fenil210/Med-Lamma huggingface dataset:
What is (are) Diabetic Kidney Disease ?
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 two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. 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. In men the urethra is long, while in women it is short.
                
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 final product becomes urine. + NIDDK + Diabetic Kidney Disease
What is (are) Diabetic Kidney Disease ?
Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia.
                
Diabetes is a disorder of metabolism the way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose, a form of sugar that enters the bloodstream. With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy.
                
Insulin is made in the pancreas, an organ located behind the stomach and below the liver. As blood glucose levels rise after a meal, the pancreas is triggered to release insulin. The pancreas contains clusters of cells called pancreatic islets. Beta cells within the pancreatic islets make insulin and release it into the blood.
                
Diabetes develops when the body doesnt make enough insulin, is not able to use insulin effectively, or both. As a result, glucose builds up in the blood instead of being absorbed by cells in the body. The bodys cells are then starved of energy despite high blood glucose levels. + NIDDK + Diabetic Kidney Disease
What are the symptoms of Diabetic Kidney Disease ?
People with diabetic kidney disease do not have symptoms in the early stages. As kidney disease progresses, a person can develop edema, or swelling. Edema happens when the kidneys cannot get rid of the extra fluid and salt in the body. Edema can occur in the legs, feet, or ankles and less often in the hands or face. Once kidney function decreases further, symptoms may include
                
- appetite loss  - nausea  - vomiting  - drowsiness, or feeling tired  - trouble concentrating  - sleep problems  - increased or decreased urination  - generalized itching or numbness  - dry skin  - headaches  - weight loss  - darkened skin  - muscle cramps  - shortness of breath  - chest pain + NIDDK + Diabetic Kidney Disease
How to diagnose Diabetic Kidney Disease ?
A health care provider diagnoses diabetic kidney disease based on
                
- a medical and family history  - a physical exam  - urine tests  - a blood test
                
Medical and Family History
                
Taking a medical and family history is one of the first things a health care provider may do to help diagnose diabetic kidney disease. He or she will ask about the symptoms and the patients diabetes history.
                
Physical Exam
                
After taking a medical and family history, a health care provider will perform a physical exam. During a physical exam, a health care provider usually
                
- examines the patients body to check for changes in skin color  - taps on specific areas of the patients body, checking for swelling of the feet, ankles, or lower legs
                
Urine Tests
                
Dipstick test for albumin. A dipstick test performed on a urine sample can detect the presence of albumin in the urine. A patient collects the urine sample in a special container in a health care providers office or a commercial facility. The office or facility tests the sample onsite or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color when blood or protein is present in urine.
                
Urine albumin-to-creatinine ratio. A health care provider uses this measurement to estimate the amount of albumin passed into the urine over a 24-hour period. The patient collects a urine sample during an appointment with the health care provider. Creatinine is a waste product that is filtered in the kidneys and passed into the urine. A high urine albumin-to-creatinine ratio indicates that the kidneys are leaking large amounts of albumin into the urine. A urine albumin-to-creatinine ratio above 30 mg/g may be a sign of kidney disease.
                
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 the kidneys filter each minute, called the estimated glomerular filtration rate (eGFR). The results of the test indicate the following:
                
- eGFR of 60 or above is in the normal range  - eGFR below 60 may indicate kidney damage  - eGFR of 15 or below may indicate kidney failure + NIDDK + Diabetic Kidney Disease
How to diagnose Diabetic Kidney Disease ?
People with diabetes should get regular screenings for kidney disease. The National Kidney Disease Education Program recommends the following:
                
- urine albumin-to-creatinine ratio measured at least once a year in all people with type 2 diabetes and people who have had type 1 diabetes for 5 years or more  - eGFR calculated at least once a year in all people with type 1 or type 2 diabetes + NIDDK + Diabetic Kidney Disease
What are the treatments for Diabetic Kidney Disease ?
A health care provider may treat kidney failure due to diabetic kidney disease with dialysis or a kidney transplant. In some cases, people with diabetic kidney disease receive kidney and pancreas transplants.
                
