bowang0911/MedQuAD huggingface dataset:
In its early stages, IgA nephropathy may have no symptoms; it can be silent for years or even decades. Once symptoms appear, the most common one is hematuria, or blood in the urine. Hematuria can be a sign of damaged glomeruli. Blood in the urine may appear during or soon after a cold, sore throat, or other respiratory infection. The amount of blood may be
                
- visible with the naked eye. The urine may turn pink or the color of tea or cola. Sometimes a person may have dark or bloody urine.  - so small that it can only be detected using special medical tests.
                
Another symptom of IgA nephropathy is albuminuriawhen a persons urine contains an increased amount of albumin, a protein typically found in the blood, or large amounts of protein in the urine. Albumin is the main protein in the blood. Healthy kidneys keep most proteins in the blood from leaking into the urine. However, when the glomeruli are damaged, large amounts of protein leak out of the blood into the urine.
                
When albumin leaks into the urine, the blood loses its capacity to absorb extra fluid from the body. Too much fluid in the body may cause edema, or swelling, usually in the legs, feet, or ankles and less often in the hands or face. Foamy urine is another sign of albuminuria. Some people with IgA nephropathy have both hematuria and albuminuria.
                
After 10 to 20 years with IgA nephropathy, about 20 to 40 percent of adults develop end-stage kidney disease.5 Signs and symptoms of end-stage kidney disease may include
                
- high blood pressure  - little or no urination  - edema  - feeling tired  - drowsiness  - generalized itching or numbness  - dry skin  - headaches  - weight loss  - appetite loss  - nausea  - vomiting  - sleep problems  - trouble concentrating  - darkened skin  - muscle cramps
Complications of IgA nephropathy include
                
- high blood pressure  - acute kidney failuresudden and temporary loss of kidney function  - chronic kidney failurereduced kidney function over a period of time  - nephrotic syndromea collection of symptoms that indicate kidney damage; symptoms include albuminuria, lack of protein in the blood, and high blood cholesterol levels  - heart or cardiovascular problems  - Henoch-Schnlein purpura
                
More information is provided in the NIDDK health topics, Kidney Disease and Kidney Failure.
A health care provider diagnoses kidney disease with
                
- a medical and family history  - a physical exam  - urine tests   - a blood test
                
Medical and Family History
                
Taking a medical and family history may help a health care provider diagnose kidney disease.
                
Physical Exam
                
A physical exam may help diagnose kidney disease. During a physical exam, a health care provider usually
                
- measures the patients blood pressure  - examines the patients body for swelling
                
Urine Tests
                
Dipstick test for albumin and blood. A dipstick test performed on a urine sample can detect the presence of albumin and blood. The patient provides a urine sample in a special container in a health care providers office or a commercial facility. A nurse or technician can test the sample in the same location, or he or she can send it to a lab for analysis. The test involves placing a strip of chemically treated paper, called a dipstick, into the patients urine sample. Patches on the dipstick change color when albumin or blood is present in urine.
                
Urine albumin-to-creatinine ratio. A health care provider uses this measurement, which compares the amount of albumin with the amount of creatinine in a urine sample, to estimate 24-hour albumin excretion. A patient may have chronic kidney disease if the urine albumin-to-creatinine ratio is greater than 30 milligrams (mg) of albumin for each gram (g) of creatinine (30 mg/g). This measurement is also called UACR.
                
Blood Test
                
A blood test involves having blood drawn at a health care providers office or a commercial facility and sending the sample to a lab for analysis. A health care provider may order a blood test to estimate how much blood a patients kidneys filter each minutea measurement called the estimated glomerular filtration rate (eGFR). Depending on the results, the test can indicate the following:
                
- eGFR of 60 or above is in the normal range  - eGFR below 60 may indicate kidney disease  - eGFR of 15 or below may indicate kidney failure
Currently, health care providers do not use blood or urine tests as reliable ways to diagnose IgA nephropathy; therefore, the diagnosis of IgA nephropathy requires a kidney biopsy.
                
