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At Soundialys® we care about providing comforting and quality services.
  • Hemodialysis Treatments
  • Nephrology
  • Traveling on Dialysis
  • Urology
  • Renal Dietitian

  • Hemodialysis Treatments

    Hemodialysis Treatments

    Hemodialysis is the most common method for treating advanced and chronic kidney disease. Hemodialysis uses an "artificial kidney," called a dialyzer, and a machine, during treatment, some of its blood is passed to the dialyzer through a system of sterile lines. During treatment, the amount of blood that is outside your body is the equivalent of 25O-26O ml. An average adult has between 4 and 5 liters of blood in the body and can easily tolerate this small amount outside of his body.

    Eliminating harmful waste, salt and unnecessary fluids helps control blood pressure and maintain the proper balance of chemicals in the body, such as potassium and sodium. One of the most important adjustments you should make when starting the hemodialysis treatment is to follow a strict schedule. Most patients go to a clinic (a dialysis unit) three times a week for 3 to 4 hours at each visit. For example, you can have a Monday, Wednesday, and Friday schedule or a Tuesday, Thursday, and Saturday schedule. You may be asked to choose the morning, afternoon or evening shift, depending on the availability and capacity of the dialysis unit. Your dialysis unit will explain the options for scheduling regular treatments.

    During your hemodialysis treatment, you will receive quality care from the staff of Soundialys Comprehensive Renal Care. Preferably go to each hemodialysis session with a family member or caregiver who is of legal age. Before starting the session, you will be evaluated by the medical staff of our unit who will decide the treatment parameters most suitable for you. Nurses will take your vital signs constantly for your safety.

    While you are on hemodialysis, you will rest in a comfortable reposet, you will have internet connection and an iPad. Your relatives can wait for you in a comfortable room with television and wireless internet.
  • Nefrológica

    Nephrologist

    Nephrology is a branch of internal medicine that is responsible for the study of the kidneys, both its structure and its function, both in health and disease, prevention, treatment and rehabilitation of diseases of the urinary system. It should not be confused with urology, which is the surgical specialty of the male urinary and genital system.

    The specialist in nephrology is the nephrologist, expert in the diagnosis of renal diseases and their treatment with the objective of prolonging the functional life of the kidneys and to avoid reaching the maximum to dialysis, in addition to effectively manage other diseases that cause the Kidney failure such as diabetes and hypertension.

    All these groups of diseases have a common goal, which is the total loss of kidney function in very variable times according to their cause, the nephrologist is the person who provides the dialysis treatment, either peritoneal or hemodialysis, but also Is responsible for kidney transplantation (the best treatment so far for advanced kidney failure).

    If you have or have had kidney disease or believe that you are at risk of having it consult the nephrologist, will provide advice and treatment appropriate to your problems.
  • Psicológica

    Traveling on Dialysis

    Traveling on Dialysis means that patients on hemodialysis therapy can travel from their place of origin to another country (or within the same) to continue their treatments.

    Soundialys makes your vacation easier during your stay in this city. We have the perfect combination, take care of your health while on vacation.

    For us, the most important thing is that you feel the peace and security of being in the best hands, your medical treatment will be as prescribed by your doctor, our specialists can be in coordination of care with your doctor, nurse and social worker, facilitating and guaranteeing a "Health Experience" that you will live with the five senses.
  • Nutrición

    Renal Dietitian

    A registered dietitian specialized in kidney disease will provide patients with a diet plan to enhance their quality of life while protecting their kidney function.

    The dietary needs will likely change with disease progression depending on how much remaining kidney function there is amongst other factors.

    A registered dietitian specializing in kidney disease will help the patient to address kidney disease–specific nutritional goals.
  • Urologist

    Urologist

    Urology is the medical-surgical specialty that is responsible for the study, diagnosis and treatment of diseases of the urinary tract in men and women, as well as diseases of the male genital tract.

    There are many conditions that require surgical intervention by the urologist, being the most common kidney and ureteral calculi, prostatic hyperplasia, among others, that if not treated in a timely manner, can irreversibly affect renal function, even reaching to the kidney disease.

    So also, the urologist offers treatment of diseases that do not require surgery such as urinary tract infections, sexually transmitted diseases, erectile dysfunction, premature ejaculation among others.

    The urologist, together with the nephrologist, are responsible for the comprehensive treatment of diseases of the kidney and urinary system, we invite you to take care of your kidneys.



Find in these articles information related to our services, and remember, for any questions you can consult the specialists of Soundialys®

Nutrition and Kidney Disease

The kidneys’ job is to keep the body’s fluids, electrolytes, and organic solutes in a healthy balance. In the kidneys their functional units are the millions of nephrons which filter most constituents of the blood, reabsorb needed substances and secrete wastes. Urine formation consists of three basic processes: filtration, secretion, and reabsorption. Several disease conditions can interfere with these functions. Inflammatory and degenerative diseases can involve the small blood vessels and membranes in the nephrons. Urinary tract infections and kidney stones can interfere with normal drainage, causing further infection and tissue damage. Hypertension, can damage the small renal arteries. Other diseases, such as diabetes, gout, and urinary tract abnormalities can lead to impaired function, infection, or obstruction. Toxic agents such as insecticides, solvents, and certain drugs may also harm renal tissue. The dietary needs will likely change with disease progression depending on how much remaining kidney function there is amongst other factors. A registered dietitian specializing in kidney disease will help the patient to address kidney disease–specific nutritional goals.

Nephrotic Syndrome An injury to the glomerular membrane causes an increased glomerular permeability, resulting in the loss of albumin in the urine. The loss of albumin leads to edema. A well-planned diet can replace lost protein and ensure efficient utilization of ingested proteins through provision of adequate calories. Dietary changes can also help control hypertension, edema, and hyperlipidemia, and slow the progression of renal disease.

Acute Renal Failure Acute renal failure, manifested by oliguria or anuria, usually occurs suddenly and is often reversible. It is marked by a reduction in the glomerular filtration rate and a reduction in the kidneys ability to excrete metabolic wastes. Diet plays a critical role in the care of patients with acute renal failure. Diets with an eye toward the possibility of uremia, metabolic acidosis, fluid and electrolyte imbalances, infection, and tissue destruction.

Chronic Renal Failure Approximately 90 % of cases of end-stage renal disease are attributable to diabetes mellitus, glomerulonephritis, or hypertension. Kidney failure results in fluid and electrolyte imbalances, the buildup of nitrogenous wastes, and reduced ability to produce renal hormones. Low-protein diets may slow the progression of mild and moderate renal insufficiency.

Dialysis Patients Dialysis changes dietary needs. Patients undergoing hemodialysis, need to follow diets that includes certain amount of protein and are restricted in sodium, potassium, phosphorus, and fluid. Patients on peritoneal dialysis, involving several dialysate exchanges per day, can be more liberal in protein, sodium, potassium, and fluid intake and controlling the sugars intake.

A registered dietitian specialized in kidney disease will provide patients with a diet plan to enhance their quality of life while protecting their kidney function.

Hemodialysis

It is most common method to treat chronic and advanced kidney disease. Since hemodialysis first became a practical treatment for kidney disease, we have learned a lot about how to make hemodialysis treatments more effective and how to minimize its side effects.

