What is kidney?

Kidneys are small bean-shaped organs located behind the belly and under the ribs. There are two kidneys, one on either side of the spine. The size of each kidney varies from 4 to 5 inches, roughly the size of a fist.

What Does The Kidney Function Perform?

The kidneys consist of many small filters called nephrons, and their purpose is to purify the blood by extracting waste out of the blood, and the waste is converted into urine. This urine accumulates in the kidney's pelvis and then passes through a tube called the ureter and the bladder. This helps balance body fluids and levels of electrolytes. This process continues several times a day. Kidneys are vital organs that help maintain healthy salt, pH, phosphorus and potassium levels. They also generate enzymes called renin, which adjusts blood pressure levels. It monitors the production of red blood cells by making a chemical called erythropoietin, which helps absorb calcium for healthy bones and teeth.

Once the kidney is damaged, blood filtering is halted, leading to fluid and waste accumulation in the body. This shows poor sleep, nausea, shortness of breath, weakness, and ankle swelling. Kidney damage needs to be treated to prevent further damage. If ignored, it can lead to serious health issues and even death.

Types of Kidney Disease And Problems

Chronic Kidney Disease- This is the most common type of kidney disease. Chronic kidney disease is called chronic kidney disease when the kidneys stop functioning for a longer period, like three months or more. It is generally caused due to high blood pressure in the body. Maintaining blood pressure levels in the body is very important, as increased blood pressure damages glomeruli in the kidneys, which leads to kidney failure. The tiny blood vessels that clean blood in the kidneys are called glomeruli. Chronic kidney disease can also be caused due to diabetes. High sugar levels cause severe damage to blood vessels in the kidneys. Once the condition is diagnosed, the patient is advised to undergo dialysis. Dialysis is a process that helps in extracting extra waste and fluids from the blood. This process can help kidneys perform better but cannot cure the disease.

Kidney Stones- Kidney stones are formed due to the crystallisation of minerals and other substances absorbed from the blood. When they are tiny, kidney stones are discarded from the kidneys through urination. However, the condition worsens and becomes difficult to pass, through urine when the stones grow big. This causes severe pain and needs medical attention to cure. This disease is curable and does not cause significant health hazards.

Glomerulonephritis - It is a condition caused by the swelling of tiny blood vessels in the kidneys called glomeruli. Glomeruli filter blood that passes through the kidneys. Glomerulonephritis can be caused by allergies, drugs, infections, or a disorder that occurs shortly after birth. It does not need treatment and heals on its own.

Polycystic kidney disease- Polycystic kidney disease is the growth of many small cysts filled with fluids in the kidney. It is usually a genetic disorder passed on from ancestors. These cysts interrupt kidney function, leading to kidney failure. This is a serious issue and needs medical attention. Individual cysts are also formed in kidneys, but these are very common and non-hazardous compared to polycystic.

Urinary tract infections- These infections caused by the urinary system are also known as UTIs. Most often, urinary tract infections begin in the bladder and urethra. They are very common and can be cured easily; however, if left untreated, they can cause serious health issues and kidney failure.

Signs and Symptoms of Kidney Disease

Kidney diseases show no symptoms in the beginning stages; they only become evident in the final stages. Some of the most common symptoms of kidney diseases are-

Pressure and pain in the chest.
Poor sleep
Difficulty in breathing
Dry and scaly skin
Frequent urination at night
Swelling around the eyes
Loss of appetite
Swollen ankles and feet
Muscle cramping
Insufficient sleep
Tiredness
Poor Concentration

Once the condition gets severe, other symptoms develop, such as

Changes in urine output
Decreased sex drive
Hike in potassium levels: this condition is called hyperkalemia
Anaemia
Fluid retention
Vomiting and nausea
Swelling in the fluid sac that covers the heart called pericardium.

Risk Factors for Kidney Disease

Diabetes- The increased sugar level in the body damages blood vessels and filters in the kidneys that purify the blood. This leads to more blood and water retention in the body and accumulates more waste. This causes nerve damage and blocks urine from passing out, which leads to kidney failure.

High Blood Pressure - Increased blood pressure causes severe damage to blood vessels in the entire body. Increased blood flow weakens and scars the blood vessels in the kidneys, stopping them from discarding waste from the blood. The accumulation of extra fluids, in turn, raises blood pressure levels, causing severe damage to the kidneys. High blood pressure can be treated through medicines and lifestyle changes like diet, exercise and stress.

