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Kidney

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Kidney

The kidneys are a pair of organs located in the back of your abdomen. Each one is about the size of a fist – four or five inches long. They function to filter your blood, which passes through the kidneys several times a day. The kidneys remove waste, control your body’s fluid balance and regulate electrolytes.

As they filter blood, they create urine, which then drain down tubes called ureters to the bladder. Each kidney contains nephrons, which are microscopic filters for blood.

 

Common Kidney Conditions Evaluated by a Urologist:

 

Kidney Stones (nephrolithiasis)

When minerals in urine form crystals, they may grow large enough to block urine flow. Kidney stones are considered one of the most painful kidney conditions. Many stones pass on their own but some can be too large and need to be treated. Even small stones may require treatment if symptoms are severe or if it takes too long for the stone to pass.

Kidney Cancer

Click here for more information about kidney cancer.

Hydronephrosis

Dilation of the renal collecting system which may be due to obstruction or a congenital problem. Sometimes obstruction is not present. Treatment is based on the disease process involved and whether or not there is obstruction present.

Polycystic Kidney Disease

This is a genetic condition that results in multiple large cysts in both kidneys, impairing their function.

Pyelonephritis (infection of kidney pelvis)

If bacteria infect the kidney, it usually results in back pain and fever. A spread of bacteria from an untreated bladder infection is the most common cause of pyelonephritis. A urologist may become involved in the treatment of kidney infection if a surgical complication, such as an abscess, occurs. In addition, if a urinary tract abnormality is present which leads to recurrent infections, a urologist may be consulted.

Treatment Options

For more information on our treatment options for kidney conditions, click here.

Kidney Cancer

There are several types of cancer that can develop in the kidneys. The most common form is renal cell carcinoma (RCC), which accounts for nearly 85% of all cases. In RCC, cancerous cells develop in the lining of the kidney’s tubules and develop into a tumor. A single tumor develops in most cases, but more than one tumor can grow within one or both kidneys.

The earlier the tumor is discovered, the better the chance for survival and treatment. If a tumor is found at an early stage, it often will respond well to treatment, increasing the chance of survival. If the tumor has grown too large or spread through the bloodstream or lymphatic system to other parts of the body, it becomes more difficult to treat.

 Symptoms Of Kidney Cancer

Below are possible signs that kidney cancer has developed. Many of these tumors are found when imaging (mainly a CT scan) is done for unrelated reasons.

  • Abdominal mass or lump
  • Blood in the urine (hematuria)
  • Fever
  • High blood pressure (hypertension)
  • Pain in the side (flank) or back
  • Fatigue
  • Rapid, unexplained weight loss
  • Swelling (edema) in the legs and ankles

 

Risk Factors For Kidney Cancer

Some of the major risk factors for kidney cancer are below.

  • Smoking
  • Obesity
    • People who are very overweight have a higher risk of developing RCC. Some doctors think obesity is a factor in about two out of 10 people who get kidney cancer. Obesity may cause changes in certain hormones that can lead to RCC.
  • Certain workplace exposures
  • Genetic and hereditary risk factors
  • Patients who have the conditions listed here have a higher risk for getting kidney cancer:
    • von Hippel-Lindau disease
    • Hereditary papillary renal cell carcinoma
    • Hereditary leiomyoma-renal cell carcinoma
    • Birt-Hogg-Dube (BHD) syndrome
    • Hereditary renal oncocytoma
  • Family history of kidney cancer
  • High blood pressure
  • End-Stage Renal Disease (ESRD)
  • Gender
    • RCC is about twice as common in men as in women. Men are more likely to be smokers and are more likely to be exposed to cancer-causing chemicals at work, which may account for some of the difference.
  • Race
    • African Americans have a slightly higher rate of renal cell cancer, though the reasons for this are not clear.

 

Treatment Options For Kidney Cancer

 Through eliminating the cancer, our physicians always try to preserve as much of your existing kidney function as possible. Our team of trained professionals will thoroughly assess your needs and preferences to determine the best approach for you.

