bowang0911/MedQuAD huggingface dataset:
- Diabetes is a complex group of diseases with a variety of causes. Scientists believe genes and environmental factors interact to cause diabetes in most cases.  - People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia. Diabetes develops when the body doesnt make enough insulin or is not able to use insulin effectively, or both.  - Insulin is a hormone made by beta cells in the pancreas. Insulin helps cells throughout the body absorb and use glucose for energy. If the body does not produce enough insulin or cannot use insulin effectively, glucose builds up in the blood instead of being absorbed by cells in the body, and the body is starved of energy.  - Prediabetes is a condition in which blood glucose levels or A1C levels are higher than normal but not high enough to be diagnosed as diabetes. People with prediabetes can substantially reduce their risk of developing diabetes by losing weight and increasing physical activity.  - The two main types of diabetes are type 1 diabetes and type 2 diabetes. Gestational diabetes is a third form of diabetes that develops only during pregnancy.  - Type 1 diabetes is caused by a lack of insulin due to the destruction of insulin-producing beta cells. In type 1 diabetesan autoimmune diseasethe bodys immune system attacks and destroys the beta cells.  - Type 2 diabetesthe most common form of diabetesis caused by a combination of factors, including insulin resistance, a condition in which the bodys muscle, fat, and liver cells do not use insulin effectively. Type 2 diabetes develops when the body can no longer produce enough insulin to compensate for the impaired ability to use insulin.  - Scientists believe gestational diabetes is caused by the hormonal changes and metabolic demands of pregnancy together with genetic and environmental factors. Risk factors for gestational diabetes include being overweight and having a family history of diabetes.  - Monogenic forms of diabetes are relatively uncommon and are caused by mutations in single genes that limit insulin production, quality, or action in the body.  - Other types of diabetes are caused by diseases and injuries that damage the pancreas; certain chemical toxins and medications; infections; and other conditions.
Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that
                
- indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered  - result in the release of too much protein from the body into the urine
                
When the kidneys are damaged, the protein albumin, normally found in the blood, will leak into the urine. Proteins are large, complex molecules that perform a number of important functions in the body.
                
The two types of childhood nephrotic syndrome are
                
- primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys  - secondarythe syndrome is caused by other diseases
                
A health care provider may refer a child with nephrotic syndrome to a nephrologista doctor who specializes in treating kidney disease. A child should see a pediatric nephrologist, who has special training to take care of kidney problems in children, if possible. However, in many parts of the country, pediatric nephrologists are in short supply, so the child may need to travel. If traveling is not possible, some nephrologists who treat adults can also treat children.
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults and the amount produced depends on their age. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder.
                
Kidneys work at the microscopic level. The kidney is not one large filter. Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called the glomerulus, and a tubule. The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it; however, it prevents blood cells and large molecules, mostly proteins, from passing. The filtered fluid then passes through the tubule, which sends needed minerals back to the bloodstream and removes wastes.
The signs and symptoms of childhood nephrotic syndrome may include
                
- edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face  - albuminuriawhen a childs urine has high levels of albumin  - hypoalbuminemiawhen a childs blood has low levels of albumin  - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal
                
In addition, some children with nephrotic syndrome may have
                
- blood in their urine  - symptoms of infection, such as fever, lethargy, irritability, or abdominal pain  - loss of appetite  - diarrhea  - high blood pressure
The complications of childhood nephrotic syndrome may include
                
- infection. When the kidneys are damaged, a child is more likely to develop infections because the body loses proteins that normally protect against infection. Health care providers will prescribe medications to treat infections. Children with childhood nephrotic syndrome should receive the pneumococcal vaccine and yearly flu shots to prevent those infections. Children should also receive age-appropriate vaccinations, although a health care provider may delay certain live vaccines while a child is taking certain medications.  - blood clots. Blood clots can block the flow of blood and oxygen through a blood vessel anywhere in the body. A child is more likely to develop clots when he or she loses proteins through the urine. The health care provider will treat blood clots with blood-thinning medications.  - high blood cholesterol. When albumin leaks into the urine, the albumin levels in the blood drop. The liver makes more albumin to make up for the low levels in the blood. At the same time, the liver makes more cholesterol. Sometimes children may need treatment with medications to lower blood cholesterol levels.
Children who have nephrotic syndrome may need to make changes to their diet, such as
                
- limiting the amount of sodium, often from salt, they take in each day  - reducing the amount of liquids they drink each day  - eating a diet low in saturated fat and cholesterol to help control elevated cholesterol levels
                
Parents or caretakers should talk with the childs health care provider before making any changes to the childs diet.
                
