The working of your kidneys & its importance
In most of the cases our kidneys do not get full respect, what it should have. The kidneys are only cared in case something goes wrong. However, the truth is many are becoming the victims all around the world, Americans are the cases for rising victims due to the problems like diabetes & hypertensions; obesity is at the back of it.
Statistics of kidney disease in USA
More than 26 million that means 1 among 9 adults in America are suffering from CKD (chronic kidney diseases). The irony is most of the victims are ignorant about it. Vanderbilt University in Nashville had a survey on the patients with CKD in the year, 2016 and found that 1/3rd of the patient undergoing the treatment of CKD, don’t know about the seriousness of their disease.
NOTE: - CKD cannot be cured, but timely intervention can prevent the disease to occur. (CKD should not be clubbed with Kidney stones)
The most affected people with CKD in USA (as per the survey)
Most of the victims were above 60s. Their ethnicities were: people to have got the disease from their heredity and the Hispanics and blacks.
Importance of kidney
It is well known that the main function of kidney is to remove the excess fluids and the other waste products from the body, this includes drugs & chemicals. The fluids are removed through urine. Urine production is a very complicated or complex process. It comprises of excretion and reabsorptions. The process is very important for maintaining the balance among the body chemicals.
Kidneys perform the critical regulations of our body’s acid, potassium and salt content. The other functions of kidneys are production of hormones, which are needed for other organs. The example is hormone production by the kidneys is stimulant for the production of red blood cells. Other hormones are helpful in controlling calcium metabolism and regulating blood pressure. Kidney, “the chemical factory” does these important functions for our body:
i) Removes waste drugs from body
ii) Removes different types waste
iii) Balances fluids within our body
iv) Controls red blood cells’ productions
v) Produces a form of Vitamin D, which is helpful for promoting healthy & strong bones
vi) It releases hormones which are helpful for regulating blood pressure
The kidneys & their functions
We have 2 kidneys. The size of each of the kidneys is similar to our fist. The kidneys are located at the lowest level of our rib cage. The kidneys are just near to our spine. Each of the kidneys has 1 million of functioning units.
Functioning of Nephrons in kidneys
Nephrons are the functioning units of kidneys. Nephrons are 1 million in number. The nephron has filtering component of tiny blood vessels, which are known as glomerulus, remains attached with a tubule.
Functioning of glomerulus in Nephrons
Blood enters the glomerulus, where blood is filtered; the unfiltered fluid is passed to the tubule.
Functioning of tubule in glomerulus
Water and Chemicals are either removed or added in the tubule as per the body’s need. The final product comes out as urine; we pass out from our body.
Both the kidneys carry out their life sustaining jobs by filtering and also returning to the blood stream.
The amount / volume of filtering by our kidneys
Our kidneys filter 200 quarts of fluids per day. And from this whole volume, only 100th part i.e. 2 quarts come out of our body as urine. And the balance 99 part gets recovered. The excreted urine normally remains stored between 1 and 8 hours in our bladder.
Chronic kidney diseases & their causes
A) If there is any kidney “marker” or abnormality, it will result in chronic kidney disease. The markers may be 1) protein in the urine and 2) minimized kidney functions for 3 months or longer period.
B) Among the many other causes of the CKD are i) high blood pressure, ii) inherited problems and iii) diabetes
C) Congenital problem (abnormality during birth) may also cause CKD
Diabetes: - A patient with this problem either cannot produce enough insulin or fails to use normal amount of insulin in a proper way. Because of this problem, sugar level goes up very much, causing lots of problems in our body. Among the leading causes of kidney diseases, diabetes is the top one.
Hypertension or high blood pressure
Hypertension or high blood pressure is the other common causes of kidney disease, which is endangered by the complications like strokes & heart attacks. The cause of high blood pressure is increased forces of blood against the artery walls. If high blood pressure is controlled, CKD related risks get minimized.
Glomerulonephritis is another type of kidney disease. The cause behind this disease is the inflammation in the glomeruli (tiny filtering units of the kidney). The occurrence of Glomerulonephritis may be sudden like strep throat, which may not last long. However the problem is not permanently over. The disease may develop over several years, causing gradual loss of kidney functions.
Among the most commonly inherited diseases, polycystic kidney disease is one of them. The main characteristic of this disease is the “kidney cysts” formation, which gets enlarged with the progression of time. This results in serious kidney damage and end up with kidney failure. Primary hyperoxaluria, Alport's Syndrome and Cystinuria are the other types of inherited kidney diseases.
