Kidney Health and Kidney Disease Basics

 Kidney Health and Kidney Disease Basics

Kidney Disorders by Pharmacytimess

Kidney Health and Kidney Disease Basics

Kidneys are responsible for regulating pH, salt, potassium, and more. Various diseases, lifestyle habits, and genetic factors can affect kidney function.

Kidney Disease / Chronic Kidney Disease

Kidney disease means your kidneys aren’t working properly. Chronic kidney disease (CKD) means your kidney function slowly gets worse with time. High blood pressure and diabetes are two common causes of CKD. There is no cure for CKD, but you can take steps to preserve function for as long as possible. Late-stage kidney disease requires dialysis or a kidney transplant.

 Learn All about: Kidney Conditions

Having kidney disease means that there is damage to your kidneys and they aren’t working as well as they should. Kidney disease is called “chronic” because kidney function slowly gets worse over time. Kidney disease leads to kidney failure, which is also called end-stage kidney disease. At this point, you’ll need dialysis (artificial filtering) or a kidney transplant.

The kidneys are a pair of fist-sized organs located at the bottom of the rib cage. There is one kidney on each side of the spine.

Kidneys are essential to having a healthy body. They are mainly responsible for filtering waste products, excess water, and other impurities out of the blood. These toxins are stored in the bladder and then removed during urination.

The kidneys also regulate pH, salt, and potassium levels in the body. They produce hormones that regulate blood pressure and control the production of red blood cells. The kidneys even activate a form of vitamin D that helps the body absorb calcium.

It occurs when your kidneys become damaged and cannot perform their function. Damage may be caused by diabetes, high blood pressure, and various other long-term (chronic) conditions.

Kidney disease can lead to other health problems, including weak bones, nerve damage, and malnutrition.

If the disease gets worse over time, your kidneys may stop working completely. This means that dialysis will be required to perform the function of the kidneys. Dialysis is a treatment that filters and purifies the blood using a machine. It cannot cure kidney disease, but it can prolong your life.

Learn all about: Kidney conditions

Kidneys Function

You have two kidneys. They are bean-shaped organs that are located toward your back, on either side of your spine, just underneath the rib cage. Each kidney is about the size of your fist.

Your kidneys have many jobs, but their main job is to filter (clean) your blood, getting rid of toxins (wastes) and excess salt and water as urine. If your kidneys are damaged and don’t work as they should, wastes can build up in your blood and can make you sick. Your kidneys also balance the amount of salts and minerals in your body, make hormones that control blood pressure, make red blood cells and keep your bones strong.

 

 

 

 

Types and causes of kidney disease

1.  Chronic kidney disease

The most common form of kidney disease is chronic kidney disease. Chronic kidney disease is a long-term condition that does not improve over time. It’s commonly caused by high blood pressure.

High blood pressure is dangerous for the kidneys because it can increase the pressure on the glomeruli. Glomeruli are the tiny blood vessels in the kidneys where blood is cleaned. Over time, the increased pressure damages these vessels, and kidney function begins to decline.

Kidney function will eventually deteriorate to the point where the kidneys can no longer perform their job properly. In this case, a person would need to go on dialysis. Dialysis filters extra fluid and waste out of the blood. Dialysis can help treat kidney disease, but it cannot cure it.

A kidney transplant may be another treatment option depending on your circumstances.

Diabetes is also a major cause of chronic kidney disease. Diabetes is a group of diseases that causes high blood sugar. The increased level of sugar in the blood damages the blood vessels in the kidneys over time. This means the kidneys cannot clean the blood properly. Kidney failure can occur when your body becomes overloaded with toxins.

Stages of chronic kidney disease:

There are five stages of kidney disease. The stages are based on how well your kidneys are able to do their job – to filter out waste and extra fluid from your blood. The stages range from very mild (stage 1) to kidney failure (stage 5). Healthcare providers determine the stage of your kidney function according to the glomerular filtration rate (GFR). Your GFR is a number based on the amount of creatinine, a waste product, found in your blood, along with other factors including your age, race and gender.

