Kidney disease

“ Anaesthetics, that is, chloroform and ether, are not well tolerated when nephritis exists, and this adds to the danger of operation in such patients. No matter how simple or short the operation that is to be performed on a person suffering from kidney disease, if an anaesthetic is to be administered it would be well to prepare the patient for an untoward event that may occur.
Kidney disease is often extremely insidious. It may develop absolutely without the patient's knowledge, even though he might be deemed to be in a position to have at least some suspicion of its existence. ”

“ Fatal terminations, however, do now and again occur, sometimes as a result of injury to the bladder-wall setting up inflammation, which extends to the kidneys, sometimes from suppression of urine. Those cases in which there has been a fatal result most frequently have been complicated with old-standing kidney disease. ”

“ Toxic elements in the blood affect the kidneys in a greater or less degree, and there produce changes at first unnoticed,—at least, as long as the kidney can perform its function,—but the day arrives when, as described by Fothergill, blood depuration is imperfect, and we get many diseases which are distinctly uræmic in character, and ending in any of the so-called kidney diseases, Bright’s disease being one of the most common. ”

“ The kidneys are the organs which serve to excrete poisons that find their way into the circulation. When the kidneys fail to act, these poisons are retained. As a result other important organs, notably the nervous system and the heart, suffer severely because of the irritating effect of the retained poison. A patient with kidney disease runs a very serious risk in any infectious fever, no matter how mild, and such patients should always be completely prepared for a fatal termination when they acquire any of these diseases. ”

“ The possession of typically healthy kidneys is a rare circumstance in this climate. The excessive micturition so universal in infancy, occasioned by excess in diet, is the beginning of renal disease.
Dr. Bright immortalized his name by discovering the fact that, when a man’s last sickness is attended with a certain class of symptoms, as albumen in the urine, final suppression of the urine, and uremic poisoning, they are occasioned by a peculiar disease or degeneration of the kidney. ”

“ A positive cure for all kidney diseases: cures rheumatism, Bright’s disease, diabetes, backache; cures female weakness, purifies the blood, cleanses the system.
The following extracts are from a circular enclosed with the pills:
Experience has proved that Dodd’s Kidney Pills are the only cure for kidney diseases. ”

“ As to the causes of kidney disease, it may be said that any thing which will give rise to a greater or less degree of congestion of the kidney will induce either a temporary albuminous condition of the urine, or a true Bright's disease of the kidneys. ”

“ Or the patient may be attacked suddenly as if with acute diffuse nephritis. The urine will contain blood and numerous casts; the dropsy and the other symptoms are rapidly developed. In some of the cases complicated with cardiac disease the history will be that of heart disease rather than that of kidney disease.
When the disease is fairly established the dropsy is always a prominent symptom, often very distressing to the patient. In some patients when once developed it continues to increase steadily up to the time of their death ”

“ Heart disease, throwing the blood pressure back on the veins and kidneys, is another cause. Disease of the ureter or bladder, preventing the escape of urine from the kidney and causing increased fullness and tension in its pelvis and tubes, will determine inflammation. Decomposition of the detained urine in such cases and the production of ammonia and other irritants must also be named. In elimination of bacteria through the kidney, the latter is liable to infection with consequent inflammation. The advance of bacteria upward from the bladder to the kidneys is another cause. ”

“ Many thousands of Americans who suffer from irreversible kidney disease have obtained treatment through the End Stage Renal Disease (ESRD) Program. This program has assured that Americans affected with otherwise fatal kidney failure will have access to lifesaving dialysis or transplantation therapy. ”

“ For no doubt the diameter of the renal blood-vessels is augmented by their engorgement, and consequently they exert a deleterious pressure on the intervascular tissues, which will interfere with their proper nourishment. While, further, this engorgement of the renal vessels will render the kidneys more liable to the injurious effects of chills; and chills are, as is well known, the most fruitful cause of kidney disease. ”

