Your Kidneys and Your Health: Kidney Function and Chronic Kidney Disease

What Do Your Kidneys Do?

Two bean-shaped organs on either side of your spine, about midway down your torso – your kidneys are amazingly multi-functional. They clean waste products from the blood, maintain blood pressure at proper levels, prompt the production of red blood cells, and keep the body’s electrolyte levels balanced.

They are closely linked to the heart. Blood comes to them through the renal (from the Latin for kidney) arteries straight from the aorta, the biggest artery, which extends along the body’s central axis. The kidneys’ de-oxygenated blood travels back to the heart through the renal veins and the biggest vein, the vena cava.

It’s the kidneys’ sensors that determine how much water is extracted from the blood for elimination in the form of urine, and what the urine’s electrolyte concentration level should be. The kidneys are very sensitive to changing conditions in the body. For instance, dehydration from any cause – heavy exercise, illness, environmental conditions – will prompt the kidneys to retain water, so urine becomes  darker and more concentrated. Higher levels of water will cause the kidneys to remove the excess, as light-colored, diluted urine. The controlling factor is the hormone renin, produced by the kidneys and a vital part of the overall bodily system that controls fluids and blood pressure.

The excess water and waste products filtered from the blood by the kidneys flow from them as urine through two thin tubes (ureters) to the bladder, where it collects before being expelled from the body.

Another vital kidney function is the creation of a hormone called erythropoietin, which prompts the bone marrow to produce red blood cells, the oxygen-transporters of the body. Again, the kidneys have special “monitor” cells that keep track of the bloodstream’s oxygen level. Should the level be too low, the kidneys release erythropoietin to signal the bone marrow to produce more red cells.

Chronic Kidney Disease (CKD) – What are the facts?

  • CKD affects approximately 26 million Americans, with millions more at increased risk.
  • High risk factors include: high blood pressure, diabetes, a family history of kidney disease. Several population groups have a higher than average CKD risk: Hispanics, African Americans, Native Americans, Pacific Islanders, and the elderly.
  • Hypertension (high blood pressure) is a cause of CKD. The reverse is also true: CKD can bring on hypertension. The major cause of death for those with CKD is heart disease.
  • CKD is shown by the persistent presence of protein in the urine (proteinuria).
  • The best way to estimate how well the kidneys are functioning is through the glomerular filtration rate (GFR).
  • Early detection is important in keeping CKD from progressing to the point of kidney failure.
  • CKD can be detected by performing three simple tests: urine albumin, serum creatinine, and blood pressure.

Kidney Function And Overall Health

Besides their all-important waste removal functions, your kidneys:

  • Maintain levels of water and necessary elements like potassium, sodium, calcium, and phosphorus in the body
  • Filter out toxins and drugs
  • Keep blood pressure at healthy levels
  • Produce hormones that
    – maintain blood pressure
    – cause the creation of red blood cells
    – maintain bone strength

Chronic Kidney Disease (CKD) Explained

Chronic kidney disease is a general term covering several conditions that cause kidney damage. A damaged kidney is less able to fulfill all the health maintenance tasks discussed above. If the conditions worsens, waste products can accumulate in the blood to dangerous levels. There can be complications: anemia or low red blood-cell count; hypertension; nerve damage; weakened bones; poor ability to absorb nutrients from food.

CKD also contributes to the risk of cardiovascular disease.

The complex of CKD-related effects may come on gradually and slowly over the course of years. Diabetes and hypertension, among other diseases, can bring on CKD.

Early detection and treatment are extremely important; often early treatment can stop CKD in its tracks. But if allowed to progress, CKD can lead to complete failure of the kidneys, meaning that either continuing dialysis or a transplant is needed to save the patient’s life.

Causes of Chronic Kidney Disease

The two most frequent causes are diabetes and high blood pressure. These conditions bring on about two-thirds of CKD. The excessive blood sugar levels of diabetes damage organs and tissues all throughout the body, including the kidneys. With high blood pressure, general physical damage to the blood vessels occurs, also throughout the body. When not properly controlled, high blood pressure puts the patient at severe risk for strokes, heart attacks, and CKD. And, as noted above, CKD itself can lead to high blood pressure.

Some other conditions that impact the kidneys include:

  • Glomerulonephritis, the name for several inflammatory diseases that cause damage to the filtering tissues within the kidneys; they rank third after diabetes and hypertension as causes of CKD.
  • Inherited conditions like polycystic kidney disease, in which the kidneys are affected by the development of large cysts.
  • Abnormalities in the formation of the kidneys during fetal development, such as narrowing of the ducts that allow urine to pass out of the kidney.
  • Lupus and other immune system diseases
  • Kidney stones, prostate enlargement, tumors, etc. that cause obstructions.
  • Recurring urinary infections.

Symptoms of  Chronic Kidney Disease

One of the difficulties with CKD is that you usually don’t have severe symptoms until the condition is at an advanced stage. However, you should be on the alert for:

  • Low energy and fatigue
  • Problems with concentration
  • Reduced appetite
  • Insomnia
  • Nighttime muscle cramping
  • Puffiness around the eyes, particularly in the morning
  • Swelling of ankles and feet
  • Itchy, dry skin
  • Increased need to urinate, especially at night

Chronic Kidney Disease – A Common Illness?

Some facts about the incidence of CKD in the United States:

  • The Centers for Disease Control (CDC) report that 16.8 percent of adults (i.e., over 20 years of age) in the US have chronic kidney disease. That comes to one in six American adults – obviously a growing health problem. The percentages of the overall adult population with the different disease stages are:
    – stage 1: 3.1%
    – stage 2: 4.1%
    – stage 3: 7.6%
    – stages 4 and 5: 0.5%
  • Over 500,000 people are either receiving kidney dialysis or have had kidney transplants.
  • CKD rates have risen by 16% compared to rates in the previous decade. The contributing factors are the increasing occurence of hypertension, obesity, diabetes mellitus, and the general aging of the population.

 

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