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. A health care provider performs a kidney biopsy in a hospital or an outpatient center with light sedation and a local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography scan to guide the biopsy needle into the kidney. A pathologista doctor who specializes in examining tissues to diagnose diseasesexamines the kidney tissue with a microscope. Only a biopsy can show the IgA deposits in the glomeruli. The biopsy can also show how much kidney damage has already occurred. The biopsy results can help the health care provider determine the best course of treatment.
Researchers have not yet found a specific cure for IgA nephropathy. Once the kidneys are scarred, they cannot be repaired. Therefore, the ultimate goal of IgA nephropathy treatment is to prevent or delay end-stage kidney disease. A health care provider may prescribe medications to
                
- control a persons blood pressure and slow the progression of kidney disease  - remove extra fluid from a persons blood  - control a persons immune system  - lower a persons blood cholesterol levels
                
Control Blood Pressure and Slow Progression of Kidney Disease
                
People with IgA nephropathy that is causing high blood pressure may need to take medications that lower blood pressure and can also significantly slow the progression of kidney disease. Two types of blood pressure-lowering medicationsangiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. A person may also need beta-blockers, calcium channel blockers, and other blood pressure medications.
                
Remove Extra Fluid
                
A health care provider may prescribe a diuretic, a medication that helps the kidneys remove extra fluid from the blood. Removing the extra fluid can improve the control of blood pressure. Taking a diuretic along with an ACE inhibitor or an ARB often increases the effectiveness of these medications.
                
Control the Immune System
                
Health care providers sometimes use medications to control a persons immune system. Since inflammation is the immune systems normal response, controlling the immune system can decrease inflammation. Health care providers may prescribe the following medications:
                
- corticosteroids, such as prednisone  - cyclophosphamide
                
Lower Blood Cholesterol Levels
                
People with IgA nephropathy may develop high blood cholesterol levels. Cholesterol is a type of fat found in the bodys cells, in blood, and in many foods. People who take medications for high blood cholesterol levels can lower their blood cholesterol levels. A health care provider may prescribe one of several cholesterol-lowering medications called statins.
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing IgA nephropathy. Health care providers may recommend that people with kidney disease, such as IgA nephropathy, make dietary changes such as
                
- limiting dietary sodium, often from salt, to help reduce edema and lower blood pressure  - decreasing liquid intake to help reduce edema and lower blood pressure  - eating a diet low in saturated fat and cholesterol to help control high levels of lipids, or fats, in the blood
                
Health care providers may also recommend that people with kidney disease eat moderate or reduced amounts of protein, although the benefit of reducing protein in a persons diet is still being researched. Proteins break down into waste products the kidneys must filter from the blood. Eating more protein than the body needs may burden the kidneys and cause kidney function to decline faster. However, protein intake that is too low may lead to malnutrition, a condition that occurs when the body does not get enough nutrients. People with kidney disease on a restricted protein diet should receive blood tests that can show nutrient levels.
                
Some researchers have shown that fish oil supplements containing omega-3 fatty acids may slow kidney damage in some people with kidney disease by lowering blood pressure. Omega-3 fatty acids may help reduce inflammation and slow kidney damage due to IgA nephropathy. To help ensure coordinated and safe care, people should discuss their use of complementary and alternative medical practices, including their use of dietary supplements and probiotics, with their health care provider. Read more at www.nccam.nih.gov/health/supplements.
                
People with IgA nephropathy should talk with a health care provider about dietary changes to best manage their individual needs.
- Immunoglobulin A (IgA) nephropathy, also known as Bergers disease, is a kidney disease that occurs when IgA deposits build up in the kidneys, causing inflammation that damages kidney tissues.  - Scientists think that IgA nephropathy is an autoimmune kidney disease, meaning that the disease is due to the bodys immune system attacking tissues in the kidney.  - IgA nephropathy is one of the most common kidney diseases, other than those caused by diabetes or high blood pressure.  - In its early stages, IgA nephropathy may have no symptoms; it can be silent for years or even decades.  - Once symptoms appear, the most common one is hematuria, or blood in the urine.  - Another symptom of IgA nephropathy is albuminuriawhen a persons urine contains an increased amount of albumin, a protein typically found in the blood, or large amounts of protein in the urine.  - Currently, health care providers do not use blood or urine tests as reliable ways to diagnose IgA nephropathy; therefore, the diagnosis of IgA nephropathy requires a kidney biopsy.  - Researchers have not yet found a specific cure for IgA nephropathy.
The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of bean-shaped organs, each about the size of a fist and located below the ribs, one on each side of the spine, toward the middle of the back. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine an adult produces each day. Children produce less urine each day; the amount produced depends on their age. The urine travels from the kidneys down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder. Routinely, urine drains in only one directionfrom the kidneys to the bladder. The bladder fills with urine until it is full enough to signal the need to urinate. In children, the bladder can hold about 2 ounces of urine plus 1 ounce for each year of age. For example, an 8-year-olds bladder can hold about 10 ounces of urine.
                
