sarnsrun/medquadmini huggingface dataset:
Question:
What is (are) Amyloidosis and Kidney Disease ?

Answer:
Primary amyloidosis and dialysis-related amyloidosis are the types of amyloidosis that can affect the kidneys.
                
Primary Amyloidosis of the Kidneys
                
The kidneys are the organs most commonly affected by primary amyloidosis. Amyloid deposits damage the kidneys and make it harder for them to filter wastes and break down proteins. When the kidneys become too damaged, they may no longer be able to function well enough to maintain health, resulting in kidney failure. Kidney failure can lead to problems such as high blood pressure, bone disease, and anemiaa condition in which the body has fewer red blood cells than normal.
                
Dialysis-related Amyloidosis
                
People who suffer from kidney failure and have been on long-term dialysis may develop dialysis-related amyloidosis. This type of amyloidosis occurs when a certain protein, called beta-2 microglobulin, builds up in the blood because dialysis does not remove it completely. The two types of dialysis are
                
- hemodialysis. Hemodialysis uses a special filter called a dialyzer to remove wastes and extra fluid from the blood.  - peritoneal dialysis. Peritoneal dialysis uses the lining of the abdominal cavitythe space in the body that holds organs such as the stomach, intestines, and liverto filter the blood.
                
Dialysis-related amyloidosis is a complication of kidney failure because neither hemodialysis nor peritoneal dialysis effectively filters beta-2 microglobulin from the blood. As a result, elevated amounts of beta-2 microglobulin remain in the blood. Dialysis-related amyloidosis is relatively common in people with kidney failure, especially adults older than 60 years of age, who have been on dialysis for more than 5 years.1
                
More information is provided in the NIDDK health topics:
                
- Treatment Methods for Kidney Failure: Hemodialysis  - Treatment Methods for Kidney Failure: Peritoneal Dialysis
Question:
What are the symptoms of Amyloidosis and Kidney Disease ?

Answer:
The most common sign of primary amyloidosis of the kidneys is nephrotic syndromea collection of signs that indicate kidney damage. The signs of nephrotic syndrome include
                
- albuminuriaan increased amount of albumin, a protein, in the urine. A person with nephrotic syndrome excretes more than half a teaspoon of albumin per day.  - hyperlipidemiaa condition in which a persons blood has more-than-normal amounts of fats and cholesterol.  - edemaswelling, typically in a persons legs, feet, or ankles and less often in the hands or face.  - hypoalbuminemiaa condition in which a persons blood has less-than-normal amounts of albumin.
                
More information is provided in the NIDDK health topic, Nephrotic Syndrome in Adults.
                
Other signs and symptoms of primary amyloidosis may include
                
- fatigue, or feeling tired  - shortness of breath  - low blood pressure  - numbness, tingling, or a burning sensation in the hands or feet  - weight loss
Question:
What are the symptoms of Amyloidosis and Kidney Disease ?

Answer:
The symptoms of dialysis-related amyloidosis may include
                
- pain, stiffness, and fluid in the joints.  - abnormal, fluid-containing sacs, called cysts, in some bones.  - carpal tunnel syndrome, caused by unusual buildup of amyloid proteins in the wrists. The symptoms of carpal tunnel syndrome include numbness or tingling, sometimes associated with muscle weakness, in the fingers and hands.
                
Dialysis-related amyloidosis most often affects bones, joints, and the tissues that connect muscle to bone, called tendons. The disease may also affect the digestive tract and organs such as the heart and lungs. Bone cysts caused by dialysis-related amyloidosis can lead to bone fractures. Dialysis-related amyloidosis can also cause tears in tendons and ligaments. Ligaments are tissues that connect bones to other bones.
Question:
How to diagnose Amyloidosis and Kidney Disease ?

Answer:
A health care provider diagnoses primary amyloidosis of the kidneys with
                
- a medical and family history  - a physical exam  - urinalysis  - blood tests  - a kidney biopsy
                
Medical and Family History
                
Taking a medical and family history may help a health care provider diagnose amyloidosis of the kidneys. He or she will ask the patient to provide a medical and family history.
                
Physical Exam
                
A physical exam may help diagnose primary amyloidosis of the kidneys. During a physical exam, a health care provider usually
                
- examines a patients body to check for swelling  - uses a stethoscope to listen to the lungs  - taps on specific areas of the patients body
                
Urinalysis
                
A health care provider may use urinalysisthe testing of a urine sampleto check for albumin and amyloid proteins in urine. The patient provides a urine sample in a special container at a health care providers office or a commercial facility. A nurse or technician can test the sample in the same location or send it to a lab for analysis. More-than-normal amounts of albumin in urine may indicate kidney damage due to primary amyloidosis. Amyloid proteins in urine may indicate amyloidosis.
                
