Kidney Infection Causes

Kidney and urinary tract infections may be caused by bacteria invading the urine, which is normally a sterile body fluid. Bacteria most commonly gain access to the urine through the urethra, which can be exposed to bacteria from outside of the body.

Common sources of bacteria invading the urinary system are the vagina, anus, and skin. Because of the shorter length of urethra in women, urine infection is more common in women compared to men. There are some factors that may predispose people to urinary tract infections.

Sexual intercourse may increase the risk of urine infection in women. Kidney infection may be facilitated by the introduction of bacteria from outside (vagina) to the urinary system through the urethra.

Pregnant women may also be at higher risk for developing develop urinary tract infections. This may be caused by slower transit of urine from the ureters into the bladder because of increased pressure on the ureters from the enlarged uterus. Approximately 10% of pregnant women may develop kidney and urinary tract infections during their pregnancy.

Kidney stones are another factor that may increase the likelihood of urinary tract infection. Stones can cause partial or complete obstruction to the flow of urine from the kidneys and ureters. This obstruction may act as a focus of infection in the urinary system, leading to urinary tract infections.

Bladder catheters (Foley catheters) are sometimes placed into the bladder in order to aid the outflow of urine from the bladder. These are used in many settings, for example, paralysis with nerve damage to the bladder causing accumulation of urine without adequate emptying, bladder obstruction from an enlarged prostate, or immobilized or hospitalized patients who are not able to independently urinate. These catheters may act as a vehicle for bacteria to gain access to the urine inside the bladder causing urinary infections.

In children some risk factors include female gender, an uncircumcised male, or a structural abnormality of the urinary system.

The most common bacteria causing urinary tract infection or kidney infection are naturally those that may be seen in the vagina, gastrointestinal tract, or skin. By far, the most common organism causing urinary tract infection is Escherichia coli (E. coli), responsible for up to 80% of kidney and urinary infections. Other common bacteria include Klebsiella, Proteus, Pseudomonas, Enterococcus, and Staphylococcus saprophyticus.

heart disease

Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease.

Causes, incidence, and risk factors

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.

Coronary heart disease is caused by the buildup of plaque in the arteries to your heart. This may also be called hardening of the arteries.

• Fatty material and other substances form a plaque build-up on the walls of your coronary arteries. The coronary arteries bring blood and oxygen to your heart.
• This buildup causes the arteries to get narrow.
• As a result, blood flow to the heart can slow down or stop.

A risk factor for heart disease is something that increases your chance of getting it. You cannot change some risk factors for heart disease, but others you can change.

The risk factors for heart disease that you CANNOT change are:

• Your age. The risk of heart disease increases with age.
• Your gender. Men have a higher risk of getting heart disease than women who are still getting their menstrual period. After menopause, the risk for women is closer to the risk for men. See: Heart disease and women
• Your genes. If your parents or other close relatives had heart disease, you are at higher risk.
• Your race. African Americans, Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk for heart problems.

Many things increase your risk for heart disease:

• Diabetes is a strong risk factor for heart disease.
• High blood pressure increases your risks of heart disease and heart failure.
• Extra cholesterol in your blood builds up inside the walls of your heart's arteries (blood vessels).
• Smokers have a much higher risk of heart disease.
• Chronic kidney disease can increase your risk.
• People with narrowed arteries in another part of the body (examples are stroke and poor blood flow to the legs) are more likely to have heart disease.
• Substance abuse (such as cocaine)
• Being overweight
• Not getting enough exercise, and feeling depressed or having excess stress are other risk factors.

Symptoms

Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms.

Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.

• It may feel heavy or like someone is squeezing your heart. You feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back.
• The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
• Other symptoms include shortness of breath and fatigue with activity (exertion).

Women, elderly people, and people with diabetes are more likely to have symptoms other than chest pain, such as:

• Fatigue
• Shortness of breath
• Weakness

Signs and tests

Many tests help diagnose CHD. Usually, your doctor will order more than one test before making a diagnosis.

Tests may include:

• Coronary angiography/arteriography -- an invasive test that evaluates the heart arteries under x-ray
• CT angiography -- a noninvasive way to perform coronary angiography
• Echocardiogram
• Electrocardiogram (ECG)
• Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries -- the more calcium, the higher your chance for CHD
• Exercise stress test
• Heart CT scan
• Magnetic resonance angiography
• Nuclear stress test

Treatment

You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels. Follow your doctor's directions closely to help prevent coronary artery disease from getting worse.

Goals for treating these conditions in people who have coronary artery disease:

• Blood pressure less than or equal to 140/90 (even lower for some patients with diabetes, kidney disease, or heart failure)
• Glycosylated hemoglobin (HbA1c) levels less than or equal to 7% for people with diabetes
• LDL cholesterol level less than or equal to 100 mg/dL (even lower for some patients)

Treatment depends on your symptoms and how severe the disease is. Your doctor may give you one or more medicines to treat CHD, including:

• ACE inhibitors to lower blood pressure and protect your heart and kidneys
• Aspirin, with or without clopidogrel (Plavix) or prasugrel (Effient) to help prevent blood clots from forming in your arteries
• Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
• Calcium channel blockers to relax arteries, lower blood pressure, and reduce strain on the heart
• Diuretics ("water pills") to lower blood pressure and treat heart failure
• Nitrates (such as nitroglycerin) to stop chest pain and improve blood flow to the heart
• Statins to lower cholesterol