Lupus - It is a condition that allows the immune system to attack a few parts of the body, including the kidneys. The condition affecting the kidneys is called lupus nephritis. It causes severe damage to blood vessels in the kidneys by scarring and swelling them. Lupus can be cured through medications to correct the immune system and blood pressure levels.

Anorexia Nervosa - This condition is found in people who are anaemic and those who weigh 15% less than their ideal body weight. It is caused by a lack of salt and water in the body, which leads to severe damage and kidney failure.

Multiple Myeloma- In numerous myeloma, excessive production of white blood cells in the bone marrow overshadows healthy blood cells. These cancer cells produce abnormal proteins that affect the kidneys and cause kidney failure.

Hemolytic Uremic Syndrome- This condition is caused by the accumulation of red blood cells in the kidney's filtering system, leading to kidney failure. The most common symptom of Hemolytic Uremic Syndrome is continuous diarrhoea for 4 to 5 days. Seek medical help if you are feeling tired and unable to pass urine with continuous diarrhoea for several days. If diagnosed earlier, this condition can be cured with medication.

ANCA Vasculitis- This kidney problem is caused when the body's antibodies, which fight germs, are attacked by the small blood vessels of kidneys and other organs. This allows the blood and proteins to mix up with urine and leads to kidney failure. The condition can be identified with specific symptoms, such as joint and muscle pain, high fever, body aches, and brown or tea-coloured urine.

Urine Blockage- When you have difficulty passing urine, this could mean the urine is blocked. Blocking of urine can cause several kidney disorders by increasing pressure and infection in the kidneys. This condition could also occur due to other underlying diseases such as kidney stones, prostate cancer, colon cancer, bladder cancer, blood clots in the urinary tract, etc. It needs medical attention and can be cured with medication if diagnosed earlier in certain conditions.

Blood Clots- Blood clots in the kidney caused by a blood disorder called thrombotic thrombocytopenic purpura can lead to severe kidney damage. The heart and brain are also affected. Not treated as soon as possible can lead to serious health issues. Some of the usual symptoms of this disease are bleeding from the nose and gums, fever, tiredness, nausea, severe headache, chest pain, bruising, and diarrhoea.

Scleroderma- This disease, which is rarely found, affects the blood vessels and connective tissues. It hardens and tightens the blood vessels and connective tissues, which affects the kidneys by leaking proteins into the urine. This increases blood pressure levels and leads to rapid kidney failure.

Polycystic Kidney Disease- Polycystic kidney disease is a genetic condition that causes several small lumps filled with fluid in the kidneys. It can lead to kidney swelling. If not treated at the earliest, it could lead to severe kidney damage and eventually kidney failure.

How To Keep Your Kidneys Healthy

A healthy kidney can be maintained by leading a healthy lifestyle. Following a healthy diet and leading a stress-free life can improve the function of the kidneys. Here are a few tips to keep your kidneys healthy-

Avoid food which increases cholesterol levels
Keep blood sugar levels under control and take proper medication to control them if affected by diabetes.
Reduce the intake of salt.
Eat a balanced diet that includes fresh fruits and vegetables, low-dairy products and whole grains.
Quit smoking
Exercise regularly
Do not overdrink. Keep alcohol consumption under control.
Reduce weight if you are suffering from obesity.

Diagnosis of Kidney Disease : Essential Tests

As soon as you see the signs and symptoms of kidney problems, you need to consult a doctor. The doctor will then run a series of tests to diagnose the problem further. Here are a few important procedures for diagnosing kidney disease.

Glomerular filtration rate (GFR) - This test is done to monitor the kidney's filtration rate and its functions to determine the stage of the disease.
Urine analysis: The urine sample is observed under a microscope for bacterial infections, bleeding and other signs of kidney problems.
Kidney Ultrasound- Ultrasound of kidneys gives clear images of the kidneys with the help of a probe placed on the skin to create images of the kidney with the help of sound waves. These images show kidney damage, such as blockage of urine and the appearance of stones and cysts.
Computed tomography (CT) scan- A CT scan uses an X-ray to take sectional pictures of the organs, giving precise details of the kidney problem.
Kidney biopsy- In this procedure, a small piece of tissue is extracted from the diseased kidney. The sample obtained is further studied under a microscope to determine the severity of the issue. This procedure is followed after you are sedated with local anaesthesia.
Magnetic resonance imaging (MRI) scan- High-resolution kidney images are captured through a scanner emitting radio waves in a magnetic field. This helps the doctor diagnose the problem with great clarity.
Blood creatinine test -A blood analysis is done to check the creatinine level in the blood. Creatine is a waste product of molecules present in the muscles called creatine. The increased creatinine level in the blood helps diagnose the issue's severity.