Stages of Chronic Kidney Disease
Stage	GFR* (ml/min)	What it Means
Stage 1	90 and higher	Your kidneys are working well but you have signs of mild kidney damage.
Stage 2	60 to 89	Your kidneys are working well but you have more signs of mild kidney damage
Stage 3	30 to 59	Your kidneys aren’t working as well as they should and you have moderately decreased kidney function. This is the most common stage. You may notice symptoms at this stage.
Stage 4	15 to 29	You have poor kidney function; your kidneys are moderately to severely damaged.
Stage 5	Less than 15	Your kidneys are very close to failing or have failed. You need kidney dialysis or a kidney transplant.
*GFR = glomerular filtration rate

 

Risk factors for chronic kidney disease

Anyone can get chronic kidney disease. You are more at risk for chronic kidney disease if you:

• Have diabetes.
• Have high blood pressure.
• Have heart disease.
• Have a family history of kidney disease.
• Have abnormal kidney structure.
• Are African-American, Hispanic, Native American or Asian.
• Are over 60 years of age.
• Have a long history of taking painkillers, including over-the-counter products such as aspirin and ibuprofen.

2.  Kidney stones

Kidneystones are another common kidney problem. They occur when minerals and other substances in the blood crystallize in the kidneys, forming solid masses (stones). Kidney stones usually come out of the body during urination. Passing kidney stones can be extremely painful, but they rarely cause significant problems.

Learn more about: Kidney Stones

3.  Glomerulonephritis

Glomerulonephritis is an inflammation of the glomeruli. Glomeruli are extremely small structures inside the kidneys that filter the blood. Glomerulonephritis can be caused by infections, drugs, or disorders that occur during or shortly after birth (congenital abnormalities). It often gets better on its own.

Learn more about: Glomerulonephritis

4.  Polycystic kidney disease

Polycystickidney disease is a genetic disorder that causes numerous cysts (small sacs of fluid) to grow in the kidneys. These cysts can interfere with kidney function and cause kidney failure.

Learn more about: Polycystickidney disease

It’s important to note that 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 part of the urinary system. Infections in the bladder and urethra are the most common. They are easily treatable and rarely lead to more health problems. However, if left untreated, these infections can spread to the kidneys and cause kidney failure.

Learn more about: urinary tract infections

Causes of kidney disease

Kidney diseases happen when your kidneys are damaged and can’t filter your blood. The damage can happen quickly – when it’s caused by injury or toxins – or, more commonly, over months or years.

High blood pressure (hypertension) and diabetes are the two most common causes of chronic kidney disease. Other causes and conditions that affect kidney function and can cause chronic kidney disease include:

• Glomerulonephritis. This type of kidney disease involves damage to the glomeruli, which are the filtering units inside your kidneys.
• Polycystic kidney disease. This is a genetic disorder that causes many fluid-filled cysts to grow in your kidneys, reducing the ability of your kidneys to function.
• Hypertensive nephrosclerosis. Kidney damage caused by chronic hypertension.
• Membranous nephropathy. This is a disorder where your body’s immune system attacks the waste-filtering membranes in your kidney.
• Obstructions of the urinary tract from kidney stones, an enlarged prostate or cancer.
• Vesicourethral reflux. This is a condition in which urine flows backward – refluxes – back up the ureters to the kidneys
• Nephrotic syndrome. This is a collection of symptoms that indicate kidney damage.
• Recurrent kidney infection (pyelonephritis).
• Diabetes-related nephropathy. This is damage or dysfunction of one or more nerves, caused by diabetes, which typically results in numbness, tingling, muscle weakness and pain in the affected area.
• Lupus and other immune system diseases that cause kidney problems including polyarteritis nodosa, sarcoidosis, Goodpasture syndrome and Henoch-Schonlein purpura.