Blood Tests
                
The health care provider may use blood tests to see how well the kidneys are working and to check for amyloid proteins and hyperlipidemia. A blood test involves drawing a patients blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. Blood tests for kidney function measure the waste products in the blood that healthy kidneys normally filter out. Hyperlipidemia may indicate nephrotic syndrome. Amyloid proteins in blood may indicate amyloidosis.
                
Kidney Biopsy
                
Only a biopsy can show the amyloid protein deposits in the kidneys. A health care provider may recommend a kidney biopsy if other tests show kidney damage. A kidney biopsy is a procedure that involves taking a piece of kidney tissue for examination with a microscope. A health care provider performs a kidney biopsy in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography (CT) scan to guide the biopsy needle into the kidney and take the tissue sample. A pathologista doctor who specializes in diagnosing diseasesexamines the tissue in a lab for amyloid proteins and kidney damage.
                
The biopsy results can help the health care provider determine the best course of treatment. More information is provided in the NIDDK health topic, Kidney Biopsy.
Question:
How to diagnose Amyloidosis and Kidney Disease ?

Answer:
A health care provider diagnoses dialysis-related amyloidosis with
                
- urinalysis  - blood tests  - imaging tests
                
A health care provider can use urinalysis and blood tests to detect the amount of amyloid proteins in urine and blood. Imaging tests, such as x-rays and CT scans, can provide pictures of bone cysts and amyloid deposits in bones, joints, tendons, and ligaments. An x-ray technician performs imaging tests in a health care providers office, an outpatient center, or a hospital. A radiologista doctor who specializes in medical imaginginterprets the images. A patient does not require anesthesia.
Question:
What are the treatments for Amyloidosis and Kidney Disease ?

Answer:
A health care provider treats primary amyloidosis of the kidneys with the following:
                
- medication therapy, including chemotherapy  - a stem cell transplant  - treating other conditions
                
Medication therapy. The goal of medication therapy, including chemotherapy, is to reduce amyloid protein levels in the blood. Many health care providers recommend combination medication therapy such as
                
- melphalan (Alkeran), a type of chemotherapy  - dexamethasone (Decadron), an anti-inflammatory steroid medication
                
These medications can stop the growth of the cells that make amyloid proteins. These medications may cause hair loss and serious side effects, such as nausea, vomiting, and fatigue.
                
Stem cell transplant. A stem cell transplant is a procedure that replaces a patients damaged stem cells with healthy ones. Stem cells are found in the bone marrow and develop into three types of blood cells the body needs. To prepare for a stem cell transplant, the patient receives high doses of chemotherapy. The actual transplant is like a blood transfusion. The transplanted stem cells travel to the bone marrow to make healthy new blood cells. The chemotherapy a patient receives to prepare for the transplant can have serious side effects, so it is important to talk with the health care provider about the risks of this procedure.
                
Read more in What Is a Blood and Marrow Stem Cell Transplant? at www.nhlbi.nih.gov/health/health-topics/topics/bmsct.
                
Treating other conditions. Primary amyloidosis has no cure, so treating some of the side effects and other conditions seen with the disease is essential. Other conditions may include
                
- anemiatreatment may include medications  - depressiontreatment may include talking with a mental health counselor and taking medications  - fatiguetreatment may include changes in diet and activity level  - kidney diseasetreatment may include medications to help maintain kidney function or slow the progression of kidney disease
                
A patient and his or her family should talk with the health care provider about resources for support and treatment options.
                
More information about kidney disease is provided in the NIDDK health topic, niddk-kidney disease.
Question:
What are the treatments for Amyloidosis and Kidney Disease ?

Answer:
A health care provider treats dialysis-related amyloidosis with
                
- medication therapy  - newer, more effective hemodialysis filters  - surgery  - a kidney transplant
                
The goal of medication therapy and the use of newer, more effective hemodialysis filters is to reduce amyloid protein levels in the blood. Medication therapy can help reduce symptoms such as pain and inflammation. A health care provider may treat a person with dialysis-related amyloidosis who has bone, joint, and tendon problems, such as bone cysts and carpal tunnel syndrome, using surgery.
                
Dialysis-related amyloidosis has no cure; however, a successful kidney transplant may stop the disease from progressing.
                
More information is provided in the NIDDK health topic, Treatment Methods for Kidney Failure: Transplantation.
Question:
What to do for Amyloidosis and Kidney Disease ?

Answer:
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing primary amyloidosis of the kidneys or dialysis-related amyloidosis. People with nephrotic syndrome may 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 more-than-normal amounts of fats and cholesterol in the blood
                
Health care providers may recommend that people with kidney disease eat moderate or reduced amounts of protein. Proteins break down into waste products that the kidneys 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 low nutrient levels. People with primary amyloidosis of the kidneys or dialysis-related amyloidosis should talk with a health care provider about dietary restrictions to best manage their individual needs.
Question:
What to do for Amyloidosis and Kidney Disease ?