When the bladder empties, a muscle called the sphincter relaxes and urine flows out of the body through a tube called the urethra at the bottom of the bladder. The opening of the urethra is at the end of the penis in boys and in front of the vagina in girls.
Most UTIs are caused by bacteria that live in the bowel. The bacterium Escherichia coli (E. coli) causes the vast majority of UTIs. The urinary tract has several systems to prevent infection. The points where the ureters attach to the bladder act like one-way valves to prevent urine from backing up, or refluxing, toward the kidneys, and urination washes microbes out of the body. Immune defenses also prevent infection. But despite these safeguards, infections still occur. Certain bacteria have a strong ability to attach themselves to the lining of the urinary tract.
                
Children who often delay urination are more likely to develop UTIs. Regular urination helps keep the urinary tract sterile by flushing away bacteria. Holding in urine allows bacteria to grow. Producing too little urine because of inadequate fluid intake can also increase the risk of developing a UTI. Chronic constipationa condition in which a child has fewer than two bowel movements a weekcan add to the risk of developing a UTI. When the bowel is full of hard stool, it presses against the bladder and bladder neck, blocking the flow of urine and allowing bacteria to grow.
                
Some children develop UTIs because they are prone to such infections, just as other children are prone to getting coughs, colds, or ear infections.
Symptoms of a UTI range from slight burning with urination or unusual-smelling urine to severe pain and high fever. A child with a UTI may also have no symptoms. A UTI causes irritation of the lining of the bladder, urethra, ureters, and kidneys, just as the inside of the nose or the throat becomes irritated with a cold. In infants or children who are only a few years old, the signs of a UTI may not be clear because children that young cannot express exactly how they feel. Children may have a high fever, be irritable, or not eat.
                
On the other hand, children may have only a low-grade fever; experience nausea, vomiting, and diarrhea; or just not seem healthy. Children who have a high fever and appear sick for more than a day without signs of a runny nose or other obvious cause for discomfort should be checked for a UTI.
                
Older children with UTIs may complain of pain in the middle and lower abdomen. They may urinate often. Crying or complaining that it hurts to urinate and producing only a few drops of urine at a time are other signs of a UTI. Children may leak urine into clothing or bedsheets. The urine may look cloudy or bloody. If a kidney is infected, children may complain of pain in the back or side below the ribs.
                
Parents should talk with their health care provider if they suspect their child has a UTI.
Only a health care provider can determine whether a child has a UTI.
                
A urine sample will be collected and examined. The way urine is collected depends on the childs age:
                
- If the child is not yet toilet trained, the health care provider may place a plastic collection bag over the childs genital area. The bag will be sealed to the skin with an adhesive strip. If this method is used, the bag should be removed right after the child has urinated, and the urine sample should be processed immediately. Because bacteria from the skin can contaminate this sample, the methods listed below are more accurate.  - A health care provider may need to pass a small tube called a catheter into the urethra of an infant. Urine will drain directly from the bladder into a clean container.  - Sometimes the best way to collect a urine sample from an infant is by placing a needle directly into the bladder through the skin of the lower abdomen. Getting urine through a catheter or needle will ensure that the urine collected does not contain bacteria from the skin.  - An older child may be asked to urinate into a container. The sample needs to come as directly into the container as possible to avoid picking up bacteria from the skin or rectal area.
                
Some of the urine will be examined with a microscope. If an infection is present, bacteria and sometimes pus will be found in the urine. A urine culture should also be performed on some of the urine. The culture is performed by placing part of the urine sample in a tube or dish with a substance that encourages any bacteria present to grow. Once the bacteria have multiplied, which usually takes 1 to 3 days, they can be identified.
                
The reliability of the culture depends on how the urine is collected and how long the urine stands before the culture is started. If the urine sample is collected at home, it should be refrigerated as soon as it is collected. The container should be carried to the health care provider or lab in a plastic bag filled with ice.
                
The health care provider may also order a sensitivity test, which tests the bacteria for sensitivity to different antibiotics to see which medication is best for treating the infection.
Most UTIs are caused by bacteria, which are treated with bacteria-fighting medications called antibiotics or antimicrobials. While a urine sample is sent to a laboratory, the health care provider may begin treatment with an antibiotic that treats the bacteria most likely to be causing the infection. Once culture results are known, the health care provider may decide to switch the childs antibiotic.
                