Minimally Invasive Surgery

Our physicians are highly trained and have extensive experience with laparoscopic and robot-assisted surgical approaches. To learn more about general laparoscopy, click here. For more information on robotic-assisted surgery, click here.

 Laparoscopic Radical Nephrectomy

A scope and small instruments are used to remove the entire kidney, the surrounding fat, part of the ureter and possibly the adjacent adrenal gland.

 Laparoscopic Partial Nephrectomy

In a partial nephrectomy, just the tumor with a margin of normal kidney tissue is removed rather than the entire organ.

Laparoscopic Renal Cryotherapy

Ablative therapy is another minimally invasive treatment which uses a freezing technique to eliminate the cancer cells without surgically removing the tumor. Click here to learn more about cryotherapy.

Kidney FAQ

 

What is kidney cancer?

Renal cell carcinoma (RCC) is the most common form of kidney cancer. Like all cancers, RCC begins small and grows over time. Although RCC usually grows as a single mass, a kidney may contain more than one tumor, sometimes being found in both kidneys at the same time. RCC can be cured if caught before it spreads to other organs through the bloodstream or lymph vessels. However, it is difficult to treat once it has spread.

Can kidney cancer be prevented?

Many cases of RCC are preventable. Avoiding smoking cigarettes can help patients significantly reduce the chance of developing RCC. Maintaining a healthy weight and diet, getting treatment for high blood pressure can also help reduce chances of getting the disease.

How is kidney cancer diagnosed?

It is most often diagnosed incidentally on imagine/x-rays. Some signs and symptoms may lead to obtaining those x-rays. Sometimes a biopsy is required prior to planned surgical removal.

Our physicians will take a complete medical history to look for any major risk factors and symptoms. A physical exam will provide us information about potential signs for kidney cancer as well as any other health issues. Your physician may also be able to feel a mass when examining your abdomen. We also use imaging and lab tests for detection.

Where can I learn more information about laparoscopic and robotic-assisted surgery?

Click here to learn more about laparoscopic (minimally invasive) surgery. Click here to learn more about robotic-assisted surgery.

Kidney Treatment

Our physicians perform many advanced procedures to treat kidney conditions Kidney problems are diverse and include everything from stones to cancer. Before deciding on a treatment option, you and your physician will discuss in detail the option that’s best for you.

In order to accurately diagnose your condition, there are several tests that our physicians will use to help determine the best treatment. After diagnosing the problem, you may receive one of the treatment options below.

Kidney treatment/procedures

Extracorporeal shockwave lithotripsy (ESWL)

Shockwaves are delivered through the body without breaking the skin. These shockwaves vibrate stones and create small passable fragments.

Ureteroscopy

A small scope is advanced up the ureter to the level of the stone and the stone is fragmented with a laser. The stones are either allowed to pass or are extracted depending on the size, and location of the stones.

Ureteral stent

A ureteral stent is a plastic tube which is placed between the kidney and bladder to allow healing and aid in passage of ureteral stones. Sometimes they are required for procedures unrelated to kidney stones to relieve kidney obstruction.

Percutaneous nephrostolithotomy (PCNL)

A scope is advanced through the back into the kidney via a small incision. Various techniques are used to fragment large renal stones and extract the fragments through the back. Often a ureteral stent and a drainage tube in the kidney are required for a short period of time after treatment. This is a very effective way of managing large renal stones.

Partial or total nephrectomy

Please refer to kidney treatments for cancer. Also, a nephrectomy may be performed for reasons unrelated to cancer. If the kidney is poorly functioning and causing recurrent infections, nephrectomy may be the best way to prevent further sickness.

Renal cryotherapy

Please refer to kidney treatments for cancer.

Pyeloplasty

A reconstructive procedure often performed laparoscopically with the aid of the robot. Often for a congenital or acquired condition causing obstruction at the junction between the renal pelvis and ureter.