How does hemodialysis work? Hemodialysis uses an "artificial kidney" called a dialyzer, and a machine during treatment a system of sterile lines of their blood leads to the dialyzer through a system. It is in the dialyzer where excess body water and waste products are removed by the action of the system. The clean blood returns to your body through another line from the dialyzer. During treatment, the amount of blood that is out of your body, is the equivalent of 25O-260 ml. An average adult has between 4 and 5 liters of blood in the body and can easily tolerate this small amount out of your body.

The removal of harmful waste, salt and extra fluids helps control blood pressure and maintain proper balance of chemicals in the body, such as potassium and sodium. One of the most important settings you should do when starting hemodialysis treatment is to follow a strict schedule. Most patients go to a clinic (a dialysis unit) three times a week for 3 to 4 hours or more on each visit. For example, you can have a Monday, Wednesday and Friday or from Tuesday, Thursday and Saturday. You may be asked to choose the morning shift, afternoon or evening, depending on the availability and capacity of the dialysis unit. Your dialysis unit will explain the options to schedule regular treatments.

Kidney Transplant

Kidney transplantation is the best choice to treat chronic kidney disease in its most advanced stage, in Mexico, the origin of the organs to be transplanted can be from cadaveric or living donor, however, not all patients can receive a kidney and not all people who wish to donate an organ can.

Chronic kidney disease is a public health problem worldwide, for this reason have taken preventive actions and conditions have been improved to increase the number of transplants performed, in 2015 2,770 transplants were achieved (live and cadaver donor).

Kidney transplantation is carried out thanks to the coordinated work of a group of medical specialists including the nephrologist, surgeons, nurses, social workers and health authorities of different levels of government.

The surgery involves removing a single donor kidney and place it on the lower right side (most cases) of the abdomen near the waist, also joins one of the arteries and larger veins of the body that carry blood to the legs, this in order that the body receive blood, nutrients and oxygen, also connects to the bladder so that urine will produce the new kidney is stored, in rare cases removal of the native kidneys of the patient is required.

Most patients with renal disease are eligible to receive a kidney, there are some (rare) diseases for its aggressive nature is also expected to damage in a short period the new body and for that reason, the transplant is not recommended in these cases.

Who can be a candidate to donate a kidney? Anyone who is healthy and is compatible with the receiver. Before the donation, extensive protocol is performed to ensure that the person who donated the board is completely healthy and that this does not pose a health risk in the future, further specialized tests are performed to check compatibility.

A kidney donor has the same life expectancy as a normal person, not forgetting that must seek changes in lifestyle and take care of food, exercise, take enough water, avoid self-medicate, eating home remedies and avoid smoking or use of other drugs (care that all people should do to protect the health of our kidneys).

Today, in our country there is little information, so the donation culture has not spread, causing more and more patients enter waiting list for an organ (Until 2015, 12,095 patients were recorded expecting a kidney).

Given the scenario, our goal is to provide quality information to the population to reduce the gap between patients with access to appropriate treatment and those who do not.

*Data obtained from the National Transplant Center "National Report 2015 Donation and Transplants.

Diabetes

What is the diabetes? Diabetes is a serious illness that occurs when the body does not produce enough insulin or cannot use the insulin it produces. Insulin is a hormone that controls the amount of sugar (called glucose) in the blood. A high blood sugar level can cause problems in many parts of the body.

There are two types of diabetes • Type 1 Diabetes. If you have this type of diabetes, the body does not produce insulin. It usually begins during childhood or late youth, although it can occur at any age. The treatment consists of the daily application of insulin injections or the use of an insulin pump, plus the follow-up of a special eating plan. Between 5 and 10 percent of diabetes cases are type 1. • Type 2 Diabetes. If you have this type of diabetes, the body produces insulin but cannot use it properly. Type 2 can be partially prevented and is usually due to poor diet and lack of exercise. Frequently, inheritance participates. It usually begins after 40 years of age but may occur before. Treatment includes physical activity, weight reduction and special meal planning. People with type 2 diabetes may need insulin, but if diet and exercise alone are not enough to control the disease, in most cases they are prescribed medicine in the form of pills (called hypoglycemic drugs). Type 2 diabetes is the most common type of diabetes.

How does diabetes affect my body? When diabetes is not well controlled, blood sugar levels increase. This phenomenon is known as hyperglycemia. A high blood sugar level can cause problems in many parts of the body, especially: kidneys, eyes, heart, feet, blood vessels, nerves.

Diabetes can also cause high blood pressure and hardening of the arteries (a process called atherosclerosis). These factors can lead to cardiac and vascular diseases.

Are people with diabetes at increased risk of developing kidney disease? Yes. About one-third of people with diabetes may develop chronic kidney disease. Certain groups may have a higher risk of developing kidney disease than others. The risk may be greater if you: • 60 years old or older • Have high blood pressure • You have a family member who suffers from kidney failure • He is African American, Hispanic, Asian, Pacific Islander or Native American.

What can people with diabetes do to prevent kidney disease? Many people with diabetes do not develop kidney disease or kidney failure. Talk to your doctor about your chances of developing kidney disease. The best way to prevent kidney disease from diabetes is to: • Controlling Your Blood Sugar Level • Keeping blood pressure under control • Asking your doctor to have you tested for kidney disease at least once a year • Taking medicines to control your blood glucose, cholesterol, and blood pressure if your doctor tells you to do so • Following the diet for diabetes • Exercising regularly • Avoiding alcohol consumption • not smoking • Visiting your doctor as often as this tells you.

How does diabetes deteriorate the kidneys? Diabetes can damage the kidneys causing damage to: • Kidney Blood Vessels Kidney filtration units have many small blood vessels. Over time, high blood sugar levels can make these vessels constrict and clog. Without enough blood, the kidneys deteriorate and albumin (a type of protein) goes through these filters and ends up in the urine, where it should not be. • Nerves of the body Diabetes can also cause damage to the nerves of the body. Nerves carry messages between the brain and all other parts of the body, including the bladder. They inform the brain when the bladder is full. But if the bladder nerves are damaged, you may not recognize when the bladder is full. Full bladder pressure can damage your kidneys. • The Urinary Tract If urine stays in the bladder for a long time, it can cause an infection in the urinary tract. This is due to the presence of bacteria, small organisms resembling germs that can cause disease. They grow rapidly in urine that contains elevated levels of sugar. Very often these infections affect the bladder, although they can sometimes spread to the kidneys.

High Blood Pressure

Blood pressure is the force exerted by the blood against the walls of the arteries when the heart pumps blood. When blood pressure is high, it is called Hypertension.

There are two types of hypertension: • Primary: The cause that causes it is unknown. • Secondary: The cause is known, usually triggered by another disease.

When performing a blood pressure measurement two figures are shown, the upper number corresponds to the systolic blood pressure (when the heart contracts) and the lower number to the diastolic blood pressure (the heart relaxes).

A normal blood pressure is when you have values equal to or less than 120/80 mm Hg in healthy people. When blood pressure reaches values of 140/90 mm Hg or higher, there is talk of arterial hypertension.

Some of the symptoms that can occur when you have an increase in blood pressure are headache, changes in vision, ringing in the ears, feeling dizzy, and shortness of breath. There are cases in which there are no symptoms and hypertension is detected when going to medical examination.

