Kidney Diseases

You have two kidneys, each about the size of your fist. They are near the middle of your back, just below the rib cage. Inside each kidney there are about a million tiny structures called nephrons. They filter your blood. They remove wastes and extra water, which become urine. The urine flows through tubes called ureters. It goes to your bladder, which stores the urine until you go to the bathroom.

Most kidney diseases attack the nephrons. This damage may leave kidneys unable to remove wastes. Causes can include genetic problems, injuries, or medicines. You have a higher risk of kidney disease if you have diabetes, high blood pressure, or a close family member with kidney disease. Chronic kidney disease damages the nephrons slowly over several years. Other kidney problems include:

• Cancer
• Cysts
• Stones
• Infections

Your doctor can do blood and urine tests to check if you have kidney disease. If your kidneys fail, you will need dialysis or a kidney transplant.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Pancreas Transplantation

The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that help break down food and the hormones that help control blood sugar levels. A pancreas transplant is surgery to place a healthy pancreas from a donor into a person with a diseased pancreas. It is mostly done for people with severe type 1 diabetes. It can allow them to give up insulin shots. An experimental procedure called islet cell transplantation transplants only the parts of the pancreas that make insulin.

People who have transplants must take drugs to keep their body from rejecting the new pancreas for the rest of their lives. They must also have regular follow-up care. Because of the risks, it is not a common treatment for type 1 diabetes.

Peripheral Arterial Disease

Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of PAD is atherosclerosis. This happens when plaque builds up on the walls of the arteries that supply blood to the arms and legs. Plaque is a substance made up of fat and cholesterol. It causes the arteries to narrow or become blocked. This can reduce or stop blood flow, usually to the legs. If severe enough, blocked blood flow can cause tissue death and can sometimes lead to amputation of the foot or leg.

The main risk factor for PAD is smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, heart disease, and stroke.

Many people who have PAD don't have any symptoms. If you have symptoms, they may include:

• Pain, numbness, achiness, or heaviness in the leg muscles. This happens when walking or climbing stairs.
• Weak or absent pulses in the legs or feet
• Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all
• A pale or bluish color to the skin
• A lower temperature in one leg than the other leg
• Poor nail growth on the toes and decreased hair growth on the legs
• Erectile dysfunction, especially among men who have diabetes

PAD can increase your risk of heart attack, stroke, and transient ischemic attack.

Doctors diagnose PAD with a physical exam and heart and imaging tests. Treatments include lifestyle changes, medicines, and sometimes surgery. Lifestyle changes include dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure.

NIH: National Heart, Lung, and Blood Institute

Peripheral Nerve Disorders

What are peripheral nerves?

Nerves are like wires that carry messages back and forth between your brain and your body. Your peripheral nerves branch off from your brain and spinal cord and connect to all parts of your body, including your muscles and organs. Peripheral nerves carry messages from your brain that control your movement, breathing, heartbeat, digestion, and more. They also carry messages from your body to your brain, so you can feel things, such as pain, heat, and cold.

What are peripheral nerve disorders?

Peripheral nerve disorders happen when one or more peripheral nerves are damaged. Damaged nerves may not carry messages correctly, or they may not work at all. As a result, you may have pain, trouble walking, or a variety of other problems, depending on which nerves are involved.

Peripheral nerve disorders are very common. There are more than 100 different types.

What causes peripheral nerve disorders?

Many things can damage nerves and lead to peripheral nerve disorders:

• Diabetes is the most common cause of peripheral nerve disorders. Most people with diabetes will develop diabetic nerve problems.
• Physical injury (trauma) that stretches, crushes, squeezes, cuts, or puts pressure on one or more nerves. Some examples of peripheral nerve disorders from physical injury include complex regional pain syndrome and brachial plexus injuries.
• Health conditions, including:
  • Certain cancers and their treatment (chemotherapy and radiation therapy).
  • Infections, such as HIV and Lyme disease.
  • Problems with blood or blood vessels.
  • Autoimmune diseases, such as rheumatoid arthritis and lupus.
  • Kidney or liver disease.
• Certain medicines.
• Contact with certain toxic substances, such as lead or mercury.
• Alcohol use disorder (AUD) and smoking.
• Vitamin imbalances, especially a lack of vitamin B12.
• Your genes, including changes in your genes or conditions that you inherit from your parents, such as Charcot-Marie-Tooth disease.

In certain cases, the cause of peripheral nerve disorder is not known.

What are the symptoms of peripheral nerve disorders?

The symptoms of peripheral nerve disorders depend on which nerves are affected, what is causing the damage, and how serious it is:

Types of nervesPossible symptoms of nerve damageMotor nerves control your muscles and all your movement, such as walking, talking, and using your hands.

• Weak or aching muscles
• Problems with balance, walking, or using your arms and hands
• Cramps or twitching muscles
• Muscle shrinking

Sensory nerves carry messages to your brain from your senses, including touch, hot and cold, and pain.

• Tingling, numbness, or pain often in the hands and feet
• Not being able to feel heat, cold, or pain, such as a cut on your foot
• Pain from even light touch

Autonomic nerves send messages to your organs to control breathing, digestion, and other body functions that happen without thinking about them.

