March is National Kidney Month, a good time to examine why the kidneys are so important to our health and how best to protect them from something going wrong.
The kidneys are bean-shaped organs located in the midsection of the body, one on the left and one on the right. They are about the size of your fist. The primary job of the kidneys is to help remove liquid waste from the body. The kidneys filter the blood, removing extra liquid and waste products, in turn producing urine.
“Our kidneys are remarkably efficient filters, clearing our body of waste every day for our entire lives,” explains Dr. Fysal Albaalbaki, a nephrologist with offices in Fort Worth and Weatherford. “Each day, our kidneys filter between 120 and 150 quarts of blood and produce 1-2 quarts of urine – they do a lot of important work for our bodies, so it’s important we keep them healthy.”
Chronic Kidney Disease
Chronic kidney disease occurs when the kidneys can no longer filter blood correctly, leading to excess waste and fluid in the body. It can also increase the risk of heart disease, stroke, anemia and other health problems.
“When we see someone with chronic kidney disease, that usually indicates there are other underlying health conditions present,” says Dr. Thomas Rajan, a Fort Worth nephrologist. “Kidney disease is generally not something that suddenly appears in an otherwise healthy person; it’s often a result of another health condition, such as diabetes or hypertension.”
In fact, diabetes is the leading cause of chronic kidney disease – 44 percent of kidney disease cases in the Unites States are a result of diabetes and a quarter of all diabetics have kidney disease. One of the dangers of diabetes is that high glucose (blood sugar) levels damage the kidneys over time. Hypertension (high blood pressure) is the second-leading cause of kidney disease.
Because chronic kidney disease does not cause noticeable symptoms until it is at an advanced stage, people at high risk, such as those with diabetes and elevated blood pressure, need to have regular renal function screenings. (“Renal” is a medical term and simply means anything having to do with the kidneys.)
Managing diabetes by keeping blood sugar levels in the target range and lowering blood pressure levels are two of the most important things someone at risk of kidney disease can do. In addition, eating plenty of fruits and vegetables and getting frequent exercise are two steps everyone should take to promote healthy kidneys.
Treatment of Chronic Kidney Disease
“Patients with chronic kidney disease can live long and full lives by working closely with their physician and following their treatment plans,” says Fort Worth nephrologist Dr. Carlos Bahrami. “Even for patients with kidney failure, there are proven treatments that extend lives, while allowing the patient to continue to work and engage in a variety of activities.”
For people who are diagnosed with chronic kidney disease, there are several measures they can take to manage the disease and slow its progression. Those include:
If diabetic, keep your A1C readings – three-month averages of glucose levels – within your goal range, as established by your physician.
Work to keep blood pressure within goal, as established by your physician
Eat healthy foods, such as fruits and vegetables, and avoid foods with high levels of sodium
Get regular exercise
Take any prescribed medications for diabetes or hypertension
At an advanced stage, chronic kidney disease can cause kidney failure. Kidney failure occurs when the kidneys are no longer able to do their job of filtering the blood, causing waste and fluid buildup in the body. “If the kidneys cannot filter the blood adequately, we must either replace the kidney with a new one or use a work-around,” explains Dr. Albaalbaki. “That work-around is called dialysis, a process in which we filter the blood independently of the kidneys.”
There are three treatments for kidney failure:
Hemodialysis: in this process, blood is filtered through a machine outside the body. A needle is inserted into the arm to remove the blood. After it has filtered through a dialyzer to remove waste, the blood is returned to the body through a second needle. Hemodialysis is usually conducted three times per week and treatments can last between three and five hours. Some patients go to a dialysis clinic for treatment, but in-home dialysis is becoming easier and more common. Your physician can help you decide which option is better for you.
Peritoneal Dialysis: This form of dialysis uses the lining of the abdominal cavity to filter the blood. A special solution is placed in the abdomen that serves to filter waste from the blood, which is then drained from the body. Peritoneal dialysis is done at home and often when the patient is sleeping at night.
Kidney Transplant: Doctors can transplant a kidney from a healthy person to a patient with kidney failure. Sometimes the transplanted kidney is thanks to an organ donor who has died. In other cases, a friend or family member may donate a kidney to a loved one, as we only need one kidney to live normally.
In a kidney transplant, the new kidney is placed in the front lower abdomen. The old, damaged kidneys usually remain where they are as the transplanted kidney takes over the work of filtering the blood. Special medications are administered following a kidney transplant to prevent the body from rejecting the new organ.
It is not unusual for people to wait years for a kidney transplant. The patient will need to undergo dialysis treatment while on the transplant waiting list. Even after a successful kidney transplant, the kidney disease is not cured – the transplant is a form of treatment, and careful monitoring of renal health is important.
Other Kidney Issues
Other kidney conditions, unrelated to chronic kidney disease, include:
Kidney stones can develop if mineral deposits build up in the kidneys. Men over the age of 40 are generally more susceptible to kidney stones. Symptoms of kidney stones include a sharp pain in the back, side, abdomen or groin, as well as blood in urine. Anyone experiencing these symptoms should seek medical attention.
Kidney stones are quite painful but are usually passed through urine without causing any permanent harm. In some cases, surgery may be required to remove them. Drinking plenty of water each day is one of the best ways to prevent kidney stones.
Kidney infections are a dangerous type of urinary tract infection (UTI). The UTI generally develops in another part of the urinary tract, such as the urethra or bladder, and travels up into the kidneys. Kidney infections are very serious and must be treated immediately.
Symptoms of a kidney infection include fever, back pain and a frequent and painful urge to urinate. Kidney infections are generally treated with antibiotics and require hospitalization. If not treated promptly, a kidney infection can spread to the bloodstream, a life-threatening condition.
Cancer of the kidney is relatively rare. The leading cause of kidney cancer is smoking. Symptoms of kidney cancer may include a lump or mass in the abdomen, blood in the urine, pain in the side or lower back that does not go away, and recurring fever.
Take Care of Your Kidneys
As with other important parts of our bodies, we can help take care of the kidneys by eating healthy foods, getting enough exercise and drinking plenty of water. If you have a chronic health condition, such as diabetes or hypertension, it is especially important to work with your physician to manage those conditions and have your kidney health checked regularly.
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