Treatment of kidney diseases

Most often, kidney diseases are caused by another underlying issue such as diabetes, cholesterol or high blood pressure levels. Kidney diseases are easy to cure when diagnosed earlier, and the survival rate is high. Doctors provide treatments depending on the severity of the disease. This means that not all kidney disease patients will undergo the same treatment. Some of the effective treatment methods for kidney problems are -

Antibiotics - Depending on the results of your blood and urine test your doctor will prescribe antibiotics to fight against bacteria. It is called antibiotic therapy.
Nephrostomy -This procedure drains out the urine blocked in the kidneys, and further relevant treatment is provided to clear the blockage. A catheter is passed through the skin to reach the kidneys.
Lithotripsy- A machine performs this procedure by projecting ultrasound shock waves that pass through the body to break large kidney stones into small pieces. These small pieces can easily pass through urine later.
Nephrectomy- This is a surgery performed in patients who have kidney cancer and other severe kidney problems. The damaged kidney is removed completely during this surgery.
Dialysis- It is a method followed to purify the blood with the help of machines. This procedure is done when the kidneys are close to failing or damaged completely. It is a repetitive process that should be done once a few days or weeks. This process is done until you find a donor. There are two types of dialysis-
Hemodialysis - In this type, the impure blood from your body is pumped into a machine that helps extract all the impurities and passes the pure blood back to the body. This procedure can be done at home or in a hospital according to your convenience. The procedure is repeated thrice a week. Some common side effects of this dialysis are muscle cramping, low blood pressure and itching.
Peritoneal dialysis- This procedure involves passing a large amount of fluid called dialysate into the abdomen through a catheter. Waste products are passed from the kidneys through the peritoneum (a membrane that covers the abdominal wall ) to reach the fluid in the abdomen. Once the fluid collects all the waste products, it is later extracted out of the abdomen and discarded.
Kidney transplant- This procedure is done when both kidneys fail. Transplantation can bring life back to normal. It involves obtaining a healthy kidney from a living or deceased organ donor.

Understanding Kidney Failure

Kidney failure occurs when the kidneys cannot filter impurities from the blood. This is often caused by an underlying reason like -

Exposure to toxic chemicals and medications
Severe dehydration
Acute and chronic diseases like diabetes, high blood pressure, cancer, etc
Kidney trauma
Kidney failure is classified into five types which are-

Acute intrinsic kidney failure - A condition that damages the kidneys directly through trauma such as an injury or an accident is called acute intrinsic kidney failure. This trauma raises the level of toxins and ischemia in kidneys and reduces the flow of oxygen in them, leading to kidney damage.

Acute prerenal kidney failure- Acute prerenal kidney failure occurs when the kidneys lack sufficient blood flow. Kidneys require adequate blood flow to remove toxins from the blood. Blood flow can be obstructed due to several other underlying diseases which will show up during diagnosis.

Chronic prerenal kidney failure- When the kidneys do not receive a blood supply for a long time, they begin to shrink and stop functioning.

Chronic intrinsic kidney failure occurs when kidneys are affected for a more extended period due to intrinsic kidney disease. It leads to a lack of oxygen and severe bleeding in the kidneys.

Chronic post-renal kidney failure- When urine is blocked for a long term in the kidneys, it raises pressure levels in the kidneys to cause kidney failure.

Stages And Prognosis

There are five stages of kidney failure. The symptoms and severity of the disease get complicated at the later stages.

Stage 1- At this stage, the condition is not severe, and symptoms are not visible. Recovery from damage is very easy by making healthy lifestyle changes.
Stage 2 - The condition is still mild, with very little or no symptoms. This condition is mainly diagnosed during a urine test where an increase in protein level is identified in urine. The disease is curable by bringing healthy lifestyle changes and consulting a doctor for medications.
Stage 3- At this stage, 50% of the kidney is damaged, and evident symptoms can be seen. This condition can be treated by medication to prevent further damage, and you will be advised to make some healthy lifestyle changes.
Stage 4- At this stage, kidney failure is severe but hasn't stopped working altogether. This condition needs immediate medical attention and treatments to slow down the damage. The condition is difficult to reverse at this stage.
Stage 5 - Kidneys are close to failure or stop working entirely. The survival rate at this stage is challenging unless there is a kidney transplant. Patients at this stage undergo dialysis regularly to survive.

