Kidneys play a key role in body function, not only by filtering the blood and getting rid of waste products, but also by balancing levels of electrolytes in the body, controlling blood pressure, and stimulating the production of red blood cells.
Kidneys are two bean-shaped organs, the size of your fists located near the middle of your back, just below the rib cage. They contain a million tiny structures called nephrons, which filter the blood removing waste products and extra water, which then becomes urine. The urine flows through ureters to your bladder, where it is stored until you go to the bathroom. Damage to the nephrons results in kidney disease. This hampers the removal of waste products from the blood. Damage occurs slowly over years and there are no specific symptoms as such for you to know it is happening.
Chronic diseases affect proper functioning of kidneys. Any problem in kidneys functioning at their optimal level is called kidney failure. Kidney failure is when dialysis or kidney transplant is required to maintain life. The infection could be mild or life threatening condition. Those with diabetes, high blood pressure and having a close family member with kidney disease are at a higher risk.
Kidney functions
Excretory functions
- Remove waste products, toxins, urea, and creatinine
- Remove drugs and drug metabolites
- Excrete acids from the body.
Regulatory functions
- Regulate body water
- Help maintain sodium and potassium balance
- Regulate calcium and phosphate balance
- Maintain acid balance.
Synthetic functions
- Produce erythropoietin [Epo] required for production of RBC’s by bone marrow
- Release hormones that regulates blood pressure
- Synthesis of active form of vitamin D that promotes strong and healthy bones.
Causes of kidney failure
Kidney failure can occur from an acute situation or from chronic problems.
In acute renal failure, kidney function is lost rapidly and can occur from a variety of reasons.
Type-II diabetes: Uncontrolled diabetes is a leading cause of kidney failure. Diabetics with a family history of Diabetic nephropathy and high BP are at an increased risk of renal failure.
High Blood Pressure [Hypertension]: It is the second common cause of kidney failure. Also remember that chronic kidney disease can lead to high BP.
Glomerulonephritis: This disease damages the filtering unit called glomeruli. Loss of protein, high BP, and blood in urine are important signals of this disease.
Kidney infections: Repeated infection of kidney can result in small and scarred kidney. This condition is called chronic pyelonephritis.
Hereditary diseases: Polycystic kidney disease and Alport’s disease cause deafness with renal failure.
Obstruction to urinary tract: Chronic obstruction by stones, prostatic enlargement, posterior urethral valve in male child, pelvic cancer like cervical cancer in females, back flow of urine from bladder to ureter and kidney [VUR] in children can also damage the kidneys.
Analgesic nephropathy: Use of over the counter medications can also cause renal failure, though this is not very common in India.
Lupus nephritis: Vasculitis, amylordosis, heavy metal exposure, reno-vascular hypertension are rare causes of chronic kidney disease.
Dos and don’ts to keep your kidneys healthy
These include everything from diet, exercise and other lifestyle factors. Prevention is better than cure.
General measures
Tips to improve kidney health:
- Eat a healthy diet
- Eat food that is fresh and low in salt, avoid fatty and refined foods
- Stop smoking
- Exercise regularly
- Check blood pressure regularly
- Avoid stress and strain.
Specific measures
If you are diabetic:
- Controlling diabetes will help preventing kidney disease.
- Checking urine proteins, lipid levels, and blood pressure regularly helps.
- Microalbuminuria is the earliest indication of kidney disease in diabetics.
- A low protein diet [consult your dietician, doctor] retards progression of microalbuminuria.
- Urinary protein reduction with angiotensin converting enzyme inhibitor ACEI/ARB retards progression of the kidney disease in diabetes.
- Control blood pressure. Target BP less than 130/90 mm of ig proteinuria should be < 125/75 of Hg. This prevents and retards progression of kidney disease.
- Prompt treatment of urinary tract infections.
For others:
- Every male and female child with recurrent urinary tract infection must be evaluated.
- Avoid excessive use of ‘over the counter’ pain killers, which may
damage your kidneys. - Avoid ayurvedic medications which contain heavy metals.
- Once you have kidney disease, a regular follow-up with nephrologists may help retard progression. An in case of advance condition help plan for renal replacement therapy.
Kidneys are vital organs that perform many functions to keep your blood clean and chemically balanced. So take good care of them.
Body signals that indicate kidney problem
An estimated one lakh Indians are affected by kidney disease and many more are at risk of developing it.
Consult your doctor in case you have:
- A burning sensation during urination or difficulty in urinating
- Have frequent urination, especially at night
- Have foamy, bloody or coffee colour urine
- Have swelling throughout the body, especially puffiness around the eyes or swelling of ankles or hands [particularly in children]
- Have lower back pain [just below the ribs in the small of the back] that is not affected by movement
- Have high blood pressure
- Feel listless.