Symptoms of kidney disease

In the early stages of kidney disease, you usually don’t have noticeable symptoms. As the disease worsens, symptoms may include:

• A need to pee (urinate) more often.
• Tiredness, weakness, low energy level.
• Loss of appetite.
• Swelling of your hands, feet and ankles.
• Shortness of breath.
• Blood in your urine; foamy urine.
• Puffy eyes.
• Dry and itchy skin.
• Trouble concentrating.
• Trouble sleeping
• Numbness.
• Nausea or vomiting.
• Muscle cramps.
• High blood pressure.
• Darkening of your skin.

Complications of chronic kidney disease

If your kidneys aren’t working properly, the rest of your body isn’t either. Some of the complications of chronic kidney disease include:

• Low red blood cell count (anemia).
• Weak and brittle bones.
• Gout.
• Metabolic acidosis. This is a chemical imbalance (acid-base) in your blood caused by decrease in kidney function.
• High blood pressure.
• Heart disease, including increased risk of stroke and heart attack.
• High potassium (hyperkalemia), which affects your heart’s ability to function correctly.
• High phosphorus (hyperphosphatemia).
• Fluid buildup, leading to swelling in feet, ankles and hands; fluid in your lungs.
• Erectile dysfunction, fertility problems.
• Decreased immune response, increasing your risk of infection.

How is kidney disease diagnosed?

Your doctor will first determine whether you are at a higher risk of developing kidney disease. They will then run some tests to see if your kidneys are functioning properly. These tests may include:

1.  Glomerular filtration rate (GFR)

This test will measure how well your kidneys are working and determine the stage of kidney disease.

2.  Ultrasound or computed tomography (CT) Scan

Ultrasounds and CT scans produce clear images of your kidneys and urinary tract. The pictures allow your doctor to see if your kidneys are too small or large. They can also show any tumors or structural problems that may be present.

3.  Kidney biopsy

During a kidney biopsy, your doctor will remove a small piece of tissue from your kidney while you’re sedated. The tissue sample can help your doctor determine the type of kidney disease you have and how much damage has occurred.

4.   Urine test

Your doctor may request a urine sample to test for albumin. Albumin is a protein that can be passed into your urine when your kidneys are damaged.

5.   Blood creatinine test

Creatinine is a waste product. It’s released into the blood when creatine (a molecule stored in muscle) is broken down. The levels of creatinine in your blood will increase if your kidneys aren’t working properly.

 

Treatment of Kidney Diseases:

Treatment for kidney disease usually focuses on controlling the underlying cause of the disease. This means your doctor will help you better manage your blood pressure, blood sugar, and cholesterol levels. They may use one or more of the following methods to treat kidney disease.

Drugs and medication

Your doctor will either prescribe angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril and ramipril, or angiotensin receptor blockers (ARBs), such as irbesartan and olmesartan. These are blood pressure medications that can slow the progression of kidney disease.

Your doctor may prescribe these medications to preserve kidney function, even if you don’t have high blood pressure.

You may also be treated with cholesterol drugs (such as simvastatin). These medications can reduce blood cholesterol levels and help maintain kidney health. Depending on your symptoms, your doctor may also prescribe drugs to relieve swelling and treat anemia (decrease in the number of red blood cells).

Dietary and lifestyle changes

Making changes to your diet is just as important as taking medication. Adopting a lifestyle with health-promoting benefits can help prevent many of the underlying causes of kidney disease. Your doctor may recommend that you:

• manage diabetes through insulin injections
• limit foods high in cholesterol
• reduce salt intake
• eat a heart-healthy diet that includes fresh fruits, veggies, whole grains, and low fat dairy products
• limit alcohol consumption
• quit smoking if you smoke
• stay as physically active as possible
• maintain a moderate weight

Dialysis and kidney disease

Dialysis is an artificial method of filtering the blood. It’s used when the kidneys have failed or are close to failing. Many people with late-stage kidney disease must go on dialysis permanently or until a donor kidney is found.

