Gachon University Gil Hospital

Hematuria means bloody urine. If the urine looks red in eyes, it is called gross hematuria. If urine color looks normal but red blood cells are observed under a microscope, it is called microscopic hematuria. Typical causes include urinary tract infection, renal stone or cancer. Common causes vary depending on age, and in case of young people, urinary tract infection, glomerular disease or ureter stones are common. But after 50s, the incidence of cancer of the kidneys, bladder or prostate gland and prostate hyperplasia increases. Even without these diseases, hematuria may temporarily appear in urine tests after severe exercise, fever, or trauma.

Proteinuria means urine with protein. Temporary proteinuria may be caused by fever or exercise, which will disappear by itself over time. In case of persistent proteinuria, diabetes, hypertension or glomerulonephritis are commonly known causes. As the amount of proteinuria is large and it lasts for long time, kidney function can decrease, so it is important to diagnose the exact cause and treat it accordingly. Patients with diabetes or high blood pressure should be checked periodically for proteinuria.

Edema refers to the accumulation of fluid in the space around tissues or organ in the body, and can occur anywhere in the body. When it occurs in the hands or legs, it is called peripheral edema. For other kinds, there are ascites in the abdomen, swelling in the chest (pleural effusion) or swelling of the lungs (pulmonary edema). Causes of edema are very diverse; it can be swollen due to normal secretion of hormones medication. Diseases that cause edema include kidney diseases, such as kidney failure or nephrotic syndrome, decreased heart function such as heart failure or cirrhosis. For edema, it is necessary to identify underlying diseases and treat the symptoms of edema accordingly.

In case of diabetes, micro bloodvessels of the whole body are damaged and complications occur in the eyes, kidneys and peripheral nerve. When diabetic kidney complications occur, the initial symptoms begin with microproteinuria and can be detected from urinalysis. As the damage progresses, kidney function gradually deteriorates, and glomerular filtration rate begins to decrease, which can be seen from blood tests. When a large amount of proteinuria is seen or kidney function decreases, edema will occur due to accumulation of water and salt in the body, and waste products will accumulate in blood. Diabetic nephropathy is responsible for 40% to 50% of terminal renal failure, requiring dialysis or kidney transplantation; therefore, intensive management and follow-up monitoring is crucial.

Polycystic kidney disease is a hereditary condition that kidney is transformed into a honeycomb shape by multiple cysts filled with liquid. Autosomal dominant hereditary polycystic disease is one of the most common human genetic diseases, which occurs about 1 in 200 to 1000 people. As the cyst grows, discomfort in the abdomen and flanks may occur accompanied with hematuria, urinary tract infection or urolithiasis. Kidney function will begin to decrease. Cysts are not only limited to the kidneys, but can also occur in liver or pancreas, and can also cause cerebral aneurysms or heart valve abnormalities. If you have an autosomal dominant hereditary polycystic kidney disease in your family or relatives, all family members should do abdominal ultrasonography to detect cyst development as early as possible.

Kidney failure refers to a condition in which the kidney is damaged due to various causes and the function is deteriorated. In case of acute renal failure, recovery is possible after a temporary decrease in function, but chronic renal failure does not recover and its function gradually decreases, causing various systemic problems. Chronic renal failure progresses to end-stage renal failure, which requires dialysis or kidney transplantation.

Dialysis is a treatment that replaces kidney function partially. Usually, dialysis is performed when kidney function is lost by more than 90%, and there are hemodialysis and peritoneal dialysis. Hemodialysis is a method that uses a dialyzer to remove waste and excess fluid from the blood. It is usually done 3 times a week for 4 hours each time. In case of acute renal failure, dialysis will be done temporarily when renal function improves. In case of chronic renal failure, continuous hemodialysis is required, and vascular pathway formation is required to maintain long-term dialysis. Peritoneal dialysis is a method that injects dialysate into the abdominal cavity to filter out excess fluid and waste products from the blood through the peritoneum. Compared to hemodialysis, it has the advantage that one can do by oneself at home.

Kidney transplant is a method of transplanting normal kidney to patients with end-stage renal failure whose kidney function is lost. In addition to the removal of waste and fluid, many kidney functions are restored, so that patients who have received transplant successfully can maintain their health almost as normal people. Transplantation requires receiving a kidney from a healthy donor, or if there is no donor, the patient must be registered to Korea organ transplant management center as a recipient candidate from a brain death donor and wait after doing all necessary tests for surgery. Since the first kidney transplant started in 1991, we are currently successfully conducting high-level transplants, such as blood type mismatch, inappropriate transplantation or re-implantation.

Electrolyte plays a very important role in maintaining body homeostasis, such as heart and nerve function, fluid balance, oxygen delivery, and acid-base balance. These electrolyte imbalance shows abnormalities in tests, such as sodium, potassium, calcium and magnesium. Common causes are dehydration, severe diarrhea and vomiting, drug abuse or hormonal disorders. However, it may occur due to genetic problem as well, so accurate diagnosis is necessary.