Kidneys are bean shaped organs in the back of your abdomen. Most of us are born with two kidneys. Kidneys clean your blood of waste products, help maintain blood pressure, and produce chemicals which regulate important body functions such as production of blood, maintenance of bone health, etc.
One should have regular annual physical examination to detect risk factors for kidney disease such as diabetes, high blood pressure, protein in urine etc. Blood pressure, diabetes, body weight, and cholesterol should remain well controlled. Exposure to unnecessary chemicals such as over the counter medications and health food supplements should be avoided. Excess water does not protect your kidneys; however, dehydration can hurt your kidneys-so remain well hydrated.
Kidney has great capacity to heal and renew itself! Accordingly, several types of kidney diseases are treatable earlier on in the course. Depending on the type of kidney disease, your kidney doctor can recommend specific therapies. Often, kidney damage that persists beyond three months is not reversible due to scarring that sets in with time.
Any damage to kidneys is called as kidney disease. Conventionally it is called acute kidney disease if the duration of damage is less than three months and chronic if it is more than three months. Acute kidney disease is potentially reversible.
The percentage your kidneys are functioning is determined by blood tests such as serum creatinine and blood urea nitrogen. These blood tests reflect function of both kidneys taken together.
Except in a few select conditions, diseases typically affect both kidneys. Therefore determination of individual kidney function is not required for treating kidney disease.
Unfortunately, quality and quantify of urine are two different things. Often patients with advanced kidney disease continue to make normal amount of urine. Only blood tests such as serum creatinine and blood urea nitrogen can tell how good your kidneys are working.
Common causes of kidney damage includes diabetes, hypertension, chronic exposure to certain types of drugs such as ibuprofen, infection, kidney stones, allergic reaction to medications etc
Common causes of kidney damage includes diabetes, hypertension, chronic exposure to certain types of drugs such as ibuprofen, infection, kidney stones, allergic reaction to medications etc
ACE inhibitors (lisinopril etc, name often ends with ...pril) and similar medications called ARB (losartan etc, name often ends with ...sartan) do not harm kidneys, rather protects them in long term. When these medications are started, there could be an initial worsening of kidney function; however, kidney function stabilizes and remains more stable than if you were not on these medications.
Kidney disease is divided into 5 stages based on your glomerular filtration rate (GFR). GFR is calculated from a blood test called serum creatinine. Stage 1: GFR is >90. In other words your serum creatinine is normal and some other test is abnormal such as blood in urine, protein in urine, abnormal kidney imaging etc. Stage 2: GFR 60-90. This is a very mild kidney condition. Stage 3: GFR 30-60. This is mild to moderately advanced kidney condition. Stage 4: GFR 15-30. This is moderately advanced kidney condition. Stage 5: GFR <15. This is severely advanced kidney condition and patient typically required dialysis or transplantation. Patient's in stage I and 2 typically have no symptoms. Patient's in stage 3 and 4 will have symptoms such as tiredness, lack of appetite, lack of energy, loss of taste, itching etc. Note these symptoms are not very specific and can be due to many different reasons. Patient's in stage 5 typically have more of the above symptoms. Do not panic based on what stage you are in. The rate at which you worsen to the next stage is variable and you can remain in the same stage for a long period of time. Follow the advice of your kidney doctor faithfully to have the best outcome.
Urine color depends on the concentration of your urine and color of the excreted waste products. Waste products are generated from what you eat and from normal wear and tear of your body. For example, after eating beet roots, urine can be reddish in color. Intensity of color depends on concentration of the urine. If you are dehydrated, urine will turn dark yellow.
Fatty kidney was defined as the presence of high renal sinus fat based on sex-specific 90th percentiles in a healthy referent sub-sample, defined using the following exclusion criteria: (1) BMI≥30 kg/m2; (2) hypertension, high triglycerides, low HDL-cholesterol, impaired fasting plasma glucose, or diabetes; (3) CKDcrea or microalbuminuria; (4) current smoking; (5) BMI<18.5kg/m2; and (6) missing covariates described in the previous exclusion steps and other model covariates. The healthy referent sample consisted of 400 women and 213 men, with 90th percentile renal sinus fat cut points of 0.445 cm2 in women and 0.71cm2 in men.
It is a medical procedure by which blood is cleaned of waste products and toxins using an artificial method.