Answer:
- Amyloidosis is a rare disease that occurs when amyloid proteins are deposited in tissues and organs.  - Primary amyloidosis and dialysis-related amyloidosis are the types of amyloidosis that can affect the kidneys.  - The most common sign of primary amyloidosis of the kidneys is nephrotic syndrome.  - The signs of nephrotic syndrome include      - albuminuriaan elevated amount of albumin in the urine. A person with nephrotic syndrome excretes more than half a teaspoon of albumin per day.    - hyperlipidemiaa condition in which a persons blood has more-than-normal amounts of fats and cholesterol.    - edemaswelling, typically in a persons legs, feet, or ankles and less often in the hands or face.    - hypoalbuminemiaa condition in which a persons blood has less-than-normal amounts of albumin.    - Other signs and symptoms of primary amyloidosis may include      - fatigue, or feeling tired    - shortness of breath    - low blood pressure    - numbness, tingling, or a burning sensation in the hands or feet    - weight loss    - The symptoms of dialysis-related amyloidosis may include      - pain, stiffness, and fluid in the joints.    - abnormal, fluid-containing sacs, called cysts, in some bones.    - carpal tunnel syndrome, caused by unusual buildup of amyloid proteins in the wrists. The symptoms of carpal tunnel syndrome include numbness or tingling, sometimes associated with muscle weakness, in the fingers and hands.    - A health care provider diagnoses primary amyloidosis of the kidneys with      - a medical and family history    - a physical exam    - urinalysis    - blood tests    - a kidney biopsy    - A health care provider diagnoses dialysis-related amyloidosis with      - urinalysis    - blood tests    - imaging tests    - A health care provider treats primary amyloidosis of the kidneys with the following:      - medication therapy, including chemotherapy    - a stem cell transplant    - treating other conditions    - A health care provider treats dialysis-related amyloidosis with      - medication therapy    - newer, more effective hemodialysis filters    - surgery    - a kidney transplant
Question:
What is (are) Amyloidosis and Kidney Disease ?

Answer:
You and your doctor will work together to choose a treatment that's best for you. The publications of the NIDDK Kidney Failure Series can help you learn about the specific issues you will face.
                
Booklets
                
- What I need to know about Kidney Failure and How its Treated  - Treatment Methods for Kidney Failure: Hemodialysis  - Treatment Methods for Kidney Failure: Peritoneal Dialysis  - Treatment Methods for Kidney Failure: Kidney Transplantation  - Kidney Failure: Eat Right to Feel Right on Hemodialysis
                
Fact Sheets
                
- Kidney Failure: What to Expect  - Vascular Access for Hemodialysis  - Hemodialysis Dose and Adequacy  - Peritoneal Dialysis Dose and Adequacy  - Amyloidosis and Kidney Disease  - Anemia in Chronic Kidney Disease  - Chronic Kidney Disease-Mineral and Bone Disorder  - Financial Help for Treatment of Kidney Failure
                
Learning as much as you can about your treatment will help make you an important member of your health care team.
                

                

                
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
                
The NIDDK would like to thank: Glenn Chertow, M.D., University of California at San Francisco; William J. Stone, M.D., Vanderbilt University; Morie A. Gertz, M.D., Mayo Clinic
                
This information is not copyrighted. The NIDDK encourages people to share this content freely.
                

                

                
September 2014
Question:
What is (are) Primary Biliary Cirrhosis ?

Answer:
Primary biliary cirrhosis is a chronic, or long lasting, disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear.
                
The bile ducts carry a fluid called bile from the liver to the gallbladder, where it is stored. When food enters the stomach after a meal, the gallbladder contracts, and the bile ducts carry bile to the duodenum, the first part of the small intestine, for use in digestion. The liver makes bile, which is made up of bile acids, cholesterol, fats, and fluids. Bile helps the body absorb fats, cholesterol, and fat-soluble vitamins. Bile also carries cholesterol, toxins, and waste products to the intestines, where the body removes them. When chronic inflammation, or swelling, damages the bile ducts, bile and toxic wastes build up in the liver, damaging liver tissue.
                
This damage to the liver tissue can lead to cirrhosis, a condition in which the liver slowly deteriorates and is unable to function normally. In cirrhosis, scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver.
                
The liver is the bodys largest internal organ. The liver is called the bodys metabolic factory because of the important role it plays in metabolismthe way cells change food into energy after food is digested and absorbed into the blood. The liver has many functions, including
                
- taking up, storing, and processing nutrients from foodincluding fat, sugar, and proteinand delivering them to the rest of the body when needed  - making new proteins, such as clotting factors and immune factors  - producing bile  - removing waste products the kidneys cannot remove, such as fats, cholesterol, toxins, and medications
                
A healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete, and the liver creates scar tissue. Scarring of the liver may lead to cirrhosis.
                