Some measures that contribute to good blood pressure control are: regular physical activity, weight management, reducing alcohol, tobacco and salt intake, eating a balanced diet, reducing stress, and requiring medication, Follow the treatment as the doctor indicated.

It is very important to have a good control of hypertension as it is an important risk factor for developing other diseases of the heart, kidney and cerebrovascular. All of these can lead to serious sequels and even death.

What link exists between arterial hypertension and renal failure? Renal failure or kidney failure occurs when the kidneys are not able to adequately filter out toxins and other waste substances from the blood. As a result, the kidneys are less able to do the following jobs to help maintain health:

Remove excess body waste and fluids Release hormones that help: • Control blood pressure • Contribute to having strong bones • Prevent anemia by increasing the number of red blood cells in the body. • Maintain the fair balance of important chemicals in the blood, such as sodium, potassium, phosphorus, and calcium. • Maintain acid and base balance in the body.

They are linked in two ways: • Hypertension is one of the main causes of chronic renal failure. Over time, hypertension can damage the blood vessels that run through the body. This can reduce the blood supply to important organs like the kidneys. • Hypertension can also be a complication of chronic kidney failure, since the kidneys play a key role in keeping blood pressure at a healthy level.

If you have chronic kidney failure, hypertension increases the chances of getting kidney disease worse and having heart problems. Following a treatment plan and maintaining controlled blood pressure can help prevent kidney failure from worsening as well as heart disease.

Premature Infants and Kidney Disease Risk

Progress in medicine has led to great achievements, one of which is to improve the survival of children, smaller and more vulnerable. In some hospitals, 9 out of 10 preterm and very low birth weight infants (those Are born weighing 500 to 1,500grs) manage to get ahead and are discharged from the neonatal intensive care unit, this is impressive, considering that in other times these children would have survived a few minutes.

However, there is the theory that these children suffer damage in their internal organs that bring consequences during their life, one of them is chronic kidney disease, although the cause is not known, is believed to be due to the growth and development of the kidneys in the fetus are disrupted when it gives birth prematurely and / or with low birth weight.

These children have been shown to be at increased risk of acute or chronic kidney disease, obesity, pre-hypertension, or hypertension.

It is currently recommended that children with this history monitor their growth, monitor blood pressure, and also perform renal function tests and check for urine protein in the urine periodically in order to detect early the disease and be able to start treatment to decrease the loss of renal function.

Ref: Carmody, Charlton, Short-Term Gestation, Long-Term Risk: Prematurity and Chronic Kidney Disease; Pediatrics; 2013.

Hemodiafiltration

Hemodialysis is currently one of the available treatment options to replace renal function in patients with renal failure in advanced stages, it aims to help in the control of complications of the disease such as alterations of body water, electrolytes, The balance of acids and for the removal of toxins. However, this therapy is not very effective compared to the work performed by healthy kidneys, this has led to the development of new and better technologies, one of them is the online Hemodiafiltration which is currently considered the most efficient technique to remove the Substances that accumulate in the body of patients with kidney disease, even better than conventional hemodialysis.

Hemodiafiltration offers to reduce the complications associated with the accumulation of substances that are not removed by conventional hemodialysis, this allows to improve the degree of anemia, nutrition, pain and alterations in phosphorus, decrease the quantity of medicines and some restrictions in the diet, this represents an improvement in the quality of life.

To carry out this treatment requires special equipment such as filters and ultra-pure water, in addition must be properly selected to the best candidate to achieve the greatest possible benefit.

Cancer and Kidney Disease

Recently, significant importance has been attached to the relationship between these two diseases, which are highly prevalent in our country. They are related since patients with chronic kidney disease have an increased risk of cancer and those patients who have cancer may develop chronic kidney disease and this is due to several reasons such as tumor invasion of the urinary tract causing obstruction, due to Metabolic alterations and secretion of substances that cause renal toxicity, even treatment with chemotherapy or radiotherapy can cause transient or permanent kidney damage. For this reason, the surveillance of the patient with cancer diagnosis is not only limited to that, but involves the care and prevention of complications, which sometimes cause greater harm to the patient.

In Mexico one of the most frequent diagnoses in women is cervical cancer and in men prostate cancer, both can cause invasion of the urinary tract, obstruction and permanent kidney damage that can lead to dialysis.

Kidney Disease and Obesity

At present, 7 of the 10 leading causes of death and disability are chronic diseases, the prevention and treatment of most of these conditions (diabetes, cancer, hypertension, etc.) are closely related to obesity.

Obesity is due to multiple factors, both environmental with increasing availability of substantial amounts of food and physical inactivity as well as genetic factors. Obesity represents a real epidemic in our country, and it is its association with different anatomical, metabolic and physiological effects which results in the deterioration of the health of the population that suffers from it so many experts consider it a chronic disease.

Overweight and obesity have been shown to lead to the emergence of various diseases such as type 2 diabetes mellitus, fatty liver and cirrhosis, coronary artery disease, congestive heart failure, chronic kidney disease, cerebrovascular events, obstructive sleep apnea, Osteoarthritis, gastroesophageal reflux, among others.

The specific association of obesity with chronic kidney disease has led to the emergence of new concepts such as the fatty kidney characterized by the appearance of proteinuria and renal damage, in addition that this disease produces accelerated deterioration of renal function in patients with another Type of underlying nephropathy.

Moderate weight reduction (between 5 and 10%) is associated with the prevention and substantial improvement of metabolic alterations and obesity-related diseases, however, it is necessary for dietary attachment and constant physical activity and in some Cases the intervention of a multidisciplinary medical team.

Source: Heymsfield et al, New England Journal of Medicine, 2017.

Vascular Accesses for Hemodialysis

Hemodialysis as a renal replacement therapy has allowed to improve the health of patients with end-stage renal disease. To do this, vascular access is required to allow blood to be withdrawn with adequate and constant flow for the removal of particles such as urea During its passage through the dialyzer.

Creating optimal vascular access for each patient is crucial and planning begins before the patient requires dialysis (pre-dialysis stage), choosing the type of vascular access and the ideal time of completion varies from patient to patient and depends on factors Demographic, anatomical, other diseases and preferences of the patient.

There are permanent venous accesses that include the native arteriovenous fistula or graft that consists of joining an artery with a vein, either directly (native) or by a bridge of synthetic material (grafting), this allows to increase the blood flow in the vein and that its walls change characteristics to achieve the channeling of this with large caliber needles repeatedly, this type of access is ideal for patients who will receive hemodialysis indeterminate. In addition, there are temporary venous accesses, these are achieved by placing large catheters in central veins (ideally jugular vein or femoral vein) to draw blood directly from their lumens, these catheters are used in cases requiring initiation Hemodialysis urgently.

The permanent vascular accesses allow to reduce the care of the same and also have low risk of infection, temporary vascular accesses save lives in case of emergency but due to their characteristics, they must be meticulously cared for and have a higher risk of producing blood infection as well as of damage in the veins in which they are placed.

Source: Woo, Lok, CJASN, 2016.

Reusing Dialyzers in Hemodialysis

One of the most important devices of therapy with Hemodialysis is the dialyzer or also known as filter, it is the additive responsible for filtering the urea and other toxins that accumulate in the body of people suffering from renal failure. There are distinct types of filters and advances in technology have allowed improvements in their efficiency, that is, in the amount of substances that have filtered for several years, and due to the search for options that allow to reduce the costs in the therapy, have led to the development of filter cleaning and sterilization methods, allowing re-use in the same patient during several sessions of hemodialysis.

