination, analysis of urea and creatinine in blood and a simple urinalysis. Signs of glomerulonephritis in physical examination are swelling in hands, feet and eyelids, dark discoloration of urine (urine may appear in tea color) and hypertension. Bleeding (hematuria) and protein loss (proteinuria) in urinalysis are signs which suggest glomerulonephritis. The challenge in diagnosis of glomerulonephritis is identifying the underlying disease. Underlying cause of glomerulonephritis cannot be detected in a large of part of cases. Kidney biopsy implies collecting a piece of renal tissue for microscopic examination and it is required to identify type of glomerulonephritis.

Renal Infections (Pyeolonephritis)

This occurs when microorganisms invading the body reach kidneys and cause inflammation there. It may be acute or chronic. Kidney infection is a critical disease. It may lead to chronic renal failure when left untreated. Moreover, infectious agent may reach the blood circulation and cause sepsis and death.

Acute Renal Failure.

This is a disorder characterized with elevated urea and creatinine in blood and decreased urinary output (under 400 ml in 24 hours) due to rapid dysfunction of kidneys. Acute renal failure may occur due to various reasons. Acute renal failure may be secondary to dehydration caused by heart failure, bleeding in any body part, burns, severe diarrhea or vomiting and excessive use of diuretic agent, resulting in poor blood supply to kidneys, as well as primary renal diseases such as glomerulonephritis and pyelonephritis, systemic diseases such as diabetes and systemic lupus erythematosus, consumption of substances and medicines which damage kidneys, obstruction of urinary flow due to reasons such as stone, tumor and enlarged prostate.

Chronic Renal Failure.

Chronic renal failure is a kidney disease, where uremia occurs due to permanent impairment of all kidney functions. Uremia: It implies the group of symptoms secondary to elevated urea in blood. Most prevalent causes of chronic renal failure in our country are diabetes mellitus and hypertension. Moreover, renal failure may be caused by glomerulonephritis, kidney stones, infections, systemic diseases which involve kidney (SLE, PAN, scleroderma), congenital anomalies of kidney (polycystic kidney, hypoplastic kidney, multi-cystic kidney disease), nephrotoxins (various antibiotics, excessive chronic use of painkillers, heavy metals such as gold, lead, cadmium), tumor or structural disorders of urinary tracts, vascular diseases of kidney (stenosis in bilateral renal arteries).

  • Various problems are faced due to dysfunction of kidney as renal failure progresses.
  • Urea and creatinine, which are harmful for body, elevate.
  • Hypertension and swelling in body (edema) occurs due to water and sodium accumulation.
  • Anemia develops.
  • Bone metabolism deteriorates.
  • Potassium levels in blood elevate which may lead to cardiac rhythm disorders.
  • Cardiovascular diseases are likely.
  • Fatigue, tiredness, nausea and vomiting, itching, dysgeusia, restless leg syndrome, shortness of breath, mental disorders, confusion and coma may emerge.
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