More information is provided in the NIDDK health topic, Nutrition for Chronic Kidney Disease in Children.
- Childhood nephrotic syndrome is not a disease in itself; rather, it is a group of symptoms that      - indicate kidney damageparticularly damage to the glomeruli, the tiny units within the kidney where blood is filtered    - result in the release of too much protein from the body into the urine    - The two types of childhood nephrotic syndrome are      - primarythe most common type of childhood nephrotic syndrome, which begins in the kidneys and affects only the kidneys    - secondarythe syndrome is caused by other diseases    - The signs and symptoms of childhood nephrotic syndrome may include      - edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face    - albuminuriawhen a childs urine has high levels of albumin    - hypoalbuminemiawhen a childs blood has low levels of albumin    - hyperlipidemiawhen a childs blood cholesterol and fat levels are higher than normal    - A health care provider may order urine tests to help determine if a child has kidney damage from childhood nephrotic syndrome.  - Health care providers will decide how to treat childhood nephrotic syndrome based on the type:      - primary childhood nephrotic syndrome: medications    - secondary childhood nephrotic syndrome: treat the underlying illness or disease    - congenital nephrotic syndrome: medications, surgery to remove one or both kidneys, or transplantation
Renal tubular acidosis (RTA) is a disease that occurs when the kidneys fail to excrete acids into the urine, which causes a person's blood to remain too acidic. Without proper treatment, chronic acidity of the blood leads to growth retardation, kidney stones, bone disease, chronic kidney disease, and possibly total kidney failure.
                
The body's cells use chemical reactions to carry out tasks such as turning food into energy and repairing tissue. These chemical reactions generate acids. Some acid in the blood is normal, but too much acidacidosiscan disturb many bodily functions. Healthy kidneys help maintain acid-base balance by excreting acids into the urine and returning bicarbonatean alkaline, or base, substanceto the blood. This "reclaimed" bicarbonate neutralizes much of the acid that is created when food is broken down in the body. The movement of substances like bicarbonate between the blood and structures in the kidneys is called transport.
                
One researcher has theorized that Charles Dickens may have been describing a child with RTA in the character of Tiny Tim from A Christmas Carol. Tiny Tim's small stature, malformed limbs, and periods of weakness are all possible consequences of the chemical imbalance caused by RTA.1 In the story, Tiny Tim recovers when he receives medical treatment, which would likely have included sodium bicarbonate and sodium citrate, alkaline agents to neutralize acidic blood. The good news is that medical treatment can indeed reverse the effects of RTA.
To diagnose RTA, doctors check the acid-base balance in blood and urine samples. If the blood is more acidic than it should be and the urine less acidic than it should be, RTA may be the reason, but additional information is needed to rule out other causes. If RTA is the reason, additional information about the sodium, potassium, and chloride levels in the urine and the potassium level in the blood will help identify which type of RTA a person has. In all cases, the first goal of therapy is to neutralize acid in the blood, but different treatments may be needed to address the different underlying causes of acidosis.
- Renal tubular acidosis (RTA) is a disease that occurs when the kidneys fail to excrete acids into the urine, which causes a person's blood to remain too acidic.  - Without proper treatment, chronic acidity of the blood leads to growth retardation, kidney stones, bone disease, chronic kidney disease, and possibly total kidney failure.  - If RTA is suspected, additional information about the sodium, potassium, and chloride levels in the urine and the potassium level in the blood will help identify which type of RTA a person has.  - In all cases, the first goal of therapy is to neutralize acid in the blood, but different treatments may be needed to address the different underlying causes of acidosis.
Diabetes problems are health problems that can happen when you have diabetes. If your diabetes is not under control, you will have too much glucose*, also called sugar, in your blood. Having too much glucose in your blood for a long time can affect many important parts of your body, such as your
                
- blood vessels and heart  - nerves  - kidneys  - mouth  - eyes  - feet
                
You can do a lot to prevent or slow down these health problems if you keep your diabetes under control.
                
This chart shows the body parts that can be affected by diabetes and the resulting health problems you may have.
                