“ If both kidneys be cut out of an animal, it dies in a few hours from blood-poisoning, due to the accumulation of waste poisonous substances which the kidneys should have got rid of. Serious kidney-disease amounts to pretty much the same thing as cutting out the organs, since they are of little use if not healthy. It is always fatal if not checked, and often kills in a short time. The things which most frequently cause kidney disease are undue exposure to cold, and indulgence in alcoholic drinks."—Martin's Human Body. ”

“ A horseshoe kidney is usually discovered only after death, and with no special frequency in cases of renal disease.
Variations in the number of the kidneys possess this point of practical interest, that diseases affecting a single organ are more dangerous than if another exists which can take upon itself extra duty. Apparent absence of one kidney may be due to atrophy, attended with very small size of the renal vessels; in which case a small mass of connective tissue is found at the upper end of the ureter, which is usually illy developed. The other kidney is usually hypertrophied. ”

“ Hyaline casts are the least significant of all the casts, [p. 115] and occur in many slight and transitory conditions. Small numbers are common following ether anesthesia, in fevers, after excessive exercise, and in congestions and irritations of the kidney. They are always present, and are usually stained yellow when the urine contains much bile. While they are found in all organic diseases of the kidney, they [p. 116] are most important in chronic interstitial nephritis. Here they are seldom abundant, but their constant presence is the most reliable urinary sign of the disease. ”

“ DISEASES OF THE KIDNEYS.—As has been abundantly proved by careful autopsies, inflammation of the retina may be developed during any form of Bright's disease, either with the enlarged mottled kidney of acute parenchymatous nephritis, the large white kidney, the amyloid kidney, or the cirrhotic kidney of chronic disease. In the vast majority of cases the retinal inflammation appears during the later stages of the last-named form of disease, and seems to be in some way dependent upon blood-poisoning, which has been caused by the degenerating kidney. ”

“ Though we are inclined to think that any real knowledge of renal disease is quite modern, and above all has come since Bright’s time, this paragraph of Ardern’s shows how long before definite pathological knowledge had developed, careful clinical observation worked out empirically the indications of the affection. The paragraph is of special interest, because it contains the first reference to the possible danger that there may be for sufferers from kidney disease using the dark or red meats rather than the white meats. ”

“ They are apt to be swollen in dilute and crenated in concentrated urines. The microscopic findings may be corroborated by chemic tests for hemoglobin, although the microscope may show a few red corpuscles when the chemic tests are negative.
When not due to contamination from menstrual discharge, blood in the urine, or hematuria, is always pathologic. Blood comes from the kidney tubules in severe hyperemia, in some forms of nephritis, and in renal tuberculosis and malignant disease. The finding of blood-casts is the only certain means of diagnosing the kidney as its source. ”

“ During the course of any case of chronic Bright's disease there are usually periods during which the urine is scanty or suppressed, especially toward the close of the disease. The kidney lesions which complicate scarlet fever, yellow fever, and cholera are often attended with suppression of urine. Any diseases accompanied by a well-marked rise of temperature are apt to be associated with a diminution in the amount of urine. Injuries to the urethra, even very slight ones, may be followed by complete suppression of urine, without any changes in the kidneys except congestion. ”

“ Recovery.—The prognosis is favorable in uncomplicated cases. It also depends upon the character of the epidemic type of the disease. In England it varies from thirteen to fourteen per cent. In this country it is sometimes as low as two to four per cent. The kidney trouble is always feared for it may result in uremia and death, or the acute may be followed by chronic nephritis or Bright's disease, which will ultimately prove fatal.
Sanitary Care of Room and Patient.—If you are exposed to this disease what can you do? If a child, it must be put in a room by itself. ”

“ Extreme congestion of the kidneys may be produced by exposure to cold, owing to some intimate relationship existing between the cutaneous and the renal vessels, the constriction of the one being accompanied by the dilatation of the other. Infective diseases, such as typhoid fever, pneumonia, scarlet fever, in fact, most acute specific diseases, produce during their height a temporary nephritis, not usually followed by permanent alteration in the kidney; but some acute diseases cause a nephritis which may lay the foundation of permanent renal disease. ”

