The kidneys are a pair of bean-shaped organs on either side of your spine, below your ribs and behind your belly. Each kidney is about 4 or 5 inches long, roughly the size of a large fist.
The kidneys’ job is to filter your blood. They remove wastes, control the body’s fluid balance, and keep the right levels of electrolytes. All of the blood in your body passes through them several times a day.
Blood comes into the kidney, waste gets removed, and salt, water, and minerals are adjusted if needed. The filtered blood goes back into the body. Waste gets turned into urine, which collects in the kidney’s pelvis — a funnel-shaped structure that drains down a tube called the ureter to the bladder.
Each kidney has around a million tiny filters called nephrons. You could have only 10% of your kidneys working, and you may not notice any symptoms or problems.
If blood stops flowing into a kidney, part or all of it could die. That can lead to kidney failure.
A person can lose up to 90% of their kidney function before experiencing any symptoms.
Kidney Diseases & Conditions
- Pyelonephritis (infection of kidney pelvis): Bacteria may infect the kidney, usually causing back pain and fever.
- Glomerulonephritis: An overactive immune system may attack the kidney, causing inflammation and some damage.
- Kidney stones (nephrolithiasis): Minerals in urine form crystals (stones), which may grow large enough to block urine flow.
- Nephrotic syndrome: Damage to the kidneys causes them to spill large amounts of protein into the urine.
- Polycystic kidney disease: A genetic condition resulting in large cysts in both kidneys.
- Acute renal failure (kidney failure): A sudden worsening in how well your kidneys work.
- Chronic renal failure: A permanent partial loss of how well your kidneys work.
- End-stage renal disease (ESRD): Complete loss of kidney strength, usually due to progressive chronic kidney disease.
- Papillary necrosis: Severe damage to the kidneys can cause chunks of kidney tissue to break off internally and clog the kidneys.
- Diabetic nephropathy: High blood sugar from diabetes progressively damages the kidneys, eventually causing chronic kidney disease.
- Hypertensive nephropathy: Kidney damage caused by high blood pressure.
- Kidney cancer: Renal cell carcinoma is the most common cancer affecting the kidney.
- Interstitial nephritis: Inflammation of the connective tissue inside the kidney, often causing acute renal failure.
- Nephrogenic diabetes insipidus: The kidneys lose the ability to concentrate the urine, usually due to a drug reaction.
- Renal cyst: A hollowed-out space in the kidney.
- Do you have high blood pressure?
- Do you suffer from diabetes?
- Do you have a family history of kidney disease?
- Are you overweight?
- Do you smoke?
- Are you over 50 years?
- Are you of African, Hispanic, Aboriginal or Asian origin?
If you have answered yes to one or more of these questions, you should discuss with your doctor, you may need testing for kidney disease! Early chronic kidney disease has no sign or symptoms. You can help delay or prevent kidney failure by treating kidney disease early.
Chronic Kidney Disease
The majority of individuals with early stages of CKD go undiagnosed. On WKD we are calling on everyone to check if they are at risk for kidney disease and encouraging people with any risk factors to take a simple kidney function test.
Kidney disease usually progresses silently, often destroying most of the kidney function before causing any symptoms. The early detection of failing kidney function is crucial because it allows suitable treatment before irreversible kidney damage or deterioration manifests itself through other complications.
Simple laboratory tests are done on small samples of blood (to measure creatinine content and estimate GFR) and on urine (to measure creatinine and albumin excretion).
Your doctor uses the results of your Serum Creatinine measured in the blood to estimate your overall kidney function, or Glomerular Filtration Rate (GFR) and your blood sugar to be sure you do not have diabetes. A simple “dipstick” test may be used to detect excess protein in the urine.
- Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function is reduced, the creatinine level rises. Your doctor can use the results of your serum creatinine test to calculate your GFR, which reflects how well your kidney is functioning.
- Glomerular Filtration Rate (GFR): Your GFR tells how much total kidney function you have. It may be estimated from your blood level of creatinine. Normal is about 100 ml/min, so lower values indicate the percentage of normal kidney function which you have. If your GFR falls below 60 ml/min you will usually need to see a kidney disease specialist (called a nephrologist), If the treatment you receive from the nephrologist does not prevent a further reduction in GFR, your nephrologist will speak to you about treatments for kidney failure you might need later like dialysis or kidney transplant. A GFR below 15 indicates that you may need to start one of these treatments soon.
- Urine albumin. The presence of excess protein in the urine is also a marker of CKD and is a better indicator of the risk for progression and for premature heart attacks and strokes than GFR alone. Excess protein in the urine can be screened for by placing a small plastic strip embedded with chemicals that change colour when protein is present (urine dipstick) into a fresh urine specimen or can be measured more accurately with a laboratory test on the urine.
- Urine albumin-to-creatinine ratio. A urine albumin-to-creatinine ratio (UACR) on a spot urine specimen is a laboratory test to measure and monitor urine albumin. UACR is a ratio between two measured substances – albumin and creatinine – in the urine. UACR is usually expressed as mg albumin/g creatinine and estimates 24-hour urine albumin excretion. UACR is unaffected by variations in urine concentration and is, therefore, more accurate than a dipstick. .Albuminuria is diagnosed when UACR is greater than 30 mg/g and is a sign of CKD.
Key preventative measures have been defined and proven successful in those with early stages of CKD as secondary prevention measures, which help slow disease progression and protect against both kidney and cardiovascular disease, such as:
- Reduction of high blood pressure -the lower the blood pressure (within the normal range) , the slower the GFR decline
- Specific medications to reduce proteinuria as well as lower blood pressure – angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs)
- Reduce salt intake to lower blood pressure
- Control of glucose, blood lipids and anaemia
- Smoking cessation
- Increase of physical activity
- Control of body weight
- Urinalysis: A routine test of the urine, Urinalysis can help detect infections, inflammation, microscopic bleeding, and kidney damage.
- Kidney ultrasound: A probe placed on the skin reflects sound waves off the kidneys, creating images on a screen. Ultrasound can reveal blockages in urine flow, stones, cysts, or suspicious masses in the kidneys.
- Computed tomography (CT) scan: A CT scanner takes a series of X-rays, and a computer creates detailed images of the kidneys.
- Magnetic resonance imaging (MRI) scan: A scanner uses radio waves in a magnetic field to make high-resolution images of the kidneys.
- Urine and blood cultures: If an infection is suspected, cultures of the blood and urine may identify the bacteria responsible. This can help target antibiotic therapy.
- Ureteroscopy: An endoscope (flexible tube with a camera on its end) is passed through the urethra into the bladder and ureters. Ureteroscopy generally cannot reach the kidneys themselves but can help treat conditions that also affect the ureters.
- Kidney biopsy: Using a needle inserted into the back, a small piece of kidney tissue is removed. Examining the kidney tissue under a microscope may help diagnose a kidney problem.
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