bowang0911/MedQuAD huggingface dataset:
People most at risk for pyelonephritis are those who have a bladder infection and those with a structural, or anatomic, problem in the urinary tract. Urine normally flows only in one directionfrom the kidneys to the bladder. However, the flow of urine may be blocked in people with a structural defect of the urinary tract, a kidney stone, or an enlarged prostatethe walnut-shaped gland in men that surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen. Urine can also back up, or reflux, into one or both kidneys. This problem, which is called vesicoureteral reflux (VUR), happens when the valve mechanism that normally prevents backward flow of urine is not working properly. VUR is most commonly diagnosed during childhood. Pregnant women and people with diabetes or a weakened immune system are also at increased risk of pyelonephritis.
Symptoms of pyelonephritis can vary depending on a persons age and may include the following:
                
- fever  - vomiting  - back, side, and groin pain  - chills  - nausea  - frequent, painful urination
                
Children younger than 2 years old may only have a high fever without symptoms related to the urinary tract. Older people may not have any symptoms related to the urinary tract either; instead, they may exhibit confusion, disordered speech, or hallucinations.
Most people with pyelonephritis do not have complications if appropriately treated with bacteria-fighting medications called antibiotics.
                
In rare cases, pyelonephritis may cause permanent kidney scars, which can lead to chronic kidney disease, high blood pressure, and kidney failure. These problems usually occur in people with a structural problem in the urinary tract, kidney disease from other causes, or repeated episodes of pyelonephritis.
                
Infection in the kidneys may spread to the bloodstreama serious condition called sepsisthough this is also uncommon.
Pyelonephritis is treated with antibiotics, which may need to be taken for several weeks. While a urine sample is sent to a lab for culture, the health care provider may begin treatment with an antibiotic that fights the most common types of bacteria. Once culture results are known and the bacteria is clearly identified, the health care provider may switch the antibiotic to one that more effectively targets the bacteria. Antibiotics may be given through a vein, orally, or both. Urinary tract obstructions are often treated with surgery.
                
Severely ill patients may be hospitalized and limited to bed rest until they can take the fluids and medications they need on their own. Fluids and medications may be given intravenously during this time.
                
In adults, repeat urine cultures should be performed after treatment has ended to make sure the infection does not recur. If a repeat test shows infection, another 14-day course of antibiotics is prescribed; if infection recurs again, antibiotics are prescribed for 6 weeks.
- Pyelonephritis is a type of urinary tract infection that affects one or both kidneys.  - Pyelonephritis is caused by a bacterium or virus infecting the kidneys. Though many bacteria and viruses can cause pyelonephritis, the bacterium Escherichia coli is often the cause. Bacteria and viruses can move to the kidneys from the bladder or can be carried through the bloodstream from other parts of the body.  - Symptoms of pyelonephritis can vary depending on a persons age and may include the following:      - fever    - vomiting    - back, side, and groin pain    - chills    - nausea    - frequent, painful urination    - Children younger than 2 years old may only have a high fever without symptoms related to the urinary tract. Older people may not have any symptoms related to the urinary tract either; instead, they may exhibit confusion, disordered speech, or hallucinations.  - Most people with pyelonephritis do not have complications if appropriately treated with bacteria-fighting medications called antibiotics.
PSC is a disease that damages and blocks bile ducts inside and outside the liver. Bile is a liquid made in the liver. Bile ducts are tubes that carry bile out of the liver to the gallbladder and small intestine. In the intestine, bile helps break down fat in food.
                
In PSC, inflammation of the bile ducts leads to scar formation and narrowing of the ducts over time. As scarring increases, the ducts become blocked. As a result, bile builds up in the liver and damages liver cells. Eventually, scar tissue can spread throughout the liver, causing cirrhosis and liver failure.
Blood tests to check levels of liver enzymes are the first step in diagnosing PSC. Doctors confirm the diagnosis using cholangiography, which provides pictures of the bile ducts.
                
Cholangiography can be performed in the following ways:
                
-  Endoscopic retrograde cholangiopancreatography (ERCP). ERCP uses an endoscopea long, flexible, lighted tubethat goes down the mouth, beyond the stomach, and into the duodenum to reach an area in the digestive tract where dye can be injected into the bile ducts. X rays are taken when the dye is injected. ERCP also can be used to take a tissue sample or to treat blocked ducts. More information about ERCP is provided in the NIDDK health topic, ERCP (Endoscopic Retrograde Cholangiopancreatography).  -  Percutaneous transhepatic cholangiography. This procedure involves inserting a needle through the skin and placing a thin tube into a duct in the liver. Dye is injected through the tube and x rays are taken.  -  Magnetic resonance cholangiopancreatography (MRCP). MRCP uses magnetic resonance imaging (MRI) to obtain pictures of the bile ducts. MRI machines use radio waves and magnets to scan internal organs and tissues. MRCP does not involve using x rays or inserting instruments into the body. This safe and painless test is increasingly used for diagnosis.
                