Affected Body Part    Resulting Health Problems You May Have          Blood vessels and heart             - Heart disease      - Heart attack      - Stroke      - High blood pressure      - Poor blood circulation, or flow, throughout your body            Nerves             - Pain, tingling, weakness, or numbness in your hands, arms, feet, or legs      - Problems with your bladder, digestion, having sex, and keeping your heartbeats and blood pressure steady            Kidneys             - Protein loss through your urine      - Buildup of wastes and fluid in your blood            Mouth             - Gum disease and loss of teeth      - Dry mouth      - Thrush, or the growth of too much fungus in the mouth            Eyes             - Loss of vision and blindness            Feet             - Sores      - Infections      - Amputation
                
*See the Pronunciation Guide for tips on how to say the the words in bold type.
The A1C test, also called the hemoglobin A1C test, HbA1C, or glycohemoglobin test, is a blood test that reflects the average level of glucose in your blood during the past 3 months. Your A1C test result is given in percents. Your doctor might use the A1C test to help diagnose your diabetes. Your doctor will draw a sample of your blood in the office or send you to a lab to have a sample of your blood drawn for the test. After being diagnosed with diabetes, you should have the A1C test at least twice a year.
                
Your A1C result plus your record of blood glucose numbers show whether your blood glucose is under control.
                
- If your A1C result is too high, you may need to change your diabetes care plan. Your health care team can help you decide what part of your plan to change. For instance, you might need to change your meal plan, your diabetes medicines, or your physical activity plan.  - If your A1C result is on target, then your diabetes treatment plan is working. The lower your A1C is, the lower your chance of having diabetes problems.
                
This chart shows the A1C goals for different types of people with diabetes.
                
Types of People    A1C Goals          Most people with diabetes    below 7%        Women with diabetes who want to get pregnant or who are pregnant    below 6%
                
A1C goals can also depend on
                
- how long you have had diabetes  - whether or not you have other health problems
                
Ask your doctor what goal is right for you.
                

                
This chart shows how your A1C result may match up to your average blood glucose number.
                
What Your A1C Result Means          My A1C Result    My Average Blood Glucose Number        6%    135        7%    170        8%    205        9%    240        10%    275        11%    310        12%    345
You can take steps each day to prevent diabetes problems.
                
Steps          Healthy Eating                     - Follow the healthy eating plan that you and your doctor or dietitian have made.      - Learn what to eat to keep your blood glucose levels under control.      - Make wise food choices to help you feel good every day and to lose weight if needed.            Blood Glucose                     - Check your blood glucose every day.      - Each time you check your blood glucose, write the number in a record book to share with your health care team.      - Treat low blood glucose quickly.            Physical Activity                     - Even small amounts of physical activity help manage diabetes. Aim for 30 to 60 minutes of physical activity most days of the week. Children and adolescents with type 2 diabetes who are 10 to 17 years old should aim for 60 minutes of activity every day.      - Not all physical activity has to take place at the same time.      - Do aerobic activities, such as brisk walking, which use your large muscles to make your heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements.      - Do activities to strengthen muscles and bone, such as lifting weights or sit-ups. Aim for two times a week.      - Stretch to increase your flexibility, lower stress, and help prevent muscle soreness after physical activity.      - Increase daily activity by decreasing time spent watching TV or at the computer. Children and adolescents should limit screen time not related to school to less than 2 hours per day. Limiting screen time can help you meet your physical activity goal.      - Always talk with your doctor before you start a new physical activity program.            Medicines                     - Take your medicines as directed, including insulin if ordered by your doctor.            Feet                     - Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.            Mouth                     - Brush and floss your teeth every day.            Blood Pressure                     - Control your blood pressure and cholesterol.            Smoking                     - Dont smoke.
This chart lists important tests, exams, and vaccines to get at least once or twice a year.
                
Tests, Exams, and Vaccines to Get at Least Once or Twice a Year    Make Sure to          A1C test             - Have this blood test at least twice a year. Your result will tell you what your average blood glucose level was for the past 3 months.            Cholesterol test             - Get a blood test to check your              - total cholesterol        - LDL        - HDL        - triglycerides                  Kidney tests             - Once a year, get a urine test to check for protein.      - At least once a year, get a blood test to check for creatinine, a waste product healthy kidneys remove from the body.            Eye exam             - See an eye doctor once a year for a complete eye exam that includes using drops in your eyes to dilate your pupils.      - If you are pregnant, have a complete eye exam in your first 3 months of pregnancy. Have another complete eye exam 1 year after your baby is born.            Dental exam             - See your dentist twice a year for a cleaning and checkup.            Flu vaccine             - Get a flu vaccine each year.            Pneumonia vaccine             - Get this vaccine if you are younger than 64.      - If youre older than 64 and your vaccine was more than 5 years ago, get another one.            Hepatitis B vaccine             - Get this vaccine if youre younger than 60 and you have not already had the vaccine.      - Prevent exposure to Hepatitis B by not sharing blood glucose monitors or other diabetes equipment.
Hepatitis B is a liver disease spread through contact with blood, semen, or other body fluids from a person infected with the hepatitis B virus. The disease is most commonly spread from an infected mother to her infant at birth. Hepatitis B is also spread through sex, wound-to-wound contact, and contact with items that may have blood on them, such as shaving razors, toothbrushes, syringes, and tattoo and body piercing needles.
                
