By Moin Qazi
Kidneys, despite being the unsung organs of public health campaigns, do not get as much attention as the other major organs like our heart, liver, and lungs. While measures to take care of our hearts and lungs are public knowledge, warning signs of kidney damage are uncommon.
The horrors of kidney disease
Kidney disease is often silent and not on the medical radar until the kidneys are close to failing. It can only be picked up by a series of blood and urine tests. A person can lose up to 90% of his or her kidney function before experiencing any signs. It affects millions of people across the globe claiming a huge number of lives each year.
The initial malfunctioning disorder which marks the onset of kidney failure is known as focal segmental glomerulosclerosis (FSGS). It causes scarring in the kidneys’ tiny blood vessels that filter waste from the blood. Once these filters are scarred, they can’t be repaired. If the scarring becomes significant enough, the damage can lead to kidney failure, which means a lifetime of dialysis, a kidney transplant or even death.
Important facts about kidneys
They’re smaller than you think
Kidneys are shaped like beans about the size of a fist. They are located near the middle of the back, one on either side of the spine, just below our rib cage. Each kidney is connected to the bladder by a thin tube called a ureter. Though the kidneys weigh just 0.5% of the entire body weight, they receive more arterial blood compared to other organs in the body. Almost 25% of the blood pumped through the heart goes to the kidneys.
They do a great amount of work
The kidneys filter waste and extra water (fluid) out of our blood to make urine. Every day, about 30 gallons of blood is needed to remove about half a gallon of extra water and waste products. They contain 140 miles of tubes and more than a million filters. The waste products in our blood come from the food we eat and the use of our muscles. This waste and extra water make up the urine. Kidneys function even when they have lost 75-80 percent of their capacity to perform.
They play a key metabolic role
As the kidneys clean the blood, they simultaneously regulate the body’s fluid levels and keep blood minerals such as sodium, phosphorus and potassium in balance. Healthy kidneys also impact other functions in the body. They activate vitamin D to maintain healthy bones and release hormones that direct the production of red blood cells and regulate blood pressure.
You can live with one kidney
Some people are born with just one kidney; the single organ usually becomes slightly larger to compensate for its missing partner, and people with one kidney can be just as healthy as those with two. If only one kidney is present, it can adjust to filter as much as two kidneys would normally be able to do. If one functional kidney is missing from birth, the other can grow to reach a size similar to the combined weight of two kidneys.
Causes of kidney disease
The causes of loss of kidney function can include an infection such as HIV, toxicity caused by a drug, obesity and underlying diseases that affect the whole body, such as sickle cell anaemia, diabetes (types one and two) high blood pressure and lupus. There may also be a genetic component.
The correct lifestyle for healthy kidneys
Kidney disease can often be treated with lifestyle changes and medication to control blood pressure and lower blood cholesterol levels. Taking care of them by staying hydrated, eating a balanced diet that is low in salt-heavy and fatty foods, watching blood pressure, exercising at least 30 minutes a day, indulging in moderate drinking and avoiding smoking can go a long way in keeping kidney diseases at bay.
Obesity alone doubles a person’s risk of developing kidney disease; an unhealthy diet raises the risk even when weight and other lifestyle factors are taken into account. Adding bitter greens like dandelion and parsley in your diet can help keep things moving through your kidneys and the rest of your body.
Signs of a kidney disease
It’s important to know the symptoms of a kidney disease because it can be threatening to one’s overall health. Symptoms include puffy eyes, hands, and feet (oedema), fatigue, nausea and vomiting, thirst, persistently itchy skin, weight loss and a yellowish-brown tint to the skin. However, mild to moderate kidney disease may not have any obvious symptoms.
It is common at such times to be more tired, have less energy or trouble concentrating, experience high blood pressure or hypertension, shortness of breath, troubled sleep, frequent urination, bloody or frothy urine, poor appetite, and cramping muscles.
Treatment for kidney failure
With advanced chronic kidney disease (CKD), patients may require renal replacement therapy, such as dialysis or renal transplantation. There are two types of dialysis. In hemodialysis, the blood percolates through an artificial kidney (external machine). The alternative dialysis procedure is peritoneal dialysis which uses the inside lining of the abdomen (the peritoneum) as the filter, rather than a machine. Like the kidneys, the peritoneum contains thousands of tiny blood vessels, making it a useful filtering device.
The two techniques are equally effective for most people, but each has its own advantages and drawbacks. Haemodialysis has to be undertaken on alternate days but treatment sessions last longer and one may need to visit the hospital every time. Peritoneal dialysis can be done quite easily at home and can sometimes be done while you sleep, but it needs to be done every day.
The optimal treatment for the end-stage renal disease is renal transplantation in an otherwise healthy patient. The best option for a patient is a live donor transplant.
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