Other testing may include ultrasound exams and a liver biopsy. Ultrasound uses sound waves to create images of organs inside the body. A biopsy involves removal of a small piece of tissue for examination with a microscope.
- Primary sclerosing cholangitis (PSC) inflames, scars, and blocks bile ducts inside and outside the liver.  - When bile ducts become blocked, bile builds up in the liver and damages liver cells.  - PSC can lead to vitamin deficiencies, infections, bile duct cancer, cirrhosis, liver failure, and the need for a liver transplant.  - The cause of PSC is not known.  - Many people with PSC also have ulcerative colitis, an inflammatory bowel disease.  - Treatment includes medications to treat symptoms and complications of PSC.
You already know you need to watch how much you drink. Any food that is liquid at room temperature also contains water. These foods include soup, Jell-O, and ice cream. Many fruits and vegetables contain lots of water, too. They include melons, grapes, apples, oranges, tomatoes, lettuce, and celery. All these foods add to your fluid intake.
                
Fluid can build up between dialysis sessions, causing swelling and weight gain. The extra fluid affects your blood pressure and can make your heart work harder. You could have serious heart trouble from overloading your system with fluid.
                
Control Your Thirst   The best way to reduce fluid intake is to reduce thirst caused by the salt you eat. Avoid salty foods like chips and pretzels. Choose low-sodium products.   You can keep your fluids down by drinking from smaller cups or glasses. Freeze juice in an ice cube tray and eat it like a popsicle. (Remember to count the popsicle in your fluid allowance!) The dietitian will be able to give you other tips for managing your thirst.
                
Your dry weight is your weight after a dialysis session when all of the extra fluid in your body has been removed. If you let too much fluid build up between sessions, it is harder to get down to your proper dry weight. Your dry weight may change over a period of 3 to 6 weeks. Talk with your doctor regularly about what your dry weight should be.
                
My dry weight should be _____________.
                
Talk With a Dietitian   Even though you are on hemodialysis, your kidneys may still be able to remove some fluid. Or your kidneys may not remove any fluid at all. That is why every patient has a different daily allowance for fluid. Talk with your dietitian about how much fluid you can have each day.   I can have _____ ounces of fluid each day.   Plan 1 day of fluid servings:   I can have _____ ounce(s) of ______________ with breakfast.   I can have _____ ounce(s) of ______________ in the morning.   I can have _____ ounce(s) of ______________ with lunch.   I can have _____ ounce(s) of ______________ in the afternoon.   I can have _____ ounce(s) of ______________ with supper.   I can have _____ ounce(s) of ______________ in the evening.   TOTAL _______ ounces (should equal the allowance written above)
Potassium is a mineral found in many foods, especially milk, fruits, and vegetables. It affects how steadily your heart beats. Healthy kidneys keep the right amount of potassium in the blood to keep the heart beating at a steady pace. Potassium levels can rise between dialysis sessions and affect your heartbeat. Eating too much potassium can be very dangerous to your heart. It may even cause death.
                
To control potassium levels in your blood, avoid foods like avocados, bananas, kiwis, and dried fruit, which are very high in potassium. Also, eat smaller portions of other high-potassium foods. For example, eat half a pear instead of a whole pear. Eat only very small portions of oranges and melons.
                
Dicing and Boiling Potatoes to Reduce Potassium   You can remove some of the potassium from potatoes by dicing or shredding them and then boiling them in water. Your dietitian will give you more specific information about the potassium content of foods.
                

                

                
Talk With a Dietitian   Make a food plan that reduces the potassium in your diet. Start by noting the high-potassium foods (below) that you now eat. A dietitian can help you add other foods to the list.           High-Potassium Foods               apricots avocados bananas beets Brussels sprouts cantaloupe clams dates figs     kiwi fruit lima beans melons milk nectarines orange juice oranges peanuts pears (fresh)     potatoes prune juice prunes raisins sardines spinach tomatoes winter squash yogurt         Others:______________________________________   Changes:   Talk with a dietitian about foods you can eat instead of high-potassium foods.   Instead of _________, I will eat _________.   Instead of _________, I will eat _________.   Instead of _________, I will eat _________.   Instead of _________, I will eat _________.
Phosphorus is a mineral found in many foods. If you have too much phosphorus in your blood, it pulls calcium from your bones. Losing calcium will make your bones weak and likely to break. Also, too much phosphorus may make your skin itch. Foods like milk and cheese, dried beans, peas, colas, nuts, and peanut butter are high in phosphorus. Usually, people on dialysis are limited to 1/2 cup of milk per day. The renal dietitian will give you more specific information regarding phosphorus.
                