There are two types of dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis

In hemodialysis, the blood is pumped through a special machine that filters out waste products and fluid. Hemodialysis is done at your home or in a hospital or dialysis center. Most people have three sessions per week, with each session lasting 3 to 5 hours. However, hemodialysis can also be done in shorter, more frequent sessions.

Several weeks before starting hemodialysis, most people will have surgery to create an arteriovenous (AV) fistula. An AV fistula is created by connecting an artery and a vein just below the skin, typically in the forearm. The larger blood vessel allows an increased amount of blood to flow continuously through the body during hemodialysis treatment.

This means more blood can be filtered and purified. An arteriovenous graft (a looped, plastic tube) may be implanted and used for the same purpose if an artery and vein cannot be joined together.

The most common side effects of hemodialysis are low blood pressure, muscle cramping, and itching.

Peritoneal dialysis

In peritoneal dialysis, the peritoneum (membrane that lines the abdominal wall) stands in for the kidneys. A tube is implanted and used to fill the abdomen with a fluid called dialysate. Waste products in the blood flow from the peritoneum into the dialysate. The dialysate is then drained from the abdomen.

There are two forms of peritoneal dialysis: continuous ambulatory peritoneal dialysis, where the abdomen is filled and drained several times during the day, and continuous cycler-assisted peritoneal dialysis, which uses a machine to cycle the fluid in and out of the abdomen at night while the person sleeps.

The most common side effects of peritoneal dialysis are infections in the abdominal cavity or in the area where the tube was implanted. Other side effects may include weight gain and hernias. A hernia is when the intestine pushes through a weak spot or tear in the lower abdominal wall.

What is the long-term outlook for someone with kidney disease?

Kidney disease normally does not go away once it’s diagnosed. The best way to maintain kidney health is to adopt a lifestyle with health-promoting benefits and follow your doctor’s advice. Kidney disease can get worse over time. It may even lead to kidney failure. Kidney failure can be life threatening if left untreated.

Kidney failure occurs when your kidneys are barely working or not working at all. Dialysis is an artificial process to manage the function of the kidneys. Dialysis involves the use of a machine to filter waste from your blood. In some cases, your doctor may recommend a kidney transplant.

How can kidney disease be prevented?

Some non-modifiable risk factors for kidney disease — such as age or family history — cannot be controlled. Also, you cannot control ethnicity, which research shows can be an indicator that you’re at higher risk of developing kidney disease.

However, there are measures you can take to help prevent kidney disease:

• drink plenty of water
• manage your blood sugar if you have diabetes
• manage your blood pressure
• reduce salt intake
• quit smoking if you smoke

Be careful with over-the-counter drugs

You should always follow the dosage instructions for over-the-counter medications. Taking too much aspirin (Bayer) or ibuprofen (Advil, Motrin) can cause kidney damage. Call your doctor if the normal doses of these medications are not managing your pain effectively.

Get tested

Ask your doctor about getting a blood test for kidney problems. Kidney problems generally don’t cause symptoms until they’re more advanced. A basic metabolic panel (BMP) is a standard blood test that can be done as part of a routine medical exam.

It checks your blood for creatinine or urea. These are chemicals that leak into the blood when the kidneys are not working properly. A BMP can detect kidney problems early, which is when they’re easier to treat.

You should be tested annually if you have:

• diabetes
• heart disease
• high blood pressure

Limit certain foods

Different chemicals in your food can contribute to certain types of kidney stones. These include:

• excessive sodium
• animal protein, such as beef and chicken
• citric acid, found in citrus fruits such as oranges, lemons, and grapefruits
• oxalate, a chemical found in beets, spinach, sweet potatoes, and chocolate

Ask about calcium

Talk with your doctor before taking a calcium supplement. Some calcium supplements have been linked to an increased risk of kidney stones.

 Learn all about: Kidney Conditions