The reuse offers some advantages, mainly in the reduction of costs by procedure, however this practice causes deleterious effects on the quality and efficiency of the filter and is directly proportional to the number of reuse, another one of the risks of this practice are related to the error Since the handling, cleaning, identification of the person who used the filter and the sterilization of the person are susceptible to this factor.

The use of a reusable filter offers to receive hemodialysis adequately with the mentioned advantages, if it is carried out in a meticulous way and ensures that the quality and performance of the filter has not been lost, this ensures efficiency and maximum utilization of each session.

Source: Twardowski, Seminars in Dialysis, 2006.

Renal Lithiasis

Renal lithiasis, also known as kidney stones, is a disease that affects people of all ages, but it is more common in people between 30 and 50 years of age.

Risk factors for developing kidney stones include: low water intake, living in very hot climates, eating a diet high in salt and animal protein, obesity, sedentary lifestyle, and frequent urinary tract infections.

Most stones are made of calcium, which binds to other elements such as oxalate or phosphate and precipitates inside the kidney to form stones. There are other types of calculi such as uric acid, cystine and struvite, the latter is formed when the urine is infected by the bacteria Proteus mirabillis.

The main symptom of renal lithiasis is flank pain, when the stones descend into the ureter, the conduit where the urine descends to the bladder, can obstruct it and generate a lot of pain, accompanied sometimes by nausea. Other symptoms of lithiasis are hematuria (blood in the urine) and dysuria (burning on urination).

The treatment of lithiasis is to relieve the pain initially and then remove the stone, this in most cases requires surgery, other times the stones can be expelled spontaneously if they are very small. Calculi do not dissolve with medication.

People who initially had a kidney stone have up to a 50% risk of forming stones again in the next 10 years, so prevent them from forming with the following measures: drink more water, at least 2 liters a day; Consume less salt and less animal proteins. Other measures that can help: exercise and lose weight. Foods that have calcium like dairy can be consumed in the normal way, it is not necessary to restrict them to avoid the formation of stones.

It is important to detect and treat renal lithiasis, as it is a disease that can damage the kidneys in the medium term, even leading to kidney failure.

At Soundialys we treat renal lithiasis and other diseases of the kidneys. Schedule an appointment with the kidney specialists.

Peritoneal Dialysis

Peritoneal dialysis is a specialized treatment that patients with advanced chronic kidney disease receive, this modality, as well as hemodialysis, is aimed at purifying toxic waste products produced in the body, liquids and electrolytes, all as a product of failure renal.

The purification process is achieved thanks to the use of the peritoneum as a natural filter. The peritoneum is the membrane that lines the intestines and forms the abdominal cavity.

To achieve this, it is necessary to place a special catheter through minor surgery, the inner end of the catheter is seated between the intestines, in the pelvic cavity, a part of the catheter crosses the abdominal wall and an end of approximately 20 cm remains outside the body. It is designed to be able to connect a bag of dialysis solution and that it passes into the abdominal cavity and encounters the peritoneum, the liquid stays inside for variable periods of time and is subsequently drained out of the body, after which the catheter Closes and is hidden under clothing.

Within this therapy there are two options for the patient to perform his treatment at home: • The first is called continuous ambulatory peritoneal dialysis, this procedure is performed 4 times a day manually every day. The time required to drain the "dirty" liquid and the subsequent infusion of new liquid is approximately 20-30 minutes. • The second option is automated peritoneal dialysis, in this, a machine called a cycler performs the liquid spares automatically during the night.

This treatment has the same benefits as hemodialysis, it can be performed by the same patient, it is simple, no special technology is required, however, like any other treatment, it requires commitment and attachment of the patient to be carried out properly and safe.

The treatment of dialysis and hemodialysis requires planning and the work of a multidisciplinary medical team to offer patients the best results of each one, go to the nephrologist in a timely manner, document about treatment and clarify the doubts with the specialist offers better results.

Vasectomy

Vasectomy is a simple operation that makes a man sterile or incapable of having a child. In the procedure, the tubes that carry the sperm from the testicles to the urethra are cut. After vasectomy, sperm cannot be mixed with semen, which is the fluid that is ejaculated during orgasm, sperm continue to be produced in the testicles, but are absorbed by the body. After vasectomy, a man can continue to have erections, feeling sexual pleasure and ejaculating, with the difference that he does not produce a pregnancy in his partner.

How is the vasectomy done? Vasectomy is an outpatient surgery, meaning that after the procedure, the patient can go home and not stay hospitalized. Currently, a minimally invasive technique is used to perform this surgery through punctures instead of incisions in the scrotum, which allow cutting and separating the vas deferens; All with local anesthesia, allowing a rapid recovery.

What are the advantages of vasectomy? Unlike salpingoclasy, surgery to make a woman sterile, vasectomy is less invasive, cheaper, faster, does not require hospitalization, can be performed under local anesthesia, and offers a higher rate of effectiveness than salpingoclasy. Vasectomy is a permanent method of contraception, so it does not require use of another method such as pills, condoms, intrauterine devices, which can become expensive in the long run.

What are the disadvantages of vasectomy? If a man wants to procreate after a vasectomy is done, surgery can be done to reverse it, however, it is expensive, laborious, and it is not always possible to achieve a pregnancy after this surgery, therefore, if you had the remote desire of procreating a biological child in the future, vasectomy is not a family planning method for you. Although vasectomy is very effective in preventing pregnancy, it does not protect against sexually transmitted diseases such as HIV, herpes, human papilloma, among others, so use a barrier method like the condom to prevent the spread of these diseases in case of having sexual relations of risk.

How effective is vasectomy? One of 1000 men who underwent vasectomy may impregnate their partner and this is due to recanalization (creating a new path for sperm) or anatomical abnormalities such as the presence of extra vas deferens. Once a vasectomy is performed, a semen analysis should be performed to check for the absence of sperm in the semen, so when a man performs the vasectomy, he should use another method of contraception the first 3 to 6 months after Surgery not to fertilize your partner.

What are the risks of vasectomy? After vasectomy, hematomas can form in the scrotum, which are collections of blood, also can infect the puncture wound, this in less than 1% of the procedures.

What are the care after the surgery? You should not exercise or carry anything heavy in the first week after surgery, use a scrotal suspender and apply local ice 3 times a day to relieve discomfort. Sexual abstinence is recommended in the first week after surgery, once resumption of sexual activity should be used a contraceptive method in the first months because of the risk of pregnancy, once performed the analysis of semen and checked the absence of sperm, the additional contraceptive method may be discontinued.

At Soundialys we offer the vasectomy package which includes: • Preoperative urology consultation and follow-up • Preoperative laboratory tests • Surgical procedure performed by a certified urologist • Medicines • Post-vasectomy semen analysis.

Early Detection of Kidney Disease.

Chronic kidney disease is defined as a decline in renal function and / or structural damage sustained for more than three months. In recent years, a worldwide effort has been made to detect this problem early in people of elevated risk. This allows us to begin treating the disease to reduce the occurrence of complications such as getting to require dialysis, in developing countries such as ours, resources for dialysis and transplantation are limited, so early diagnosis and Interventions by physicians to delay the progression of the disease are very important, in addition the costs of the disease, both for the patient and for society, increase as the disease progresses.

Early detection in the correct patient could improve the quality and quantity of life of the patient, delay the onset of complications and the need for dialysis, be able to carry out renal transplantation before the need for dialysis and reduce costs, however this Effort is jointly, both physicians and a society that requires to be informed, to be screened to diagnose kidney disease is recommended only to people at high risk as those who suffer from diseases that can cause kidney damage such as diabetes mellitus, hypertension, Obesity, those with relatives with the disease, those who have suffered previous kidney damage even if it disappeared completely, those who smoke, those with a history of prematurity or low birth weight.

Ref: Levin, Stevens; Nature Reviews in Nephrology; 2011.

Smoking and Chronic Kidney Disease.

For many years we have known the negative health effects of smoking, this has caused a decrease in the number of people who smoke, however, the current number of smokers is very high.

Thanks to studies conducted for many years we know that the main adverse effects of smoking are lung and cardiovascular damage, however, it has been shown that other organs also suffer both direct and indirect damage, one of them is the kidney.

Exposure to tobacco is associated with the development of hypertension, diabetes mellitus and renal damage secondary to atherosclerosis that compromises the blood flow to the kidney but also is associated with direct damage, which causes the organ to lose protein through the urine and this to its It causes damage and development of chronic kidney disease.

Passive smoking has been shown to increase the risk of the same diseases as in active smokers, and in children and adolescents increases the risk of being a smoker in adult life.

Taking this information into account we know that it is as important to avoid smoking as to avoid places where you are exposed to cigarette smoke.

Ref.: Hogan, et al; Renal Failure Journal; 2007/ Garcia Esquinas, et al; Pediatrics; 2013.

Stages of Kidney Disease

The function of the kidneys is vital, remembering that they have regulatory functions of body fluids, blood pressure, the disposal of toxic substances to the body, the control of electrolytes and even the production of a series of hormones. When chronic kidney disease occurs due to any cause, these functions are progressively lost, and this loss is more pronounced when the disease is advanced.

The care required by patients with this disease are many, including food. But we must consider that the recommendations for a person who still has 80% of the functionality of the kidneys are not the same as for a person who counts 20%, due to this has been classified the disease in 5 stages of According to the glomerular filtration rate, that is, the percentage of remaining function.

In the early stages of the disease, grades 1 and 2, where more than 60% of renal function is conserved, treatment is mainly directed to the care of the remaining renal function by taking dietary actions such as the reduction of salt intake and Avoiding practices that may damage renal function more like the consumption of home remedies and smoking, as the disease progresses towards grade 3 and 4, dietary restrictions are stricter in order to have better control of some substances in the Organism that can bring additional problems, in addition, regularly it is necessary to add other medicines for the control of liquids, anemia, etc. In grade 5, medical treatment and dietary restrictions are insufficient to control the alterations caused by the disease and dialysis therapy is necessary.

It is important to know that the treatment varies from patient to patient and it is the responsibility of the nephrologist to apply the necessary measures at the right time, sometimes regardless of the degree of illness, this allows to improve the health and quality of life of patients.

Benign Prostatic Hyperplasia or Prostatic Enlargement

It is a frequent condition in adults older than 50 years and consists of the abnormal growth of the prostate gland whose main function is to contribute to the formation of semen for reproduction.

Symptoms occurring in prostatic hyperplasia are mainly due to the increase in smooth muscle tone at the base of the bladder and increase in the amount of prostate tissue; This causes obstruction in the urine output producing very annoying symptoms such as urinating very frequently, getting up at night to urinate, a weak and thin urinary stream among other discomforts.

The symptoms of prostatic hyperplasia are not always related to the size of the prostate. This means that patients with small prostates may have very severe symptoms or patients with very large prostates may have mild or no symptoms.

The diagnosis of prostatic hyperplasia is made through a thorough questioning of the urinary symptoms of the patient and a rectal examination to calculate the approximate volume of the prostate, we can also aid in studies such as ultrasound of prostate and bladder. Blood determination of the prostate-specific antigen helps us to differentiate benign growth from prostate cancer, the latter does not generate symptoms until it is well advanced.

Complications that may arise from prostatic hyperplasia include: bladder stones, inguinal hernias, urinary tract infections, hematuria (bleeding from the urine), and one of the most serious, kidney failure.

It is important to administer pharmacological treatment before these complications arise. Another treatment option is surgery in patients who do not respond adequately to medications or in those who already have any of the complications mentioned.

Remember that it is not normal to get up to urinate at night and to urinate with a thin and weak jet, in case of presenting these discomforts, go to your trusted urologist where they can help.

The importance of Dry Weight in patients in Hemodialysis and Peritoneal Dialysis

The term "dry weight" refers to the weight achieved when there is no excess or deficiency of fluid in the body, knowing it is very useful in patients who are on hemodialysis or in peritoneal dialysis.

The importance lies in two fundamental aspects; First, the excess of fluids in the body produces hypertension and poor control of the same despite the medications, this in turn produces cardiac alterations and poor prognosis with increased risk of death and secondly, the extraction of excess fluid during the dialytic process causes blood pressure to decrease with an increased risk of complications associated with a lack of oxygen reaching the brain, heart and other organs.

Dry weight is therefore of vital importance for patients on dialysis. Usually the determination of this parameter is performed with different techniques, difficult to perform and some unreliable, and others that, although they are good at detecting over-hydration, do not They detect states of dehydration.

In recent years the analysis of the dry weight has been implemented through the electrical bio impedance that refers to the resistance exerted by the different tissues of the body to the passage of electric currents, this allows to determine the body composition (amount of total body fat, muscle mass and the amount of total body water), however few devices are validated and have proven to be reliable in patients with renal disease or on dialysis.

These technological advances allow us to improve the safety and effectiveness of the care we provide our patients to improve their health, improve their hope and quality of life.

Hepatitis

Hepatitis is an inflammation of the liver. The condition may spontaneously regress or develop into fibrosis (scarring), cirrhosis, or liver cancer. Hepatitis viruses are the most common cause of hepatitis, which can also be due to other infections, toxic substances (egg, alcohol or certain drugs) or autoimmune diseases.

Hepatitis A and E are usually caused by ingestion of contaminated food or water. Hepatitis B, C, and D are usually caused by contact with infected body fluids. The transfusion of contaminated blood or blood products, invasive medical procedures in which contaminated equipment is used and, in the case of hepatitis B, the transmission of the mother to the child at birth or A family member to the child, and sexual contact.

Acute infection may be accompanied by few or no symptoms; It can also produce manifestations such as jaundice (yellowing of the skin and eyes), dark urine, intense fatigue, nausea, vomiting and abdominal pain.

What are the different hepatitis viruses? Scientists have identified five hepatitis viruses designated by the letters A, B, C, D, and E. They all cause liver disease but are distinguished by several important traits.

Hepatitis A virus (HAV) is present in the stool of infected people and is almost always transmitted by the consumption of contaminated food or water. It can also spread by certain sexual practices. In many cases the infection is mild, and most people recover completely and acquire immunity against future infections from this virus. However, HAV infections can also be serious and life-threatening. Most people in areas of the developing world with poor sanitation have become infected with this virus. Safe and effective vaccines are available to prevent HAV infection.