KIDNEY HEALTH FAQS: ALL YOUR CONCERNS ADDRESSED

Q1. How long can I live with chronic kidney disease (CKD)?
A1. Living with CKD depends on your age, other health problems, and how involved you become in your care. Most people with early CKD will never have kidney failure. Others will have kidney failure and may live for decades with dialysis or kidney transplants. The survival rate for kidney diseases depends on treatment methods and healthy lifestyle habits.

Q2. How does diet affect kidney function?
A2. One way to preserve your kidney function is to modify your diet. Proper nutrition can reduce the kidneys' workload and prevent or delay the further progression of your kidney disease. A renal dietitian can help you make good choices with the foods you usually eat, suggesting foods to add and foods to moderate. The dietitian is an integral part of your healthcare team and can assist you in living well with chronic kidney disease.

Q3. Can I still have a good life if I need dialysis?
A3. Yes, you can live long and live well with dialysis. It is often observed that people who are very sick before they start dialysis feel much better a few weeks or months later. Feel free to consult a doctor to clear all your doubts about kidney dialysis.

Q4. What are the first signs of Kidney Disease?
A4. A few early signs that you might have kidney disease:

Fatigue
Poor appetite
Chills (Even if the weather is warm)
Shortness of breath
Dry and itchy skin
Trouble thinking clearly or concentrating
Swelling of ankles, legs and hands
Ammonia breath
Urge to urinate more often
Bloody or foamy urine
Persistent puffiness of eyes
Muscle twitching or cramping

Q5. What Causes Chronic Kidney Disease?
A5. CKD typically develops over a long period. It often develops due to underlying health conditions that can affect the kidneys. Causes of CKD include:

Diabetes: When blood sugar is too high for a long time, it damages many body organs, including the kidneys, heart, blood vessels, nerves, and eyes.
High blood pressure: High BP or Hypertension, if poorly controlled for long, can be a leading cause of strokes, heart attacks and chronic kidney disease.
Glomerulonephritis : It is a group of diseases that cause inflammation and damage to the kidney's filtering units.
Polycystic kidney disease : It is a genetic condition that causes large cysts to form in the kidney and damage the surrounding tissue.

Q6. Does Chronic Kidney Disease (CKD) always lead to kidney failure?
A6. Chronic kidney disease damages the kidneys, reducing their ability to perform kidney functions. If not treated properly, waste can build up to high levels in the blood and make you feel sick. When CKD progresses, if not treated medically, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life. Also, it increases the risk of having heart and blood vessel disease.

Q7. What are the five stages of chronic kidney disease (CKD)?
A7. Estimated Glomerular Filtration Rate or eGFR is based on your blood test for creatinine, a waste product in your blood. It indicates how well your kidneys are working. The stages of kidney disease are based on the eGFR number.

Stage 1 CKD: eGFR 90 or greater, which means your kidneys are healthy and working well
Stage 2 CKD: eGFR Between 60 and 89 indicates you have mild kidney damage
Stage 3 CKD: eGFR Between 30 and 59 means that there is some damage to your kidneys, and they are not working as well as they should.
Stage 4 CKD: eGFR Between 15 and 29 means your kidneys are moderately or severely damaged. This stage should be taken very seriously.
Stage 5 CKD: An eGFR of less than 15 means the kidneys are getting very close to or completely failing.

Q8. What should I do to maintain a good GFR?
A8. GFR is an equation that uses your age, race, gender, and the creatinine level in your blood to determine how well your kidneys are working. If your eGFR is less than 60, talk to your doctor soon! At this stage, proper medication and a few healthy tips for a better lifestyle can help you win the battle of Kidney Disease. You can take the following steps to keep your kidneys as healthy as possible:

Maintain a healthy blood pressure
Control your blood sugar level if you are diabetic
Improve your heart and lung health
Follow a low-fat, low-salt diet
Do 30 minutes of exercise (at least five days a week)
Keep a healthy weight
Do not smoke or use tobacco
Talk to your doctor about medicines that might help protect your kidneys