. Saturday, September 27, 2008
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Think of your kidneys as your body’s own, personal sewage treatment plant (please, humor us). As the cells in your body turn nutrients into energy, they create waste by-products. The kidneys get rid of these by-products, so that your cells don’t languish, buried in waste. Your city’s public works department only wishes it could have a sewage treatment facility as wonderfully efficient as your kidneys. These two bean-shaped organs, each with over one million tiny filtering units, remove the waste products from the blood, combine them to form urine and send the entire shipment southward toward the bladder, urethra and the great outdoors.

But while this liquid shipment is in transit, danger lurks, especially for women. Bacterial bandits, especially Escherichia coli, wait in ambush around the urethral and anal openings. They can invade the urine, multiple, infect the urethra and bladder and then scurry up toward the kidneys. A kidney infection––or nephritis––almost always begins as a lower urinary tract infection. (See “Urinary Tract Infections” on page 673.)

An Easy Diagnosis

Get a kidney infection, and you’ll know it, says kidney specialist Neil Kurtzman, M.D., chairman of the Department of Internal Medicine at Texas Tech University Health Sciences Center and vice president of the National Kidney Foundation. “The pain is excruciating,” he says. “It’s very sudden and very intense. If I give even the lightest touch to the skin on the back of someone with nephritis, they’ll jump off the bed. It’s an easy diagnosis.”

Despite infections, the kidneys usually keep working, but they’ll save notice they’re working under duress, says Dr. Kurtzman. If just one of the kidneys is infected, the pain will be one-sided, spreading down to the groin. The pain comes from the body’s immune system cells attacking and killing the bacteria, causing inflammation and fever, sometimes up to 104oF. Along with the fever can come chills, trembling and possibly nausea and vomiting. Since you probably also have urethritis or a bladder infection, you can have pain when urinating––as well as a constant urge to urinate. You may cloudy or even red-tinted urine. You’ll know it isn’t the flu.

Women are more susceptible than men to kidney infections. The main reason, Dr Kurtzman says, “Is the anatomical arrangement of their plumbing. They have short urethra, which makes it very easy for bacteria to get into the bladder.” Despite their anatomical susceptibility, most women still never get kidney infections. “We don’t know why some get it and most don’t,” says Dr. Kurtzman.

Nothing to Kid About

Although you’d probably live through a kidney infection without medical care, you shouldn’t take chances. Untreated, a kidney infection can cause abscesses and spread to the rest of the body, says Dr. Kurtzman.

Of course, you’ll probably be so sick that you wouldn’t want to tough it out. The pain is so intense, Dr. Kurtzman says, that people generally opt to go to the doctor. He or she will give you oral antibiotics. You’ll feel better in one or two days, but you need to take all the antibiotics (usually about a week’s worth) to be sure you’ve killed all the bacteria. If you’re extremely ill, you may be hospital so that you can receive intravenous antibiotics.

Besides being sure to take the full course of antibiotics, you can do a few things to help yourself. Here’s what Dr. Kurtzman suggests.

Take painkillers. Aspirin, acetaminophen or ibuprofen can lessen the suffering. Take as needed, but don’t take more than the recommended dosage.

Take it easy. Plenty of bed rest will take a load off your kidneys and help them heal faster.

Drink plenty of fluids. Flushing out the kidneys helps to eliminate the infection. “Make sure you get at least 2 quarts of fluids a day,” says Dr. Kurtzman.

Avoiding Problems

The best way to discourage a potential kidney infection is to make sure you never get a urinary tract infection. By far the most important precaution for women is to be careful of the way they clean after a bowel movement. “Always wipe from front to back, not from back to front,” Dr. Kurtzman says. This can help keep the fecal bacteria from invading the urethra.

If you’re a man over 50, your best precaution may be an annual prostate exam. As you get older, it’s more likely that your prostate will enlarge and keep the bladder from emptying, promoting infection, says Dr. Kurtzman. This enlargement, once diagnosed, can be treated.


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