Chapter

Renal and urological disease

John Hobson and Edwina A. Brown

in Fitness for Work

Fifth edition

Published on behalf of Oxford University Press

Published in print January 2013 | ISBN: 9780199643240
Published online April 2013 | e-ISBN: 9780191755668 | DOI: http://dx.doi.org/10.1093/med/9780199643240.003.0019

Series: Landmark Papers

Renal and urological disease

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  • Occupational Medicine
  • Public Health and Epidemiology
  • Occupational Therapy
  • Nephrology

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The kidney has the vital function of excretion, and controls acid–base, fluid, and electrolyte balance. It also acts as an endocrine organ. Renal failure, with severe impairment of these functions, results from a number of different processes, most of which are acquired, although some may be inherited. Glomerulonephritis, which presents with proteinuria, haematuria, or both, may be accompanied by hypertension and impaired renal function. Pyelonephritis with renal scarring is the end result of infective disorders. Diabetes is now the commonest cause of end-stage renal disease (ESRD) in the UK and other systemic disease such as hypertension and collagen disorders can also affect the kidney. Polycystic kidney disease is the commonest inherited disorder leading to renal failure. Chronic renal failure implies permanent renal damage, which is likely to be progressive and will eventually require renal replacement therapy. Treatment of ESRD using haemodialysis (HD) and peritoneal dialysis (PD) can significantly improve physical and metabolic well-being and function but the proportion of those who continue to work with ESRD remains very low despite advances in treatment. Kidney transplantation enables many patients to return to normal lives including work. Reintegration of patients into the workforce following transplantation or dialysis offers an exciting and rewarding challenge to the wider health team. Renal disease is not within the top ten of the most costly diseases for employers and accounts for less than 1 per cent of sickness absence and incapacity claims. Urinary incontinence affects significant proportions of the workforce particularly women. Better management of urinary infections and calculi, prostatic obstruction, incontinence, and other complications of urinary tract disease has significantly reduced time lost from work.

Chapter.  7408 words. 

Subjects: Occupational Medicine ; Public Health and Epidemiology ; Occupational Therapy ; Nephrology

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