Kidney Health and Kidney Disease Basics
What is Kidney Disease?
The kidneys are twin, fist-size organs located at the bottom of the rib cage on either side of the spine. They perform several functions, the most important of which is filtering waste products, excess water, and other impurities out of the blood. These waste products are stored in the bladder and later expelled from the body as urine.
In addition, the kidneys regulate pH, salt, and potassium levels in the body, and they produce hormones that regulate blood pressure and control the production of red blood cells. The kidneys are also responsible for activating a form of vitamin D that helps the body absorb calcium to build bones and modulate muscle function.
he kidneys' main function is to remove waste products from your blood through urine.
Kidneys are essential to having a healthy body.
Kidney disease occurs when one or more conditions damage your kidneys, keeping them from operating properly. This can lead to health problems including high blood pressure, weak bones, nerve damage, and poor nutritional health.
Illnesses such as diabetes, high blood pressure, and a host of other chronic conditions can cause kidney disease. Kidney disease that gets worse can cause your kidneys to completely fail, which ultimately will require dialysis (a medical procedure) to clean your blood.
According to the National Kidney Foundation, 26 million American adults have kidney disease (NKF).
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Part 2 of 10: Types and Causes
Types and Causes of Kidney Disease
Chronic Kidney Disease
The most common form of kidney disease ischronic kidney disease, caused by high blood pressure. Because the kidneys are constantly processing the body's blood supply, they are exposed to about 20 percent of the total blood volume of the body every minute.
High blood pressureis dangerous for the kidneys because it can lead to increased pressure on the glomeruli, which are the functional units of the kidney. In time, this high pressure compromises the filtering apparatus of the kidney, and kidney function begins to decline.
Eventually, kidney function will deteriorate to the point where the kidney can no longer properly perform its job, and a person will be required to go on dialysis. Dialysis filters fluid and wastes out of the blood, but it is not a long-term solution when the kidneys stop functioning. Eventually, kidney transplant may be an appropriate next move, but each circumstance will be different.
Diabetes is also a major cause of chronic kidney disease. Over time, uncontrolled blood sugar will damage the functional units of the kidney, leading to kidney failure.
One other common kidney problem is kidney stones. Minerals and other substances in the blood crystallize in the kidneys, forming solid particles (stones) that usually pass out of the body with urine. Passing kidney stones can be extremely painful but rarely causes significant problems.
Glomerulonephritis is an inflammation of the glomeruli, microscopic structures inside the kidneys that perform the actual filtration of the blood. Glomerulonephritis can be caused by infections, drugs, congenital abnormalities, and autoimmune disease. This condition often gets better on its own or is responsive to immunosuppressive medications.
Polycystic Kidney Disease
Polycystic kidney disease is a genetic disorder that causes many cysts—round sacs of fluid—to grow inside and on the surfaces of the kidneys. These cysts can interfere with kidney function. (Individual kidney cysts are fairly common and almost always harmless; polycystic kidney disease is a separate, more serious condition.)
Urinary Tract Infections
Urinary tract infections (UTIs) are bacterial infections of any of the components of the urinary system. Infections in the bladder and urethra are most common. They are easily treatable and cause few long-term effects. However, if left untreated, these infections could spread to the kidneys and lead to kidney failure. A kidney infection is also known as pyelonephritis.
Part 3 of 10: Symptoms
Symptoms of Kidney Disease
Kidney disease is a condition that can easily go unnoticed until the symptoms become severe.
The following symptoms are the early warning signs that you might be developing kidney disease:
• trouble concentrating
• poor appetite
• problems sleeping
• muscle cramping
• swollen feet/ankles
• puffiness around eyes in morning
• dry, scaly skin
• increased urination, especially during the late evening
Severe symptoms that could indicate that your kidney disease is progressing into kidney failure include:
• loss of appetite
• changes in urine output
• fluid retention
• decreased sex drive
• sudden rise in potassium levels (hyperkatemia)
• decreased immune response
• inflammation of sac around heart—pericarditis
Part 4 of 10: Risk Factors
Risk Factors for Developing Kidney Disease
Certain people run a higher risk of developing kidney disease. Diabetes is the leading cause of kidney disease—44 percent of people on dialysis have kidney failure caused by diabetes (NKDEP). Other risk factors include:
• high blood pressure
• other family members with chronic kidney disease
• being elderly
• belonging to a demographic with a history of high diabetes rates and high-blood pressure rates such as African and Hispanic Americans, Asians, American Indians and people from the Pacific Islands.
Part 5 of 10: Diagnosis
How Is Kidney Disease Diagnosed?
Your doctor will first determine if you belong in any of the high-risk groups. Doctors will then have a choice of different methods to use to test whether or not your kidneys are functioning properly including:
Glomerular Filtration Rate (GFR)
This test will measure level of kidney function and determine the stage of kidney disease.
Ultrasound or CT Scan
This will give your doctor a clear picture of your kidneys and urinary tract. It will also let your doctors know if your kidneys are too small or large and if any tumors or structural problems are present.
This test will allow doctors to see what type of kidney disease you have and how much damage has occurred. The doctor will remove a small piece of tissue from your kidney while you are sedated.
Your doctor may order a urine test to look for albumin. This is a protein that can be passed into urine when your kidneys are damaged.
Blood Creatinine Test
Creatinine is a released into the blood when creatine, a molecule stored in muscle, is broken down. If your kidney is not functioning as it should, the levels of creatinine in your blood will increase.
Part 6 of 10: Treatment
Treating Your Kidney Disease
Treating kidney disease usually focuses on controlling the underlying cause of the kidney disease. This means your doctor will help you better manage your blood pressure, blood sugar, and cholesterol levels.
Drugs and Medication
Your doctor will either prescribe ACE inhibitors (like Zestril, ramparil or Altace) or ARBs (like Avapro and Benicar), which are both blood pressure medications that can slow the progression of kidney disease. They often prescribe these medications even if you do not have high blood pressure to preserve kidney function.
You may be treated with cholesterol drugs like Vytorin to reduce blood cholesterol levels and to maintain kidney health. Depending on your symptoms, your doctor may also prescribe drugs to relieve swelling and also to treat anemia or low red-blood-cell levels.
Dietary and Lifestyle Changes
Dietary changes are just as important as any medications you would take. This is because the causes of kidney disease are mostly lifestyle diseases, or those that are preventable with a healthy lifestyle. Your doctor may recommend you:
• control diabetes through insulin injections and frequent monitoring
• cut back on cholesterol
• cut back on salt
• choose heart-healthy diet including fresh fruits, fresh veggies, whole grains and low fat dairy
• limit alcohol consumption
• increase physical activity
• lose weight
• quit smoking
Written by Shannon Johnson | Published on July 9, 2012
Medically Reviewed by George Krucik, MD
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