The choice of medication and length of treatment depend on the childs history and the type of bacteria causing the infection. When a child is sick or unable to drink fluids, the antibiotic may need to be put directly into the bloodstream through a vein in the arm or hand or be given as an injection. Otherwise, the medicationliquid or pillsmay be given by mouth. The medication is given for at least 3 to 5 days and possibly for as long as several weeks. The daily treatment schedule recommended depends on the specific medication prescribed: The schedule may call for a single dose each day or up to four doses each day. In some cases, a child will need to take the medication until further tests are finished.
                
After a few doses of the antibiotic, a child may appear much better, but often several days may pass before all symptoms are gone. In any case, the medication should be taken for as long as the health care provider recommends. Medications should not be stopped because the symptoms have gone away. Infections may return, and bacteria can resist future treatment if the medication is stopped too soon.
                
If needed, the health care provider may recommend an appropriate over-the-counter medication to relieve the pain of a UTI. A heating pad on the back or abdomen may also help.
Some abnormalities in the urinary tract correct themselves as the child grows, but some may require surgical correction. While milder forms of VUR may resolve on their own, one common procedure to correct VUR is the reimplantation of the ureters. During this procedure, the surgeon repositions the connection between the ureters and the bladder so that urine will not reflux into the ureters and kidneys. This procedure may be performed through an incision that gives the surgeon a direct view of the bladder and ureters or laparoscopically. Laparoscopy is a procedure that uses a scope inserted through a small incision.
                
In recent years, health care providers have treated some cases of VUR by injecting substances into the bladder wall, just below the opening where the ureter joins the bladder. This injection creates a kind of narrowing or valve that keeps urine from refluxing into the ureters. The injection is delivered to the inside of the bladder through a catheter passed through the urethra, so there is no surgical incision. Evidence of clinically significant obstruction may indicate the need for surgery.
If a child has a normal urinary tract, parents can help the child avoid UTIs by encouraging regular trips to the bathroom. The parents should make sure the child gets enough to drink if infrequent urination is a problem. The child should be taught proper cleaning techniques after using the bathroom to keep bacteria from entering the urinary tract. Loose-fitting clothes and cotton underwear allow air to dry the area. Parents should consult a health care provider about the best ways to treat constipation.
- Urinary tract infections (UTIs) usually occur when the body fails to remove bacteria rapidly from the urinary tract.  - UTIs affect about 3 percent of children in the United States every year.  - Most UTIs are not serious, but chronic kidney infections can cause permanent damage.  - A UTI in a young child may be a sign of an abnormality in the urinary tract that could lead to repeated problems.  - Symptoms of a UTI range from slight burning with urination or unusual-smelling urine to severe pain and high fever. A child with a UTI may also have no symptoms.  - Parents should talk with their health care provider if they suspect their child has a UTI.
Anyone can get hepatitis C, but those more likely to are people who
                
- were born to a mother with hepatitis C  - are in contact with blood or infected needles at work  - have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease  - are on kidney dialysisthe process of filtering wastes and extra water from the body by means other than the kidneys  - are infected with HIV  - have injected illegal drugs  - have had tattoos or body piercings  - work or live in a prison  - had a blood transfusion or organ transplant before July 1992  - have hemophilia and received clotting factor before 1987
                
Also, men who have sex with men are more likely to get hepatitis C.
Most people do not have any symptoms until the hepatitis C virus causes liver damage, which can take 10 or more years to happen. Others may have one or more of the following symptoms:
                
- feeling tired  - muscle soreness  - upset stomach  - stomach pain  - fever  - loss of appetite  - diarrhea  - dark-yellow urine  - light-colored stools  - yellowish eyes and skin, called jaundice
                
When symptoms of hepatitis C occur, they can begin 1 to 3 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis C.
A blood test will show if you have hepatitis C. Blood tests are done at a doctors office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis C.
                
If you are at higher risk of getting hepatitis C, get tested. Many people with hepatitis C do not know they are infected.
                
Your doctor may suggest getting a liver biopsy if chronic hepatitis C is suspected. A liver biopsy is a test to take a small piece of your liver to look for liver damage. The doctor may ask you to stop taking certain medicines before the test. You may be asked to fast for 8 hours before the test.
                
During the test, you lie on a table with your right hand resting above your head. Medicine is applied to numb the area where the biopsy needle will be inserted. If needed, sedatives and pain medicine are also given. The doctor uses a needle to take a small piece of liver tissue. After the test, you must lie on your right side for up to 2 hours. You will stay 2 to 4 hours after the test before being sent home.
                
A liver biopsy is performed at a hospital or outpatient center by a doctor. The liver sample is sent to a special lab where a doctor looks at the tissue with a microscope and sends a report to your doctor.