Stones in kidney are very common, but as they pass severe pain is caused at the patient’s side and back. Many other causes of stones in the kidney are by inheritance, which are responsible for too much calcium absorptions from foods, infections in urinary tracts or even obstructions in the urinary tracts. Some preventive measures can stop the recurrence of kidney stone formations. In case the kidney stones are so large that it cannot pass, in this case medications can break them into small sizes for passing them out of the body or they can also be removed. Urinary tracts can also be infected by those germs which enter into the urinary tracts and symptomize burning sensations or pain at the time of urination. Some patients may feel the frequent urges for urinations. Those patients, who are affected by urinary tract infection, may be the victims of bladder infection, which may even affect their kidneys with the symptoms of pains in back or have fever.
Kidneys can also be affected by the congenital causes, which damage the urinary tracts even when the baby is in the womb. The most commonly problem is valve mechanism between ureter (urine tube) and bladder stops working in a proper way for which urine refluxes or backs up. This situation causes infection in the kidneys, which may lead to kidney damages.
Kidney problems can also be due to drug abuse or toxicities. Most of the drug abuses are due to long use of over the counter pain relievers, which are very much harmful to the kidneys.
Crack and heroin, pesticides, toxins and some other types of drugs can also damage kidneys.
Detection of Chronic Heart Disease
If the CKD is early detected and rightly treated, it can be possible to stop the problem from progressing further. There are some simple tests which can be of much help for detecting the disease. They are:
a) Regular measurement of blood pressure
b) Urine protein test. In case it is detected that your urine has protein, it will indicate that your kidney is damaged for some disease(s). Sometimes heavy exercises or fever can also be the cause. So your doctor can rightly detect the actual cause of the problem.
c) A blood creatinine test is also a way for detecting kidney disease. A patient’s age, gender, race and many other factors, along with the test report are taken into consideration for the evaluation of the patient’s GFR (rate of glomerular filtration). The GFR report can say about a patient’s state of kidney functions.
The following conditions are vital for those patients with high risks of Chronic Kidney Disease:-
a) Are you diabetic?
b) Are you old in age?
c) Do you have high blood pressure, and
d) Have / had any of your family members any or chronic kidney problem
e) Do you belong to an African American, Asians, Hispanic American and American Indian or Pacific Islander?
In case you are the candidate of any of these categories or you feel you have increased risk of kidney disease, you must talk to your doctor without losing much time.
Successful treatment of kidney disease
There are many successful treatments for kidney disease. In case high blood pressure and diabetes are carefully controlled, kidney diseases can be rightly controlled or stopped from getting worse. However, many types of kidney diseases’ causes are still now not known, and that is why treating those ailments “still knows no end”. There are many occasions when the kidney disease can result in kidney failure. If a patient’s kidneys fail to function, the patient has to either undertake dialysis or opt for kidney transplantation.
In case any high blood pressure needs to be treated with special medication, the procedure is known to be ACE (angiotensin converting enzyme) inhibitors, which can often help a patient to slow down the kidney disease’s progression. Many researches are going on to explore the possibilities of effective treatments for all types of chronic kidney diseases.
Treatment of kidney failure
Treatments of kidney failure are 1) peritoneal dialysis, 2) haemodialysis and 3) kidney transplantation.
Treatments with haemodialysis mean use of artificial kidneys, which is performed at home or at a dialysis unit. This type of treatments is done thrice a week.
Treatments of Peritoneal dialysis are done at home in every day. There is a requirement of machine for the Continuous Cycling Peritoneal Dialysis but it is not so in case of Continuous Ambulatory Peritoneal Dialysis. These are the paradigm of a kidney specialist, so he or she can rightly classify varied types of approaches for helping the individual patients to choose the best available for him or her.
Success rates of kidney transplantations
High success rates have been found in kidney transplantations. The donor kidney may come (mostly) from the relatives or from the dying / dead persons. In some cases, some philanthropic stranger may be the donor.
The early stages of kidney diseases
In most of the cases, the early stages of kidney diseases have no signs & symptoms, but with the progression of the stage or worsening of the case, a patient may have nausea, BUN and creatinine, less appetite or vomiting, anemia, muscle cramps, itching, weakness and extreme tiredness.
Warning signs of kidney diseases
a) Protein or blood in the urine
b) High blood pressure
c) A BUN (Blood Urea Nitrogen) or creatinine blood test are beyond the normal range of tests. The two BUN (Blood Urea Nitrogen) or creatinine is the built-up wastes which are formed when a patient’s kidneys function in a reduced way.
d) Kidney function is measured by GFR (glomerular filtration rate). GFR must be less than less than 60.
e) Frequencies of urinations are more, particularly at night. Urination may either be painful or be bundled with difficulty.
f) Symptoms like puffy eyes, swelled feet and hands are some of the characteristics of the CKD.
How can you measure the working of your Kidneys?
Several important jobs are done by kidneys. The important jobs include
1) Balancing acid in our blood,
2) Excretion of impure minerals and chemicals from blood and
3) Controlling body fluids.