Hepatitis B virus (HBV) is transmitted through exposure to blood, semen and other infectious bodily fluids. It can also be transmitted from the infected mother to the baby at the time of delivery or from an infected family member to a baby. Another possibility is transmission through blood transfusions and contaminated blood products, injections with contaminated instruments during medical interventions and injecting drug use. HBV also poses a risk to health care personnel when they are accidentally punctured while assisting people infected with the virus. There is a safe and effective vaccine to prevent this infection.

Hepatitis C virus (HCV) is most often transmitted through exposure to contaminated blood, which can occur through contaminated blood transfusions and derivatives, injections with contaminated instruments during medical interventions, and injecting drug use. Sexual transmission is also possible, but much less common. There is no vaccine against HCV infection.

Hepatitis D virus (HBV) infections only occur in people infected with HBV; Simultaneous infection by both viruses can cause a more serious condition and have a worse outcome. There are safe and effective vaccines against hepatitis B that provide protection against infection by HDV.

Hepatitis E virus (HEV), such as HAV, is transmitted through the consumption of contaminated food or water. HEV is a common cause of outbreaks of hepatitis in developing areas and is increasingly recognized as a major cause of disease in developed countries. Safe and effective vaccines have been obtained to prevent HEV infection but are not widely distributed.

Polycystic Kidney Disease

Autosomal dominant polycystic kidney disease is a common hereditary disease and is responsible for 10% of chronic renal failure in patients with dialysis. Renal failure may occur from 2 to 80 years of age. The kidneys in autosomal dominant polycystic disease are almost always enlarged, can exceed 40 cm in height and weigh up to 8 kg. The cysts can vary in size: from a few millimeters to several centimeters in diameter and their contents may be clear, cloudy or chocolate, in case of bleeding.

The main symptoms that make the patients consult the doctor are: hypertension, flank pain, urinary infection, hematuria (blood in the urine) and nephrolithiasis (kidney stones). Each of these manifestations appear in 20 to 30% of the cases.

Abdominal pain in the back or flank is one of the frequent symptoms of the disease; 60% of patients suffer from it. It is argued that the pain is due to the large kidneys.

Nephrolithiasis is noted in 15% to 20% of cases and can cause pain and hematuria. Estimates are mainly composed of urate and calcium oxalate and are associated with low urinary pH, decreased urinary citrate excretion, and increased uric acid excretion.

Extrarenal manifestations may be cystic and noncystic. Cysts occur in the liver, ovaries, pancreas, and spleen. Noncystic manifestations include abnormalities.

The treatment consists of genetic counseling, early diagnosis, taking medications to control blood pressure, painkillers and excising the cyst. It may be necessary to have a kidney transplant. A specialist should be consulted for medical advice.

When Kidneys Fail

What is the function of the kidneys? The kidneys remove excess water from the body and waste products through the urine. In addition, they regulate the balance of electrolytes, such as potassium and sodium in your body; Produce hormones that help control blood pressure, produce red blood cells, and keep bones strong.

What is Chronic Kidney Disease? Chronic Kidney Disease (CKD) means that your kidneys do not work enough to keep you healthy and will reduce your functions to a phase where replacement therapy will be needed.

What happens when the kidneys fail? When the kidneys begin to fail, excess body water and waste products accumulate in the blood. This is called uremia.

Due to the accumulation of water and waste products, as well as the decline in production of certain hormones, you may start to feel some symptoms.

Symptoms At the beginning, you may not notice signs and symptoms. Because of the accumulation of water and waste products you may experience one or more of the following symptoms: • Decreased urine output • Edema on hands, face and legs • Difficulty breathing • Sleeping problems • Loss of appetite, nausea or vomiting • High blood pressure • Feeling cold and tired.

Urinary Tract Infections

Urinary infections are a frequent cause of consultation with the doctor and affect people of all ages.

Symptoms of urinary tract infections will be determined by the site of infection (kidney, bladder or urethra) and by the severity of the infection, which in turn is influenced by the general health of the person suffering from it. These symptoms can be: • Suprapubic pain (lower belly) • Dysuria (burning in the urethra when urinating) • Polaquiuria (increase in the number of miccions and of small quantity) • Hematuria (blood in the urine) • Urgency (urge to urinate without delaying urination) • Feeling of incomplete bladder emptying • Fever and chills • General discomfort • Pain in the flank and / or lower back

They are divided into simple and complex.

The simple ones are those that appear in a person with a normal urinary system, both anatomically and functionally, so it predicts a good response to conventional empirical treatment.

Complex infections are those that occur in people with anatomical or functional abnormalities of the urinary system that require, in addition to antibiotic treatment, the correction of such abnormality for the eradication of infection, for example: performing urethrotomy or urethral pasty in patients with urethral stenosis to facilitate the exit of urine from the bladder.

The diagnosis of urinary tract infections is carried out with an examination of the patient, a physical examination and confirmed by urine culture analysis. This one reports the bacterium that causes the infection that is isolated in the urine and its sensitivity to some antibiotics, which can be implemented a targeted treatment.

The treatment of simple urinary tract infections is based on antibiotics, mostly for a period of 7 days, accompanied by an abundant intake of fluids to improve symptoms.

In the case of complex infections, adequate drainage of the urine (treatment of prostatic hyperplasia or urethral stenosis), removal of foreign bodies such as ureteral catheters and catheters (double J), surgical removal of renal, ureteric or bladder stones, to correct malformations of the urinary apparatus as stenosis of the ureteropelvic union; In addition to antibiotic treatment, which should sometimes be administered intravenously.

Urinary tract infections that are not treated properly can complicate and jeopardize the function of the kidneys, so it is important to determine the cause of the infection and administer an effective treatment.

If you have a urinary tract infection, it is best to go to the urologist for proper management of this disease. Schedule your appointment at SOUNDIALYS, we are waiting for you!

Chronic Kidney Disease: Public Health Problem in Mexico

Chronic kidney disease continues to be a serious public health problem in our country for several years since it is within the first ten causes of death, the main causes of which are diabetes mellitus and hypertension, Recently an epidemic of renal failure of unknown cause has been identified in Central America along the coast of the Pacific Ocean, this entity has been called Mesoamerican Nephropathy (still little known, even by the medical community) because it does not Is caused by other diseases that classically damage the kidneys, patients diagnosed with this disease have characteristics in common: most are workers in sugarcane fields or work long days in the field, are young and have no symptoms until The disease is at an advanced stage.

Dehydration has been identified as one of the main risk factors for this kidney disease since workers spend long hours of strenuous work in climates where temperatures can become very high, coupled with the fact that Water consumption is not adequate.

Like any other disease that causes chronic kidney damage, those affected may require dialysis. In general, it is estimated that more than 65,000 patients are being treated with a modality of dialysis, leading Mexico to be one of the countries with the most patients at this stage, this undoubtedly represents a problem not only health but also economic.

Knowing the disease and its causes, informing and encouraging the actions of prevention and renal care to avoid exposure to risk factors for kidney damage and self-care of chronic diseases are strategies that will help us solve this problem for the benefit of our society.

Garcia-Garcia, et al; End-Stage Renal Disease in México; Chronic Kidney Disease in Disadvantage Populations; 2017. Roncal-Jimenez, et al; Mesoamerican Nephropathy or Global Warming Nephropathy? Blood Purification; 2016.

