MARCH 1, 2015
Most people probably don’t think about their kidneys too often. To the extent we think about the health of organs in our body, we’re probably thinking about our heart, lungs and digestive system. Even though our kidneys are an integral part of the functioning of the human body, we may not think much about them – unless and until something goes wrong. March is National Kidney Month, a time to focus on kidney health and understand the causes and treatments for chronic kidney disease.
The kidneys perform a vital function for our bodies – they filter and clean our blood. As blood circulates throughout our body, it picks up excess water and waste. The kidneys filter out these waste fluids, converting them to urine and sending them to the bladder. The cleaned blood comes out of the kidney and recirculates through our body. In the course of a day, our kidneys filter between 120 and 150 quarts of blood and produce 1-2 quarts of urine.
Chronic kidney disease occurs when the kidneys become damaged – generally over a period of many years – and are no longer able to filter the blood normally. Kidney disease can lead to excess waste and fluid in the body, anemia (due to a lower red blood cell count) or even brittle bones.
Physicians use a measure called the glomerular filtration rate (GFR) to measure how well the kidneys are filtering the blood. A normal GFR value ranges from 90-120. A patient with a GFR value of 15 or less is in kidney failure (also known as acute renal failure), often necessitating a kidney transplant or dialysis.
Causes of Kidney Disease
The overwhelming majority of kidney disease occurrences are caused by either diabetes or high blood pressure. In addition, family history, heart disease and obesity can all contribute to developing kidney disease. African Americans and Hispanics have a greater incidence of chronic kidney disease, possibly due to the higher incidence of diabetes and hypertension in these populations.
Kidney disease does not cause noticeable symptoms until the disease is quite advanced; therefore, people who suffer from diabetes or hypertension should be screened for kidney disease. Diabetics who can keep their glucose levels within target ranges (as prescribed by their physician) and patients with hypertension who keep their blood pressure within target ranges (also as prescribed by their physician) can lower their chances of developing chronic kidney disease.
“Kidney disease is often a reflection of the overall health of a patient,” says Thomas Rajan, M.D., a Texas Health Care nephrologist. “When we’re treating kidney disease, we try to figure out what the underlying health factors are that are causing the kidney problems and address those in an effort to improve the patient’s overall health and well-being.”
Whether you are at risk or not, everyone can help keep their kidneys healthy by avoiding excess sodium, eating fruits and vegetables, keeping blood pressure and cholesterol levels in the appropriate range and getting plenty of exercise.
Treating Chronic Kidney Disease
Physicians use blood tests and urine tests to screen for kidney disease. Many patients who are diagnosed with chronic kidney disease can maintain an active professional and personal life with some key lifestyle adjustments which slow the progression of the disease. These most commonly include:
- Keeping blood pressure at recommended levels
- Limiting sodium intake
- Maintaining healthy cholesterol levels
- Keeping blood sugars at recommended levels
- Eating fresh and healthy foods (your physician may have you work with a dietician)
- Staying physically active
For patients whose kidney disease has progressed into kidney failure, dialysis or a kidney transplant are the most common treatments. Dialysis is a process in which water and waste is filtered from the patient’s blood since their kidneys are no longer able to do the job. There are two types of dialysis treatment:
Hemodialysis: in this process, blood is filtered through a machine outside the body. A needle is inserted into the arm to remove the blood and after it has filtered through a dialyzer which removes waste, it 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 which serves to filter waste from the blood, which is then drained from the body. This form of dialysis is done at home and often when the patient is sleeping at night.
According to Carlos Bahrami, D.O. a Texas Health Care nephrologist, “I view dialysis as a bridge to help carry the patient to kidney transplant which is the safest approach to renal failure. Many patients are reluctant to start dialysis because it may sound painful or difficult, however, most dialysis patients realize the benefits of this process after they have started it.”
A kidney transplantation is another approach to treating kidney failure for some patients. In this procedure, a healthy kidney is transplanted from a donor into the patient with kidney failure. For kidney transplants, the organ donor may be a deceased individual or a friend or relative who is living and agrees to donate a kidney (people can live normally with just one kidney).
Often times, people wait years for a kidney transplant and will need to undergo dialysis treatment while they are on a 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.
Patients with chronic kidney disease can live long and full lives by working closely with their physician and following their treatment plans. Even for patients with kidney failure, there are proven treatments which extend lives while allowing the patient to continue to engage in a variety of activities.
Other Kidney Issues
People can also develop kidney problems unrelated to chronic kidney disease:
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. Kidney stones are quite painful but are usually eventually 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 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.
This article contains information sourced from:
National Kidney Disease Education Program, a project of the National Institutes of Health and the U.S. Department of Health and Human Services