“ Prognosis. Life is endangered in case of any subsequent kidney disease.
241 ATROPHY OF THE KIDNEY. Result of hyperplasia of connective tissues and compression and absorption of parenchyma. Unilateral or partial. Causes: chronic productive inflammation, calculus in tubes, ureter, or pelvis, tumor, retention cyst, embolism. Lesions: sclerosis of kidney, firmness, pallor, anæmia, lack of glomeruli and tubules, cysts, congenital, urinous retention, colloid. Symptoms: reduced secretion, palpation of kidney. ”

“ The cirrhotic kidney is distinguished from the other forms by the abundant aqueous urine, containing comparatively little albumen—none at all at times—cardiac hypertrophy, and hard pulse. In the differential diagnosis of chronic tubal nephritis and the kidney of pregnancy chief reliance must be placed upon the history of the case and the course of the affection. Albuminuria is a very inconstant symptom of the lardaceous kidney, especially in the beginning and ultimate stages of the disease. ”

“ But the most common cause of all is organic disease of the heart. Practically, the lesion comes under consideration as a complication of heart disease, of aneurism of the arch of the aorta, and of emphysema of the lungs.
LESIONS.—If the congestion has not existed for a long time, we find the kidneys increased in size and their weight great in proportion to their size. They are of an unnatural hardness—a hardness which can be imitated by injecting the blood-vessels of a normal kidney with water. The capsules are not adherent, the surfaces of the kidneys are smooth. ”

“ A congestion of the kidney of only a few days' duration does not seem usually to give rise to any symptoms. Even if such a congestion is prolonged to two or three weeks, as we see in some cases of hydro-pneumothorax from perforation of the lung, there may be no renal symptoms and no changes in the urine. On the other hand, it is extremely rare for organic heart disease or emphysema of the lungs to prove fatal without some disease of the kidneys. ”

“ The patches of congestion, so characteristic of this disease in other organs, are not here observed. This may depend upon the peculiar disposition of the capillary system of the kidney. The blood has to pass through the Malpigian tufts, and may be purified, or altered in character, before it reaches the proper venous system of the organ.
In cases where purulent infection of the blood has been purposely produced, portions of the kidney will not unfrequently be found inflamed and firmer than natural ”

“ The soundness of the other kidney, however, may be considered highly probable if in spite of demonstrated extensive disease of one kidney a sufficient quantity of urine with a normal amount of urea and salts continues to be formed. ”

“ Uraemia is of toxic origin, and it is probable that the dropsy of renal disease is due to effects produced in the capillaries by the presence of abnormal substances in the blood. High arterial tension, cardiac hypertrophy and arterial degeneration may also be of toxic origin, or they may be produced by an attempt of the body to maintain an active circulation through the greatly diminished amount of kidney tissue available. ”

“ The most rational hygiene of the kidneys for the prevention of kidney diseases consists in the avoidance of all those causes which are injurious to the kidneys, and which we have mentioned in the previous chapter. A great part of the poisonous products that are eliminated by the kidneys are introduced with the food and beverages, and it is important for us to bear in mind the fact that what we eat or drink must pass through our kidneys, and that the structure of these organs is delicate ”

“ Cure, as it is dangerous to neglect your kidneys for even one day. Bright’s disease, gravel, liver complaint, pains in the back, rheumatism, rheumatic gout, inflammation of bladder, stone in the bladder, uric acid poison, dropsy, eczema, scrofula, blood disease, offensive odour from sweating, so-called ‘female weakness,’ painful periods, too frequent desire to urinate, and painful passing of urine are all caused by diseased kidneys, and can be speedily cured by Warner’s “Safe” Cure, which has been prescribed for twenty-five years.” ”