Hepatitis B is not spread through casual contact such as shaking hands or hugging; nor is it spread by sharing food or beverages, by sneezing and coughing, or through breastfeeding.
Hepatitis B may start as a brief, flu-like illness. Most healthy adults and children older than 5 completely recover after the bodys immune system gets rid of the virus.
                
Hepatitis B becomes chronic when the bodys immune system cant get rid of the virus. Over time, having the virus can lead to inflammation of the liver; scar tissue in the liver, called cirrhosis; or liver cancer. Inflammation is the painful red swelling that results when tissues of the body become infected. Young children and people with weakened immune systems are especially at risk. People who were infected as infants have a 90 percent chance of developing chronic hepatitis B.1
Since 1986, a hepatitis B vaccine has been available and should be given to newborns and children in the United States. The vaccine, however, is unavailableor has only recently become availablein many parts of the world. You are at higher risk for hepatitis B if you or your mother was born in a region of the world where hepatitis B is common, meaning 2 percent or more of the population is chronically infected with the hepatitis B virus.1 In most Asian and Pacific Island nations, 8 to 16 percent of the population is chronically infected.2
Hepatitis B is called a silent killer because many people have no symptoms, so the disease often progresses unnoticed for years. Unfortunately, many people first learn they have chronic hepatitis B when they develop symptoms of severe liver damage, which include
                
- yellowish eyes and skin, called jaundice  - a swollen stomach or ankles  - tiredness  - nausea  - weakness  - loss of appetite  - weight loss  - spiderlike blood vessels, called spider angiomas, that develop on the skin
Anyone can get hepatitis B, but some people are at higher risk, including
                
- people who were born to a mother with hepatitis B  - people who have close household contact with someone infected with the hepatitis B virus  - people who have lived in parts of the world where hepatitis B is common, including most Asian and Pacific Island nations  - people who are exposed to blood or body fluids at work  - people on hemodialysis  - people whose sex partner(s) has hepatitis B  - people who have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease  - injection drug users  - men who have sex with men
Acquired cystic kidney disease happens when a person's kidneys develop fluid-filled sacs, called cysts, over time. Acquired cystic kidney disease is not the same as polycystic kidney disease (PKD), another disease that causes the kidneys to develop multiple cysts.
                
Acquired cystic kidney disease occurs in children and adults who have
                
- chronic kidney disease (CKD)a condition that develops over many years and may lead to end-stage kidney disease, or ESRD. The kidneys of people with CKD gradually lose their ability to filter wastes, extra salt, and fluid from the blood properly.  - end-stage kidney diseasetotal and permanent kidney failure that requires a kidney transplant or blood-filtering treatments called dialysis.
                
The cysts are more likely to develop in people who are on kidney dialysis. The chance of developing acquired cystic kidney disease increases with the number of years a person is on dialysis. However, the cysts are caused by CKD or kidney failure, not dialysis treatments.
                
More information is provided in the NIDDK health topics, kidney failureand dialysis.
Acquired cystic kidney disease differs from PKD in several ways. Unlike acquired cystic kidney disease, PKD is a genetic, or inherited, disorder that can cause complications such as high blood pressure and problems with blood vessels in the brain and heart.
                
The following chart lists the differences:
                
People with Polycystic Kidney Disease   - are born with a gene that causes the disease   - have enlarged kidneys   - develop cysts in the liver and other parts of the body   People with Acquired Cystic Kidney Disease   - do not have a disease-causing gene   - have kidneys that are normal-sized or smaller   - do not form cysts in other parts of the body
                
In addition, for people with PKD, the presence of cysts marks the onset of their disease, while people with acquired cystic kidney disease already have CKD when they develop cysts.
                
More information is provided in the NIDDK health topic, Polycystic Kidney Disease.
Acquired cystic kidney disease becomes more common the longer a person has CKD.
                
- About 7 to 22 percent of people with CKD already have acquired cystic kidney disease before starting dialysis treatments.  - Almost 60 percent of people on dialysis for 2 to 4 years develop acquired cystic kidney disease.1  - About 90 percent of people on dialysis for 8 years develop acquired cystic kidney disease.1