Majority of the patients with irreversible kidney damage requires dialysis when kidney function drops below 10 to 15% of normal. Your kidney doctor makes this decision of starting dialysis based on your symptoms, blood tests, and examination. It is important to know that the decision to start dialysis is not solely based blood test and there is no single cut off below which dialysis should be started.
It is a good idea to undergo dialysis education before you require dialysis. Learning about various options you have for dialysis is reassuring rather than anxiety provoking. Also, proper planning and time is required for initiation of dialysis such as construction of AV fistula (requires a small surgery) for accessing your blood for dialysis.
Broadly speaking there are two types of dialysis, peritoneal dialysis and hemodialysis. In peritoneal dialysis, a catheter is placed in your abdomen and fluid is cycled. The fluid goes into an enclosed space in the abdomen outside your bowel and organs. This space is called the peritoneal cavity. Fluid does not directly touch your blood. In hemodialysis blood in allowed to pass through a filter outside your body. The filter cleans your blood of the waste products. Peritoneal and hemodialysis are both good options. One is not superior to the other. Often, patients have to switch between two modalities.
Kidney stones 6 mm or less in size can potentially pass on their own.
Majority of the kidney stones are calcium oxalate stones. The risk factors for calcium oxalate stone formation includes: Obesity, high intake of sodium ( >2.4 g/day), animal protein (> 5 servings per week), sucrose/fructose (sweetener), vitamin C, & oxalate in the diet; low intake of fluids, calcium (surprised!), potassium, phytate, magnesium in the diet; abnormal structure of the kidney and it's drainage system; family history of stone disease; and tendency to excrete more calcium & oxalate and less citrate in the urine. You should contact your kidney specialist for guidance regarding diet modification and medication advice to prevent the recurrence of kidney stones.
One should drink enough liquids to make at least 2-2.5 L (67.6-84.5 fl oz) of urine. Typically 2.5-3.0 L (84.5-101.4 fl oz) of liquids is sufficient to make adequate amount of urine. More fluids one drinks less are the chances of stone formation. One should avoid sugar-sweetened soda (increases oxalate excretion in the urine). There is no strong data to support that consumption of alcoholic beverages, tea, and coffee increases the risk of stone formation. Increased fluid intake alone can reduce the stone formation risk by half!
Without treatment you have a 35-50% chance of having another episode of kidney stone within 5 years. The good news is that the risk of recurrence can be lowered in majority of the cases-so see a kidney specialist.
One can reduce the chances of stone formation by increasing fluid intake, reducing intake of salt, soft drinks, oxalate & animal protein , and taking normal amount of calcium in the diet. You should consult a registered dietitian for specific advice or calculate your intake by going to the following website: http://ndb.nal.usda.gov/ndb/search/list
Proper amount of protein intake by patient with chronic kidney disease is essential to remain in optimum health. Too little protein results in wasting and excess protein intake is harmful for your kidneys. Unlike egg and vegetarian proteins, animal proteins make kidneys to overwork and eventually burn out. Protein intake of 0.8 g/kg/d delays may delay worsening of kidney function and greater than 1.3 g/kg/d results in rapid worsening of kidney function. You can calculate your protein intake by going to following website: http://www.foodvalues.us
Unless you have a tendency for dehydration, you should eat less than 2 gm/d of sodium, which is same as eating less than 5 gm/d of sodium chloride.
Phosphorus intake is tightly linked to the dietary protein intake. Phosphorus is also present in large amounts in food preservatives. Phosphorus present in vegetables is less easily absorbed from the gut as compare to that present in the animal proteins. Egg white protein has the least amount of phosphorus and is the best source of protein. Boiling food and discarding the water significantly reduces phosphorus content of the food. Bottomline: Prefer egg white and vegetarian protein over animal protein. Boil your food and discard water. Avoid preserved and prepared food. Avoid cola, cans, etc.
No, water pills ( lasix, hydrochlorthiazide) are not harmful to your kidneys. Although, dehydration due to over use of water pills, vomiting, diarrhea etc can damage your kidneys.
Two groups of medications called calcium channel blacker (amlodepine, nifedipine, diltiazem,etc) & thiazide diuretics (hydrochlorothiazide, chlorthalidone, etc) are particularly beneficial in blacks. This does not mean other medications are bad for you. Trust your medical providers judgment.
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