• A heartbeat that's too fast or too slow
• Trouble swallowing
• Sweating too much or too little
• Vomiting, diarrhea, or constipation
• Problems with urination or sexual function

Symptoms may range from mild to very strong. They may develop quickly over days or slowly over months and years. But they are rarely life-threatening.

How are peripheral nerve disorders diagnosed?

To find out if you have a peripheral nerve disorder, your provider will:

• Ask about your medical history
• Ask about your family health history
• Do a physical exam
• Order tests, which may include:
  • Blood tests
  • Genetic tests
  • Nerve tests that measure:
    • Electrical activity in your nerves and muscles
    • How well your autonomic nerves are working
  • A biopsy of nerve or skin tissue
  • CT or MRI scan to see what may be pressing on your nerves

What are the treatments for peripheral nerve disorders?

It's important to treat any conditions that are causing nerve damage. In certain cases, that will allow your nerves to heal over time.

Treatment for symptoms depends on the type of peripheral nerve disorder you have, where it is, and how severe. Treatment options include:

• Braces or splints
• Over-the-counter patches and skin creams
• Prescription medicines
• Non-drug pain management, such as electrical stimulation or relaxation therapy
• Surgery to relieve pressure on a nerve

Can peripheral nerve disorders be prevented?

You can help prevent peripheral nerve disorders by:

• Managing health conditions that may cause nerve damage, especially diabetes
• Preventing falls and accidents
• Avoiding toxic substances
• Being careful to avoid repeated motions and body positions that press on your nerves
• Eating a balanced diet, exercising, limiting alcohol, and not smoking

NIH: National Institute of Neurological Disorders and Stroke

Prostate Diseases

What is the prostate?

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

What are prostate diseases?

There are many types of prostate diseases:

• Prostatitis is inflammation (swelling and pain) in the prostate gland. It's the most common type of prostate problem in people under than age 50. There are different types:
  • Chronic prostatitis is also called chronic pelvic pain syndrome. It's the most common type of prostatitis.
  • Acute bacterial prostatitis starts suddenly from a bacterial infection and is treated with antibiotics. It is not common.
  • Chronic bacterial prostatitis happens when a bacterial infection keeps coming back. The symptoms usually start slowly. It may take longer to treat than acute bacterial prostatitis.
  • Asymptomatic prostatitis has no symptoms and usually doesn't need treatment. You may learn you have it after having tests for other health problems.
• Enlarged prostate is also called benign prostatic hyperplasia (BPH). The prostate gland tends to grow larger with age. That's why enlarged prostate is very common in older people and rare in those who are under age 40. When the prostate grows larger, it may press on your urethra and cause problems with urination.
• Prostate cancer happens when cancer cells form in the prostate gland. Prostate cancer is a common type of cancer in those aged 50 and older. Most prostate cancers grow slowly and may never cause health problems. But certain prostate cancers are serious.

Who is more likely to develop prostate diseases?

Anyone with a prostate can develop prostate problems. But some people are at higher risk.

You may be more likely to develop prostatitis if you have:

• A lower urinary tract infection, also called a UTI. An infection in your lower urinary tract (bladder and urethra) may lead to acute or chronic bacterial prostatitis.
• Nerve damage in your lower urinary tract from surgery or an injury. This may lead to chronic prostatitis.
• Emotional stress, which can lead to chronic prostatitis.

You may be more likely to develop an enlarged prostate (BPH) if you:

• Are age 40 or older.
• Have family members who have had BPH.
• Have certain health conditions such as:
  • Obesity.
  • Heart disease and problems with blood circulation.
  • Type 2 diabetes.
• Don't get enough physical activity.

You may be more likely to develop prostate cancer if you:

• Are older than age 50.
• Have a parent, sibling, or child who has or had prostate cancer.
• Are African American.

What are the symptoms of prostate diseases?

The symptoms of prostate problems include:

• Needing to urinate a lot.
• Needing to rush to the bathroom, but not being able to urinate or only going a little.
• Leaking or dribbling urine.
• Having a weak urine stream.

Other symptoms depend on the type of prostate problem you have and may include:

• Not being able to urinate at all. This is a medical emergency.
• Any problems, starting or controlling urine flow.
• Waking up often to urinate.
• Blood in your urine or urine that has an unusual smell or color.
• Fever, chills, or body aches.
• Great discomfort or pain:
  • While urinating or after ejaculation.
  • In your abdomen (belly), between your scrotum and anus, or in your scrotum or penis.

Contact your provider if you have any of these symptoms.

How are prostate diseases diagnosed?

To find out if you have a prostate problem, your provider will:

• Ask about your medical history and symptoms.
• Ask about your family health history.
• Do a physical exam. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to feel the general size and condition of your prostate.
• Order tests, if needed. Tests may include:
  • Blood and urine tests to look for infection.
  • Urodynamic testing to see how well you can hold and release urine.
  • Cystoscopy to look inside your urethra and bladder.
  • Ultrasound pictures of your prostate and urinary tract.
  • A PSA blood test (prostate-specific antigen test).
  • Prostate biopsy to diagnose or rule out cancer.

Treatment depends on what prostate disease you have and which symptoms bother you most.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases