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Understanding the Basics of Kidney Disease

By DuPage Medical Group Nephrology

What do your kidneys do?

Your kidneys filter blood and sift out waste product/extra water in the form of urine. This helps keep the electrolyte levels in your bloodstream normal. Your kidneys also release hormones that help maintain blood pressure, promote bone health and produce red blood cells.

What is renal failure?

Renal failure occurs when your kidneys stop functioning properly. This can lead to abnormal electrolyte levels, toxin build-up in your blood stream and fluid retention. There are two forms of renal failure: acute and chronic. Acute renal failure, or acute kidney injury (AKI), is often reversible. Chronic kidney disease (CKD) occurs when there has been damage to the kidneys resulting in dysfunction and/or urinary protein loss for more than 3 months. Chronic kidney disease cannot be reversed, but worsening kidney function can be delayed with treatment.

What are risk factors and causes of kidney injury?

Acute kidney injury can result from decreased blood flow to the kidneys due to dehydration, heart failure, liver failure, or direct damage from drugs (certain pain relieving medications, chemotherapy, recreational drugs, contrast dye, heavy metals, etc).

Infections, rheumatologic diseases, or a blockage of urine drainage due to an enlarged prostate, tumors, or kidney stones can also cause acute kidney injury. Acute kidney injury increases your risk of chronic kidney disease as well.

Diabetes and high blood pressure are the most common causes of chronic kidney disease. Some kidney diseases are hereditary.

What are kidney disease symptoms?

Patients with both forms of kidney disease are often asymptomatic. Very severe kidney damage can result in fatigue, sleep disturbances, anorexia, nausea, vomiting, intractable hiccups, itching, weight loss, tremors, shortness of breath, fluid build-up in the legs, abdomen and/or face, tea colored or foamy urine, and abnormal heart rhythms.

How is kidney disease diagnosed?

A blood test can be used to measure a chemical in the blood called creatinine. Creatinine is produced from the metabolism of creatine in muscle. Creatinine is normally filtered by the kidneys, but in acute and chronic kidney disease, creatinine builds up in the blood instead. Creatinine levels in conjunction with your age, gender, and race are used to estimate your glomerular filtration rate which helps your physician determine how well your kidneys are functioning.

A urine test can also be performed to look for protein loss in the urine. A specific protein in the blood called albumin should not be filtered into urine. If albumin spills into the urine, there is a problem with the filtering part of the kidney. Albuminuria is associated with a higher risk of kidney failure requiring renal replacement therapy, cardiovascular disease and stroke.

What treatments are available for kidney disease?

Treatment of acute kidney injury is generally geared towards addressing the underlying cause, and often requires hospitalization.

Chronic kidney disease can progress to end stage renal disease (ESRD) at which point the kidneys cannot keep up with the demands of toxin removal and fluid management. Dialysis and kidney transplantation are recommended treatments for end stage renal disease.

Progression to end stage renal disease can be delayed with medications such as ACE inhibitors, maintaining a normal blood pressure and treatment of diabetes. Following a balanced diet, engaging in moderate physical activity, tobacco cessation, treatment of high cholesterol levels and avoiding certain medications can also help slow disease progression.

What preventive measures can I take against kidney disease?

To prevent kidney disease follow a healthy lifestyle by exercising, eating a healthy diet and limiting your alcohol intake. Avoid tobacco and other recreational drugs. Pain-relieving medications such as ibuprofen and naproxen should be used with caution because prolonged and excessive use can cause various kidney problems. Be aware of your baseline creatinine level and family history and work with your doctor to manage any other medical conditions you may have.

Topics and Subtopics: Kidney Disease

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