Minimal Change Disease

The disease of minimal changes is a kidney disease of the so-called glomerulopathies that characteristically presents with edema (fluid retention), proteinuria (elimination of proteins by the urine), dyslipidemia (lipid disorder) and hypoalbuminemia (level of albumin in blood low), this set of alterations is commonly known as nephrotic syndrome.

Affects children and adults, in children is the most common cause of nephrotic syndrome and although the manifestations can be very striking, it is expected that with proper treatment this is completely resolved without alterations in kidney function. In adults it is not as common as other diseases and patients often require treatment for longer periods of time and the disease may be resistant to it.

The disease can be of a primary nature it is not possible to identify a cause, however, there is the secondary form to other diseases or pathologies that condition it, such as allergies to pollen and dust, cancer, medicines such as analgesics, infections and other autoimmune diseases such as systemic lupus erythematosus.

Unlike other diseases that affect the kidney, the nephrotic syndrome is particularly striking in its presentation, seeking medical attention with the specialist before any symptoms or data of edema is significant since many kidney diseases with appropriate and timely treatment can improve kidney function and prognosis. Consult the Nephrologist.

Hematuria

The term hematuria refers to the presence of blood in the urine and is a frequent cause of medical consultation.

The coloration of urine during hematuria can range from light pink to intense red blood-like, depending on the severity of the urine, sometimes it is possible to see deep brown urine due to the change in hemoglobin in urine.

Some foods such as beets and medicines like Phenazopyridine can change the color of the urine in a manner like that of blood, so it is important to differentiate the probable causes of an abnormal color in the urine.

There are many causes of hematuria, depending on the site of the genitourinary system where bleeding occurs, for example, in the nephritic syndrome, there is bleeding at the level of the glomerulus, renal lithiasis can result from bleeding from injury of the renal calyces or system Kidney collector, in the case of kidney tumors there may also be hematuria, other causes are urinary tract infections, prostatic hyperplasia among many others.

To make the diagnosis of hematuria is due to perform a complete examination and physical examination, and a urinalysis initial way to analyze the possible cause of bleeding, since in hematuria of renal origin we can see proteinuria and hypertension blood and need an assessment by the nephrologist, when we look leukocytes and nitrites in the urinalysis, the possible cause of urinary tract infection.

Besides urinalysis it is important to conduct a study like ultrasound image or scan to assess the possibility of structural changes of the urogenital system such as prostate hyperplasia, calculi or renal tumors.

Treatment is focused on correcting the specific cause of hematuria as antibiotics for urinary infections or extracting stones, urinary tract by surgery. Occasionally it is necessary to place a catheter in the bladder to perform a bladder lavage and prevent the formation of clots while correcting the cause of hematuria.

In the presence of blood in the urine, it is important to make a medical assessment to know the origin of the same and to use a directed treatment. At Soundialys we have specialists in Nephrology and Urology who can assess and treat the causes of hematuria.

Premature Ejaculation

Premature ejaculation is a common complaint in sexually active men and is characterized by having an earlier orgasm during sexual intercourse. This problem can arise occasionally or continuously affect the sexual life of many men, in the latter case the support of a specialist is recommended.

Although the exact cause of this disorder is not known, there are both biological and psychological factors that affect ejaculation and are briefly mentioned below: • Psychological factors • Sexual abuse • Early sexual life at an early age • Low self-esteem • Depression • Preoccupation About Premature Ejaculation • Anxiety • Partner problems • Erectile dysfunction, men who have difficulty maintaining an erection can rush during sex because of the concern that the erection is lost • Biological factors • Hormonal imbalance • Abnormal levels of neurotransmitters • Urethral or prostatic infections • Hereditary Disorders

Treatment: People with this problem should receive psychological and sexual counseling to know the causes of premature ejaculation. This orientation is intended to reduce the anxiety generated by the disease, to improve the relationship and sexual life in general. There are techniques that allow without the need to use drugs, a considerable improvement in the control of ejaculation. Pre-sexual masturbation: this allows prolonging ejaculation time during intercourse. "Stop-and-go" technique: stimulation must be stopped before ejaculation, once the desire to ejaculate continues with stimulation. Using a condom, it decreases the sensitivity in the penis with which it is possible to prolong the time of ejaculation.

Medicines: Local anesthetics: it works by decreasing sensitivity in the penis, they should be applied 15 minutes before having sex, then placing a condom to prevent the anesthetic from being transmitted to the partner and losing sensitivity. Antidepressants: taken one hour before intercourse, should not be taken in case of not having sex since they produce erectile dysfunction.

Counseling: This condition generates frustration to the men who suffer it, however, with psychological support, sexual counseling and medical treatment can greatly improve the sexual life of the patient and his partner.

Testicular Cancer

The age at which malignant testicular tumors most frequently appear is from 15-35 years, the risk factors for developing a testicular cancer are cryptorchidism (during development the testicle does not descend to the scrotum and remains in the abdomen or in the groin), family history of testicular cancer, personal history of cancer in the contralateral testicle, history of radiotherapy in the genital region. Testicular tumors usually produce no symptoms until they are advanced and patients in the initial stage notice an increase in the size and consistency of the testicle, in these cases should seek immediate medical attention. The diagnosis is made with ultrasound support where the tumor can be observed, other useful studies are computed tomography to evaluate sites of distant metastasis as retroperitoneum (on the sides and in front of the spine), thorax and head, also Some blood tests called tumor markers are useful. The treatment consists of surgically removing the testicle and in most cases chemotherapy or radiotherapy is additionally required to improve the remission rate of the tumor. The prognosis of testicular cancer is very good, since with the administration of chemotherapy, remission rates above 90% are obtained. The timely detection and treatment directly favor the prognosis of this disease.

Prostate Cancer

This cancer is the most frequent in men and occurs from the seventh decade of life, the risk factors to develop prostate cancer are not clearly known, but the family history, whether a brother, father or grandfather have suffered prostate cancer, increases the risk of developing the disease. As with most cancers, prostate cancer does not produce symptoms during the initial phase of the disease, so it is necessary after 45 years to perform laboratory tests and a physical examination that includes digital rectal examination to assess If the patient has a hard prostate, if there is a suspicion of cancer in these tests, a prostate biopsy should be performed to analyze the tissue under a microscope; in case of cancer in this test, we must choose among a variety of treatments available for cancer that includes surgery, radiotherapy or medications, the treatment chosen will be determined by the patient's age, health status and stage of the disease. In general, prostate cancer progresses slowly and patients can lead a life with few symptoms if they receive timely treatment.

Erectile Dysfunction

Also known as impotence, is a condition suffered by men of all ages, but is more common in older ages, the causes of this disease can be hormonal, anatomical or psychological, because for an erection to be achieved, it is necessary to have adequate levels of testosterone in the blood, the penis and its structures (nerves, muscle and blood vessels) must function properly and finally, the individual must have a mental well-being to initiate and maintain the erection. Some frequent examples of the causes that generate erectile dysfunction are: decreased testosterone production in adults, hypercholesterolemia, hyperprolactinemia, diabetes, hypertension, heavy smoking, sequelae of treatments for prostate or colorectal cancer (pelvic surgery and radiotherapy), depression, low self-esteem, couple problem among other causes. To make the diagnosis, a complete interrogation should be done, including a history of surgeries, cancer, radiotherapy, emotional situation of the individual and a physical examination. Once these options have been discarded, blood tests should also be carried out to determine the hormonal levels in the blood. The treatment of erectile dysfunction should be directed to the cause that is producing it, such as the administration of testosterone in patients who have low levels of testosterone, there are medical treatments that help produce and maintain an erection, but should be taken with previous medical evaluation, there is also surgical treatment for erectile dysfunction that does not respond to medication and involves placing a prosthesis inside the penis.