In most cases, people with diabetic kidney disease start dialysis earlier than people with kidney failure who do not have diabetes. People with diabetic end-stage kidney disease who receive a kidney transplant have a much better survival rate than those people on dialysis, although survival rates for those on dialysis have increasingly improved over time. However, people who receive a kidney transplant and do not have diabetes have a higher survival rate than people with diabetic kidney disease who receive a transplant.5
                
More information about treatment options for kidney failure is provided in the NIDDK health topics:
                
- Treatment Methods for Kidney Failure: Hemodialysis  - Treatment Methods for Kidney Failure: Peritoneal Dialysis  - Treatment Methods for Kidney Failure: Transplantation + NIDDK + Diabetic Kidney Disease
What are the treatments for Diabetic Kidney Disease ?
People with diabetes should work with their health care team to prevent or manage CKD through the following steps:
                
- measure A1C levelsa blood test that provides information about a persons average blood glucose levels for the previous 3 months at least twice a year and keep A1C levels below 7 percent  - learn about insulin injections, diabetes medications, meal planning, physical activity, and blood glucose monitoring  - find out whether protein, salt, or liquid should be limited in the diet  - see a registered dietitian to help with meal planning  - check blood pressure every visit with a health care provider or at least two to four times a year  - learn about possible benefits from taking an ACE inhibitor or an ARB if a person has high blood pressure  - measure eGFR at least once a year to check kidney function  - get the amount of protein in the urine tested at least once a year to check for kidney damage + NIDDK + Diabetic Kidney Disease
What to do for Diabetic Kidney Disease ?
- Diabetic kidney disease, also called diabetic nephropathy, is kidney disease caused by diabetes.  - People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia.  - At the onset of diabetes, blood flow into the kidneys increases, which may strain the glomeruli and lessen their ability to filter blood.  - Higher levels of blood glucose lead to the buildup of extra material in the glomeruli, which increases the force of the blood moving through the kidneys and creates stress in the glomeruli.  - Many people with diabetes can develop high blood pressure, another factor in the development of kidney disease. High blood pressure, also called hypertension, is an increase in the amount of force that blood places on blood vessels as it moves through the entire body.  - Diabetic kidney disease takes many years to develop.  - People with diabetic kidney disease do not have any symptoms in the early stages. As kidney disease progresses, a person can develop edema, or swelling. Edema happens when the kidneys cannot get rid of the extra fluid and salt in the body. Edema can occur in the legs, feet, or ankles and less often in the hands or face.  - Once kidney function decreases further, symptoms may include      - appetite loss    - nausea    - vomiting    - drowsiness, or feeling tired    - trouble concentrating    - sleep problems    - increased or decreased urination    - generalized itching or numbness    - dry skin    - headaches    - weight loss    - darkened skin    - muscle cramps    - shortness of breath    - chest pain    - People can prevent or slow the progression of diabetic kidney disease by      - taking medication to control high blood pressure    - managing blood glucose levels    - making changes in their eating, diet, and nutrition    - losing weight if they are overweight or obese    - getting regular physical activity + NIDDK + Diabetic Kidney Disease
What is (are) Hemolytic Uremic Syndrome in Children ?
Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys' filtering system. Red blood cells contain hemoglobinan iron-rich protein that gives blood its red color and carries oxygen from the lungs to all parts of the body.
                
When the kidneys and glomerulithe tiny units within the kidneys where blood is filteredbecome clogged with the damaged red blood cells, they are unable to do their jobs. If the kidneys stop functioning, a child can develop acute kidney injurythe sudden and temporary loss of kidney function. Hemolytic uremic syndrome is the most common cause of acute kidney injury in children. + NIDDK + Hemolytic Uremic Syndrome in Children
What is (are) Hemolytic Uremic Syndrome in 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 two 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. + NIDDK + Hemolytic Uremic Syndrome in Children
What causes Hemolytic Uremic Syndrome in Children ?
The most common cause of hemolytic uremic syndrome in children is an Escherichia coli (E. coli) infection of the digestive system. The digestive system is made up of the gastrointestinal, or GI, tracta series of hollow organs joined in a long, twisting tube from the mouth to the anusand other organs that help the body break down and absorb food.
                
Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream. The toxins travel through the bloodstream and can destroy the red blood cells. E.coli O157:H7 can be found in
                
- undercooked meat, most often ground beef  - unpasteurized, or raw, milk  - unwashed, contaminated raw fruits and vegetables  - contaminated juice  - contaminated swimming pools or lakes
                
Less common causes, sometimes called atypical hemolytic uremic syndrome, can include
                
- taking certain medications, such as chemotherapy  - having other viral or bacterial infections  - inheriting a certain type of hemolytic uremicsyndrome that runs in families
                
More information about foodborne illnesses and the digestive system is provided in the NIDDK health topic, foodborne illnesses. + NIDDK + Hemolytic Uremic Syndrome in Children
What are the symptoms of Hemolytic Uremic Syndrome in Children ?
A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritisan inflammation of the lining of the stomach, small intestine, and large intestine such as
                
- vomiting  - bloody diarrhea  - abdominal pain  - fever and chills  - headache
                
As the infection progresses, the toxins released in the intestine begin to destroy red blood cells. When the red blood cells are destroyed, the child may experience the signs and symptoms of anemiaa condition in which red blood cells are fewer or smaller than normal, which prevents the body's cells from getting enough oxygen.
                
Signs and symptoms of anemia may include
                
- fatigue, or feeling tired  - weakness  - fainting  - paleness
                
As the damaged red blood cells clog the glomeruli, the kidneys may become damaged and make less urine. When damaged, the kidneys work harder to remove wastes and extra fluid from the blood, sometimes leading to acute kidney injury.
                
Other signs and symptoms of hemolytic uremic syndrome may include bruising and seizures.
                
When hemolytic uremic syndrome causes acute kidney injury, a child may have the following signs and symptoms:
                
- edemaswelling, most often in the legs, feet, or ankles and less often in the hands or face  - albuminuriawhen a child's urine has high levels of albumin, the main protein in the blood  - decreased urine output  - hypoalbuminemiawhen a child's blood has low levels of albumin  - blood in the urine
                

                
Seek Immediate Care   Parents or caretakers should seek immediate care for a child experiencing any urgent symptoms, such as   - unusual bleeding   - swelling   - extreme fatigue   - decreased urine output   - unexplained bruises + NIDDK + Hemolytic Uremic Syndrome in Children
What are the complications of Hemolytic Uremic Syndrome in Children ?
Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health.1
                
However, children with hemolytic uremic syndrome may have serious and sometimes life-threatening complications, including
                
- acute kidney injury  - high blood pressure  - blood-clotting problems that can lead to bleeding  - seizures  - heart problems  - chronic, or long lasting, kidney disease  - stroke  - coma + NIDDK + Hemolytic Uremic Syndrome in Children
What are the treatments for Hemolytic Uremic Syndrome in Children ?
A health care provider will treat a child with hemolytic uremic syndrome by addressing
                
- urgent symptoms and preventing complications  - acute kidney injury  - chronic kidney disease (CKD)
                
In most cases, health care providers do not treat children with hemolytic uremic syndrome with antibiotics unless they have infections in other areas of the body. With proper management, most children recover without long-term health problems.2
                
Treating Urgent Symptoms and Preventing Complications
                
A health care provider will treat a child's urgent symptoms and try to prevent complications by
                
- observing the child closely in the hospital  - replacing minerals, such as potassium and salt, and fluids through an intravenous (IV) tube  - giving the child red blood cells and platelets cells in the blood that help with clottingthrough an IV  - giving the child IV nutrition  - treating high blood pressure with medications
                
Treating Acute Kidney Injury
                
If necessary, a health care provider will treat acute kidney injury with dialysisthe process of filtering wastes and extra fluid from the body with an artificial kidney. The two forms of dialysis are hemodialysis and peritoneal dialysis. Most children with acute kidney injury need dialysis for a short time only.
                
Treating Chronic Kidney Disease
                
Some children may sustain significant kidney damage that slowly develops into CKD. Children who develop CKD must receive treatment to replace the work the kidneys do. The two types of treatment are dialysis and transplantation.
                
In most cases, health care providers treat CKD with a kidney transplant. A kidney transplant is surgery to place a healthy kidney from someone who has just died or a living donor, most often a family member, into a person's body to take over the job of the failing kidney. Though some children receive a kidney transplant before their kidneys fail completely, many children begin with dialysis to stay healthy until they can have a transplant.
                