All these vital functions take place when the blood passes through the kidneys.
4) The other function of the kidneys is helping in controlling the red blood cells’ productions in our body-systems.
5) Some other function of kidney is also to help keeping the bones healthy and strong.
6) Each kidney consists of 1 million tiny nephrons and each nephron has glomerulus (a group of tiny blood cells)
7) The job of the glomerulus is filtering as well cleaning blood, as it passes through kidneys. GFR is the rate of filtration of blood, so it is termed as G (glomerulus), F (filtration) & R (rate).
8) Each day 2 quarts of urine is produced from almost 200 quarts of blood filtration process by kidneys. Improper working of kidneys, the removable items like creatinine (Cr) and blood urea nitrogen (BUN) do not get flushed out of our body. They stay in our blood stream. Their volume can be measured through blood test.
9) There are some other products which also stay in our blood stream is protein. Presence of protein can also be measured through blood tests.
According to the suggestion of NKF (National Kidney Foundation) doctors must calculate the GFR and the patients must know about the GFR reading/number. In case your blood has been drawn for the creatinine check, it will be easier for the doctor for figuring out your GFR. Both the protein level and GFR reading can help the doctor to either diagnose or reject about your chronic heart disease. From the very beginning doctors will take steps (if CKD is detected) to slow down the worsening of kidney functions. If the case is brought to the doctor at a later stage, doctors will have little option because by this time the kidney might have already reached to a worsening condition.
Kidney disease, without any symptoms & signs
In most of the cases of kidney disease, both the kidneys become affected. If the kidneys are seriously affected, they fail to filter blood. The result of which is building up of wastes in the body. Many kidney diseases do not symptomize anything until they are in their later stage.
Conclusive warnings about chronic kidney disease
The most common or most frequent causes of CKD
As said before, both the high blood pressure and poorly controlled diabetes are responsible for kidney diseases. Other than this, the inflammations causing and responsible for damaging glomerulus result in the occurrence of glomerulonephritis. Further to this, the other conditions like polycystic kidney disease, which is a kidney disease by inheritance, responsible for chronic heart disease.
One more cause of chronic kidney disease which is often overlooked is “analgesics” medicine, which is used for relieving pain. Some other drugs like acetaminophen (Tylenol), especially aspirin and non-steroidal drugs (NSAIDs) like naproxen (Aleve), ibuprofen and ketoprofen. These drugs are available over the counter. These are the toxic drugs, and so can cause permanent damages to the kidney.
Preventive part of chronic kidney disease
There are many ways to prevent the CKD and if not possible, it can be slowed down to some extent. They are:
A) Talk to your doctor for starting a blood pressure medicine i.e. “ACE Inhibitor”. This is very effective for helping kidney functions to remain protected. “ACE Inhibitor” is also helpful in lowering down the blood pressure.
B) The diabetic patients, even without high blood pressure, should take “ACE Inhibitor” for the protection of kidneys.
C) Controlling blood sugar is also an important issue in the preventive part of CKD
D) Those patients, who are diagnosed with protein in their urine, must consult their dietician for controlling diabetes. They should also alter their diet so that protein content can be minimized, but only after the consultation with the dietician.
E) Exercising in a regular way is a good stepping stone towards remaining fit & healthy. With exercises, muscle functions get improved, so the kidneys also become healthy. Regular exercises can also lower the blood pressure. Exercise is also helpful in maintaining healthy body weight. This also helps in improving sleep.
If exercises are clubbed with dancing, cycling, swimming, walking etc. the result will be very healthy. In these cases a patient needs to start low and go slow. The exercises must be at least 30 minutes and 3 times in a week.
It is a good habit to talk to your exercise partner while working out. This will help one to get complete recovery from any type of exhaustion or fatigue, which will make the session very enjoying.
F) If you are under any other medication, you must be careful about pain killers. Take them (pain killers) if you really need. You must consult your doctor, in special cases like any other chronic problem for which you need to take the pain killers at a stretch for 10 days or more than that. Example may be arthritis.
G) Combine drugs with NSAIDs, caffeine and acetaminophen need to be avoided.
H) Your water intake will be minimum 6 to 8 glasses per day, if you are taking any of the above medicines.
You must be careful to the problems like
1) Blood and/or protein in the urine;
2) High blood pressure
3) Decreasing GFR;
4) Pain or difficulty urinating;
5) More frequent urination;
6) Swelling of feet and hands;
7) Puffiness around the eyes.
I) It is very easy to calculate your GFR. GFR calculation should be done minimum once in a year for those who are at risk of kidney disease. Those who are already diagnosed with kidney disease must get the GFR calculation done.
J) In case any one can’t understand the way of calculating GFR, they can take online help for getting the GFR calculated through National Kidney Foundation. They have online GFR calculator.