Male diseases have a solution, if the patient is attended to in a timely manner. We recommend frequent self-examination of the testicles and make an appointment with the urologist if you are 45 or older to assess the prostate. We wait for you in your appointment with UROLOGIST, who is responsible for assessing and treating these diseases.

Kidney and Aging

The world population is aging and the percentage of people over 85 is the fastest growing group, especially in developed countries.

Normally, there is a decrease in renal function over time, a fact that occurs after 40 years of age, however, not all individuals develop chronic renal failure with old age. Those who are genetically predisposed and who throughout their lives evolved or presented cardiovascular risk factors (smoking, obesity, diabetes, hypertension, high lipids, sedentary lifestyle, heart attacks) are more likely to have impaired renal function, to develop vascular damage and chronic renal failure over the years.

Aging at the renal level, generates important and irreversible changes in the tissue and the renal vasculature. It is therefore important to periodically evaluate the renal function of our older adults with laboratory studies, since the prevalence of chronic renal failure has been increasing, derived from our changes in diet and a more sedentary life, especially in older patients. 75 years, so detection is essential to stop the disease, since chronic kidney failure in older people is associated with limitation of strength, osteoporosis, fractures, falls, disability, malnutrition, mental / cognitive impairment and increased mortality.

What can we do to prevent deterioration of kidney function at advanced ages? It is important to consider the following: Aging does not inexorably condition the loss of renal function. The function can be maintained up to 80 years. Renal function should be evaluated routinely in laboratory studies. The objective, therefore, should be: • Early detection of kidney damage. • Control of the factors of progression: proteins in the urine, hypertension, obesity, high lipids. • Adjustment of drugs according to renal function • PREVENT: To lead a healthy life, with an adequate diet, consumption of antioxidant foods, adequate weight for height, sleep and regular exercise.

Female Urology

It is believed that only men go to the urologist, however, women also get sick from the urinary tract and need treatment by a specialist.

Some of the urological diseases that most often affect women are urinary tract infections and urinary incontinence. There are other conditions that affect both men and women such as kidney stones, kidney tumors, etc.

Urinary tract infections occur more frequently in women because the anatomical arrangement of the urethra favors the entry of bacteria into the bladder and manifests with burning at the time of urination, increase in the number of urinations, pain in the belly low and feeling of incomplete emptying. For its diagnosis it is recommended to perform a urine culture test to isolate the bacteria responsible for the infection and thus be able to administer a treatment aimed at eradicating said bacteria. If these infections occur frequently, they can cause chronic kidney damage, so it is important to diagnose and treat urinary tract infections.

Urinary incontinence is the involuntary leakage of urine through the urethra and can be from a few drops to the abundant output of urine that requires the use of protectors or diapers. It is more common in older age but can also appear in young women. It occurs in a third of the female population of Mexico, is a condition that affects the quality of life of patients because they limit their ability to perform activities outside the home and other social activities. The main cause of incontinence is the weakness of the tissues that support the bladder and the urethra in the pelvic floor, therefore, pregnancy and obesity favor the onset of urinary incontinence. In some cases, incontinence can be treated with medication, but in other cases it is necessary to perform a surgical treatment to correct it.

Chronic Kidney Disease in patients with HIV Infection

The treatment for HIV infection has contributed to the increase in life expectancy of patients, this has led to the emergence of new challenges for medical specialists, such as chronic kidney disease.

The frequency of chronic kidney disease in patients living with HIV infection ranges from 15% to 24%, with the presence of proteins in the urine, one of the early manifestations of the disease.

The presence of other diseases with diabetes, hypertension and advanced age, as well as remaining with active infection (not receiving treatment, stopping or resistance to it) are factors that facilitate the development and progression of kidney disease.

Ref: World J Nephrol July 2015.

Lupus and Kidney

Lupus is an autoimmune disease, which means that the immune system (the system that is normally responsible for defending against infectious processes) attacks the body itself. It is a disease that most often attacks young women between 20-30 years of age, is incurable, only controllable. Lupus can affect multiple organs of the body, including the kidney.

What percentage of patients will present kidney damage associated with Lupus or also called Lupus Nephritis? About 40% of patients. The risk factors for Lupus Nephritis are: Being Hispanic, younger age, low socioeconomic status, involvement of lupus to other organs, longer duration of the disease, systemic hypertension, lupus in childhood, male sex, history of lupus in the family.

How is Lupus Nephritis manifested? In the initial stages, there are very few signs that something is wrong with the kidneys, often the first symptoms are weight gain, foamy urine, swelling of the feet, ankles, legs, hands and eyelids. Lupus nephritis can be detected in laboratory studies of urine, blood and even kidney biopsy, so it is very important to monitor this disease by a trained doctor for detection and treatment of it. Other symptoms of Lupus Nephritis: Urine with blood, high blood pressure, desire to urinate continuously.

What are the factors of poor prognosis for renal function in Lupus Nephritis? Impaired renal function, elevated urine proteins, anemia, low platelets, delay in the start of treatment, prolonged evolution of the disease.

Although Lupus Nephritis is one of the most serious complications of lupus, there are effective treatments for this condition, which responds better in initial stages, so it is important to go with a doctor certified and trained in the detection and treatment of these patients.

Obstructive Uropathy

Obstructive uropathy occurs when one or both kidneys cannot excrete urine to the outside due to an obstruction in the ureters, prostate or urethra. This condition has several causes and a correct diagnosis must be made to correct its cause and thus avoid the irreversible damage of the kidneys.

The most common cause of obstructive uropathy is ureteral lithiasis, where a calculus or stone is lodged in the path between the kidney and the bladder and does not allow the passage of urine, these calculations can be a few millimeters, which favors its spontaneous expulsion or can measure more than one centimeter, being necessary in these cases a surgical intervention for its extraction.

Prostatic hyperplasia can generate obstruction of the lower urinary tract due to the proliferation of prostate tissue, this occurs frequently in older adults, in some cases, it causes discomfort to urinate, as a weak and thin stream, but occasionally they may present with urinary retention and obstructive uropathy, so it is necessary to unclog the urinary tract with a tube to prevent the kidneys from getting damaged.

Other less frequent causes of obstructive uropathy are pelvic tumors such as cancer of the colon, cervix or prostate, where the ureters are obstructed by the mechanical obstructive effect of the tumor or because of treatments such as radiotherapy, in these cases catheters can be placed JJ to derive the urinary tract and allow urine output.

Obstructive uropathy is a risk for kidney function if not treated in time, it is considered that when the kidney remains clogged for 6 weeks or more, it loses its function irreversibly, due to this, the obstruction with a catheter must be alleviated JJ, transurethral catheter or nephrostomy as soon as possible to preserve renal function while correcting the cause of the obstruction.


 
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