The buildup of scar tissue that causes cirrhosis is usually a slow and gradual process. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse and scar tissue replaces more healthy tissue, the liver will begin to fail. Chronic liver failure, which is also called end-stage liver disease, progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or effectively replace damaged cells.
                
Primary biliary cirrhosis usually occurs between the ages of 30 and 65 and affects women more often than men.1
Question:
What causes Primary Biliary Cirrhosis ?

Answer:
The causes of primary biliary cirrhosis are unknown. Most research suggests it is an autoimmune disease. The immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. An autoimmune disease is a disorder in which the bodys immune system attacks the bodys own cells and organs. In primary biliary cirrhosis, the immune system attacks the small bile ducts in the liver.
                
Genetics, or inherited genes, can make a person more likely to develop primary biliary cirrhosis. Primary biliary cirrhosis is more common in people who have a parent or siblingparticularly an identical twinwith the disease. In people who are genetically more likely to develop primary biliary cirrhosis, environmental factors may trigger or worsen the disease, including
                
- exposure to toxic chemicals  - smoking  - infections
                
Genetics can also make some people more likely to develop other autoimmune diseases, such as
                
- autoimmune hepatitis, a disease in which the bodys immune system attacks liver cells  - Sjgrens syndrome, a condition in which the immune system attacks the glands that produce tears and saliva  - autoimmune thyroid dysfunctions, conditions in which the immune system attacks the thyroid gland
Question:
What are the symptoms of Primary Biliary Cirrhosis ?

Answer:
The first and most common symptoms of primary biliary cirrhosis are
                
- fatigue, or feeling tired  - itching skin, and darkened skin in itching areas due to scratching  - dry eyes and mouth
                
Some people may have jaundice, a condition that causes the skin and whites of the eyes to turn yellow. Health care providers diagnose up to 60 percent of people with primary biliary cirrhosis before symptoms begin.2 Routine blood tests showing abnormal liver enzyme levels may lead a health care provider to suspect that a person without symptoms has primary biliary cirrhosis.
Question:
What to do for Primary Biliary Cirrhosis ?

Answer:
A healthy diet is important in all stages of cirrhosis because malnutrition is common in people with this disease. Malnutrition is a condition that occurs when the body does not get enough nutrients. Cirrhosis may lead to malnutrition because it can cause
                
- people to eat less because of symptoms such as loss of appetite  - changes in metabolism  - reduced absorption of vitamins and minerals
                
Health care providers can recommend a meal plan that is well balanced and provides enough calories and protein. If ascites develops, a health care provider or dietitian may recommend a sodium-restricted diet. To improve nutrition, the health care provider may prescribe a liquid supplement. A person may take the liquid by mouth or through a nasogastric tubea tiny tube inserted through the nose and throat that reaches into the stomach.
                
A person with cirrhosis should not eat raw shellfish, which can contain a bacterium that causes serious infection. Cirrhosis affects the immune system, making people with cirrhosis more likely than healthy people to develop an infection after eating shellfish that contain this bacterium.
                
A health care provider may recommend calcium and vitamin D supplements to help prevent osteoporosis.
Question:
What to do for Primary Biliary Cirrhosis ?

Answer:
- Primary biliary cirrhosis is a chronic disease that causes the small bile ducts in the liver to become inflamed and damaged and ultimately disappear.  - When chronic inflammation damages the bile ducts, bile and toxic wastes build up in the liver, damaging liver tissue. This damage to the liver tissue can lead to cirrhosis.  - The causes of primary biliary cirrhosis are unknown. Most research suggests it is an autoimmune disease.  - Primary biliary cirrhosis is more common in people who have a parent or siblingparticularly an identical twinwith the disease.  - The first and most common symptoms of primary biliary cirrhosis are fatigue, itching, and dry eyes and mouth. Some people may have jaundice, a condition that causes the skin and whites of the eyes to turn yellow. Health care providers diagnose up to 60 percent of people with primary biliary cirrhosis before symptoms begin.  - Most complications of primary biliary cirrhosis are related to cirrhosis and start after primary biliary cirrhosis progresses to cirrhosis.  - A health care provider may use the following tests to diagnose primary biliary cirrhosis:      - a medical and family history    - a physical exam    - blood tests    - imaging tests    - a liver biopsy    - Health care providers prescribe ursodiol (Actigall, Urso) to treat primary biliary cirrhosis. Early treatment with this medication reduces the likelihood of needing a liver transplant and improves survival.  - A health care provider may consider a liver transplant when cirrhosis leads to liver failure or treatment for complications is ineffective.