Non-infectious Diseases of the Urinary Tract

Non-infective diseases of the urinary tract include pre-existing damage to the kidneys, hereditary disorders, “stones” and anomalies. Fortunately, most of these conditions are rare in young, pregnant women.

Pre-existing kidney damage is often the result of past urinary tract or blood system infection. Before antibiotics were available (prior to World War II), “strep” bacteria (similar to that in “strep throat”) would often travel via the blood to the kidneys, and damage the filtration system in the kidney. Similarly, bacteria may “ascend” from the bladder. Some women come into pregnancy with a history of these problems.

“Proteinuria” means protein in the urine. Proteinuria is not actually a disease. However, it is often the sign of a problem. Typically, the kidneys filter the blood and leave the blood proteins in the blood, not allowing them to pass into the urine. When protein presents in the urine your clinician will probably want to delve a little deeper. Protein may suggest bacterial infection somewhere in the urinary tract. It can also be a sign of past kidney damage or some disorder affecting the kidney. Proteinuria is also seen in the disease, toxemia/pre-eclampsia.

Kidney stones, or “renal calculi” are the body’s equivalents of the stalagtites and stalagmites seen in wet caves. They are actual crystalline stones, largely made up of calcium, which precipitate out of the urine of some people. Kidney stones form in the collecting duct of the kidney (much like a pearl forming inside an oyster). When a stone begins to work its way down the ureter, it produces pain…..usually, an extradordinary degree of pain. Because the stone is hard and rough, it scratches the delicate lining of the urinary tract, which bleeds. This blood mixes with urine, and is easily detected. (People also form similar stones in the gallbladder.)

The passage of a kidney stone, or smaller pieces of “gravel”, is an experience none forget, nor ever want to repeat. The pain is excrutiating. Often, narcotics are given to help with the pain while the stone passes. Sometimes, the stone will not pass. If the stone blocks the flow of urine, the kidney can be damaged. In these cases, a urologist may be consulted to insert a “stent” in the ureter, so that urine can bypass the stone.

“Nephrosis” is a general term used to describe decreased kidney function. People with advanced nephrosis exhibit symptoms and signs which collectively are called “nephrotic syndrome”. Nephrosis may be the result of previous infections, hereditary problems, or may be idiopathic (which means the cause is unknown). Pregnant women with nephrosis need high level, specialized care, usually seeing both an obstetrician and a renal specialist (a nephrologist).

“Lupus” is a condition wherein the body reacts against itself. In lupus and other “autoimmune” diseases the body produces antibodies against its own tissue. Lupus can affect any organ system, and sometimes the kidneys are attacked by the disorder. In these cases, kidney function may be impaired, and nephrosis occurs.