You probably will need to take a phosphate binder like Renagel, PhosLo, Tums, or calcium carbonate to control the phosphorus in your blood between dialysis sessions. These medications act like sponges to soak up, or bind, phosphorus while it is in the stomach. Because it is bound, the phosphorus does not get into the blood. Instead, it is passed out of the body in the stool.
Before you were on dialysis, your doctor may have told you to follow a low-protein diet. Being on dialysis changes this. Most people on dialysis are encouraged to eat as much high-quality protein as they can. Protein helps you keep muscle and repair tissue. The better nourished you are, the healthier you will be. You will also have greater resistance to infection and recover from surgery more quickly.
                
Your body breaks protein down into a waste product called urea. If urea builds up in your blood, it's a sign you have become very sick. Eating mostly high-quality proteins is important because they produce less waste than others. High-quality proteins come from meat, fish, poultry, and eggs (especially egg whites).
                

                
Talk With a Dietitian   Meat, fish, and chicken are good sources of protein. Talk with a dietitian about the meats you eat.   I will eat ______ servings of meat each day. A regular serving size is 3 ounces. This is about the size of the palm of your hand or a deck of cards.   Try to choose lean (low-fat) meats that are also low in phosphorus. If you are a vegetarian, ask about other ways to get your protein.   Low-fat milk is a good source of protein. But milk is high in phosphorus and potassium. And milk adds to your fluid intake. Talk with a dietitian to see if milk fits into your food plan.   I (will) (will not) drink milk. I will drink ______ cup(s) of milk a day.
Sodium is found in salt and other foods. Most canned foods and frozen dinners contain large amounts of sodium. Too much sodium makes you thirsty. But if you drink more fluid, your heart has to work harder to pump the fluid through your body. Over time, this can cause high blood pressure and congestive heart failure.
                
Try to eat fresh foods that are naturally low in sodium Look for products labeled low sodium.
                
Do not use salt substitutes because they contain potassium. Talk with a dietitian about spices you can use to flavor your food. The dietitian can help you find spice blends without sodium or potassium.
                

                
Talk With a Dietitian   Talk with a dietitian about spices and other healthy foods you can use to flavor your diet. List them on the lines below.   Spice: _____________________________   Spice: _____________________________   Spice: _____________________________   Food: _____________________________   Food: _____________________________
Calories provide energy for your body. If your doctor recommends it, you may need to cut down on the calories you eat. A dietitian can help you plan ways to cut calories in the best possible way.
                
Some people on dialysis need to gain weight. You may need to find ways to add calories to your diet. Vegetable oils-like olive oil, canola oil, and safflower oil-are good sources of calories. Use them generously on breads, rice, and noodles.
                
Butter and margarines are rich in calories. But these fatty foods can also clog your arteries. Use them less often. Soft margarine that comes in a tub is better than stick margarine. Vegetable oils are the healthiest way to add fat to your diet if you need to gain weight.
                
Hard candy, sugar, honey, jam, and jelly provide calories and energy without clogging arteries or adding other things that your body does not need. If you have diabetes, be very careful about eating sweets. A dietitian's guidance is very important for people with diabetes.
The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. 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 a person produces each day. The urine flows to the bladder through tubes called ureters where it is stored until being released through urination.
During fetal development, a babys kidneys first appear as buds inside the pelvisthe bowl-shaped bone that supports the spine and holds up the digestive, urinary, and reproductive organsnear the bladder. As the kidneys develop, they move gradually toward their usual position in the back near the rib cage. Sometimes, one of the kidneys remains in the pelvis or stops moving before it reaches its usual position. In other cases, the kidney moves higher than the usual position. Rarely does a child have two ectopic kidneys.
                
Most kidneys move toward the rib cage, but one may cross over so that both kidneys are on the same side of the body. When a crossover occurs, the two kidneys often grow together and become fused.
                
Factors that may lead to an ectopic kidney include
                
- poor development of a kidney bud  - a defect in the kidney tissue responsible for prompting the kidney to move to its usual position  - genetic abnormalities  - the mother being sick or being exposed to an agent, such as a drug or chemical, that causes birth defects
Possible complications of an ectopic kidney include problems with urine drainage from that kidney. Sometimes, urine can even flow backwards from the bladder to the kidney, a problem called vesicoureteral reflux (VUR). More information about VUR is provided in the NIDDK health topic, Vesicoureteral Reflux.
                
Abnormal urine flow and the placement of the ectopic kidney can lead to various problems:
                
- Infection. Normally, urine flow washes out bacteria and keeps them from growing in the kidneys and urinary tract. When a kidney is out of the usual position, urine may get trapped in the ureter or in the kidney itself. Urine that remains in the urinary tract gives bacteria the chance to grow and spread. Symptoms of a urinary tract infection include frequent or painful urination, back or abdominal pain, fever, chills, and cloudy or foul-smelling urine.  - Stones. Urinary stones form from substances found in the urine, such as calcium and oxalate. When urine remains in the urinary tract for too long, the risk that these substances will have time to form stones is increased. Symptoms of urinary stones include extreme pain in the back, side, or pelvis; blood in the urine; fever or chills; vomiting; and a burning feeling during urination.  - Kidney damage. If urine backs up all the way to the kidney, damage to the kidney can occur. As a result, the kidney cant filter wastes and extra water from the blood. One ectopic kidney, even when it has no function, will not cause kidney failure. The other kidney can usually perform the functions of two healthy kidneys. Total kidney failure happens only in rare cases when both kidneys are damaged.  - Trauma. If the ectopic kidney is in the lower abdomen or pelvis, it may be susceptible to injury from blunt trauma. People with an ectopic kidney who want to participate in body contact sports may want to wear protective gear.
No treatment for an ectopic kidney is needed if urinary function is normal and no blockage of the urinary tract is present.
                
If tests show an obstruction, surgery may be needed to correct the position of the kidney to allow for better drainage of urine. Reflux can be corrected by surgery to alter the ureter or injection of a gellike liquid into the bladder wall near the opening of the ureter.
                
If extensive kidney damage has occurred, surgery may be needed to remove the kidney. As long as the other kidney is working properly, losing one kidney should have no adverse health effects. More information is provided in the NIDDK health topic, Solitary Kidney.
                
With the right testing and treatment, if needed, an ectopic kidney should cause no serious long-term health problems.
- An ectopic kidney is a birth defect in which a kidney is located below, above, or on the opposite side of its usual position.  - Factors that may lead to an ectopic kidney include      - poor development of a kidney bud    - a defect in the kidney tissue responsible for prompting the kidney to move to its usual position    - genetic abnormalities    - the mother being sick or being exposed to an agent, such as a drug or chemical, that causes birth defects    - An ectopic kidney may not cause any symptoms and may function normally, even though it is not in its usual position.  - Possible complications of an ectopic kidney include problems with urine drainage from that kidney. Abnormal urine flow and the placement of the ectopic kidney can lead to various problems such as infection, stones, kidney damage, and injury from trauma.  - No treatment for an ectopic kidney is needed if urinary function is normal and no blockage of the urinary tract is present. Surgery or other treatment may be needed if there is an obstruction, reflux, or extensive damage to the kidney.
Dehydration is the most common complication of viral gastroenteritis. When someone does not drink enough fluids to replace those that are lost through vomiting and diarrhea, dehydration can result. When dehydrated, the body does not have enough fluids to keep the proper balance of important salts or minerals, known as electrolytes. Infants, young children, older adults, and people with weak immune systems have the greatest risk of becoming dehydrated.
                
The signs of dehydration in adults are
                
- excessive thirst  - infrequent urination  - dark-colored urine  - dry skin  - lethargy, dizziness, or faintness
                
Signs of dehydration in babies and young children are
                
- dry mouth and tongue  - lack of tears when crying  - no wet diapers for 3 hours or more  - high fever  - unusually cranky or drowsy behavior  - sunken eyes, cheeks, or soft spot in the skull
                
Also, when people are dehydrated, their skin does not flatten back to normal right away after being gently pinched and released.
                
People should talk with a health care provider if they have
                
- blood in their stool, which may indicate a bacterial infection  - symptoms that are severe or last more than a few days  - symptoms of dehydration
                
Severe dehydration may require intravenous fluids and hospitalization. Untreated severe dehydration can cause serious health problems such as organ damage, shock, or comaa sleeplike state in which a person is not conscious.