More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure in Children. + NIDDK + Hemolytic Uremic Syndrome in Children
How to prevent Hemolytic Uremic Syndrome in Children ?
Parents and caregivers can help prevent childhood hemolytic uremic syndrome due to E. coli O157:H7 by
                
- avoiding unclean swimming areas  - avoiding unpasteurized milk, juice, and cider  - cleaning utensils and food surfaces often  - cooking meat to an internal temperature of at least 160 F  - defrosting meat in the microwave or refrigerator  - keeping children out of pools if they have had diarrhea  - keeping raw foods separate  - washing hands before eating  - washing hands well after using the restroom and after changing diapers
                
When a child is taking medications that may cause hemolytic uremic syndrome, it is important that the parent or caretaker watch for symptoms and report any changes in the child's condition to the health care provider as soon as possible. + NIDDK + Hemolytic Uremic Syndrome in Children
What to do for Hemolytic Uremic Syndrome in Children ?
At the beginning of the illness, children with hemolytic uremic syndrome may need IV nutrition or supplements to help maintain fluid balance in the body. Some children may need to follow a low-salt diet to help prevent swelling and high blood pressure.
                
Health care providers will encourage children with hemolytic uremic syndrome to eat when they are hungry. Most children who completely recover and do not have permanent kidney damage can return to their usual diet. + NIDDK + Hemolytic Uremic Syndrome in Children
What to do for Hemolytic Uremic Syndrome in Children ?
- Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys' filtering system.  - The most common cause of hemolytic uremic syndrome in children is an Escherichia coli (E. coli) infection of the digestive system.  - Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream.  - A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritis, an inflammation of the lining of the stomach, small intestine, and large intestine.  - Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health.  - Some children may sustain significant kidney damage that slowly develops into chronic kidney disease (CKD).  - Parents and caregivers can help prevent childhood hemolytic uremic syndrome due to E. coli O157:H7 by      - avoiding unclean swimming areas    - avoiding unpasteurized milk, juice, and cider    - cleaning utensils and food surfaces often    - cooking meat to an internal temperature of at least 160 F    - defrosting meat in the microwave or refrigerator    - keeping children out of pools if they have had diarrhea    - keeping raw foods separate    - washing hands before eating    - washing hands well after using the restroom and after changing diapers + NIDDK + Hemolytic Uremic Syndrome in Children
What is (are) Zollinger-Ellison Syndrome ?
Zollinger-Ellison syndrome is a rare disorder that occurs when one or more tumors form in the pancreas and duodenum. The tumors, called gastrinomas, release large amounts of gastrin that cause the stomach to produce large amounts of acid. Normally, the body releases small amounts of gastrin after eating, which triggers the stomach to make gastric acid that helps break down food and liquid in the stomach. The extra acid causes peptic ulcers to form in the duodenum and elsewhere in the upper intestine.
                
The tumors seen with Zollinger-Ellison syndrome are sometimes cancerous and may spread to other areas of the body. + NIDDK + Zollinger-Ellison Syndrome
What is (are) Zollinger-Ellison Syndrome ?
The stomach, duodenum, and pancreas are digestive organs that break down food and liquid.
                
- The stomach stores swallowed food and liquid. The muscle action of the lower part of the stomach mixes the food and liquid with digestive juice. Partially digested food and liquid slowly move into the duodenum and are further broken down.  - The duodenum is the first part of the small intestinethe tube-shaped organ between the stomach and the large intestinewhere digestion of the food and liquid continues.  - The pancreas is an organ that makes the hormone insulin and enzymes for digestion. A hormone is a natural chemical produced in one part of the body and released into the blood to trigger or regulate particular functions of the body. Insulin helps cells throughout the body remove glucose, also called sugar, from blood and use it for energy. The pancreas is located behind the stomach and close to the duodenum. + NIDDK + Zollinger-Ellison Syndrome
What causes Zollinger-Ellison Syndrome ?
Experts do not know the exact cause of Zollinger-Ellison syndrome. About 25 to 30 percent of gastrinomas are caused by an inherited genetic disorder called multiple endocrine neoplasia type 1 (MEN1).1 MEN1 causes hormone-releasing tumors in the endocrine glands and the duodenum. Symptoms of MEN1 include increased hormone levels in the blood, kidney stones, diabetes, muscle weakness, weakened bones, and fractures.
                
More information about MEN1 is provided in the NIDDK health topic, Multiple Endocrine Neoplasia Type 1. + NIDDK + Zollinger-Ellison Syndrome
How many people are affected by Zollinger-Ellison Syndrome ?
Zollinger-Ellison syndrome is rare and only occurs in about one in every 1 million people.1 Although anyone can get Zollinger-Ellison syndrome, the disease is more common among men 30 to 50 years old. A child who has a parent with MEN1 is also at increased risk for Zollinger-Ellison syndrome.2 + NIDDK + Zollinger-Ellison Syndrome