WHEN THE KIDNEYS START TO FAIL…
Do you know where the kidneys are or what they do? Believe it or not, most people don't! Your kidneys are a pair of organs located just above your waist level, either side of your spine at the back, and serve a couple of very important functions, as we'll discuss in this article!
One of doctors' biggest concerns regarding kidney health is that there may not be any obvious signs or symptoms of reduced kidney function until irreversible damage has already been done, and the kidneys are already in failure. That's why all GP's like to keep tabs on patients' kidney health every so often by means of a simple blood test or two - known as a Kidney Function Test! If you're looking for a private gp London Doctors Clinic is here.
What Are The Kidneys And What Is Kidney Failure?
Healthy kidneys are important to regulate water and minerals in your blood, as well as to filter waste such as ‘urea’ from it (by producing urine). Your kidneys also play a major role in regulating your blood pressure, and telling your body to produce red blood cells and active vitamin D (a vitamin important for bone health).
Kidney (or renal) failure occurs when your kidneys become damaged and lose the ability to carry out these important functions, leading to waste product and fluid build-up in your body, which, without treatment, can be serious and even life-threatening!
Types of Kidney Injury
Kidney failure can be divided into 2 main categories:
1. Acute Kidney Failure (Acute Kidney Injury, AKI)
Where your kidneys suddenly lose their normal ability to function
2. Chronic Kidney Disease (CKD)
Where your kidneys lose the ability to function and shrink over a period of time.
Acute Kidney Injury: Causes & Treatment
In acute kidney injury, both kidneys must be damaged to cause complete renal failure. Having only one working kidney is usually enough to function.
Generally, treating the underlying cause of the acute kidney injury will allow your kidneys to regain their function. There are a variety of causes of acute kidney injury, which can be grouped according to where they occur:
- Any problem causing reduced blood flow to the kidney
- Such as blood loss or dehydration
- The kidneys can’t filter your blood properly if they aren't receiving enough flow!
- Direct damage to the kidney itself
- This includes:
- Toxic medications
- Inflammation of the kidney or blood vessels
- Major infection
- Other rare causes
- This includes:
- Obstruction of the urine flow coming out of your kidney
- This may be due to:
- Prostate enlargement
- Kidney stones
- Abdominal tumours
- This may be due to:
Chronic Kidney Disease: Causes & Treatment
Chronic kidney failure develops over months to years and is most commonly caused by poorly controlled diabetes or high blood pressure.
A condition known as ‘glomerulonephritis’, which damages the tiny filters in your kidneys, can also lead to chronic kidney disease and eventually failure.
There are other less common causes such as:
- Polycystic kidney disease
- Structural kidney abnormalities (reflux nephropathy)
- Kidney stones
- Prostate disease
- Other disease of the kidney tissue itself.
When someone who already has chronic kidney disease has an acute injury to their kidney, they are much more likely to develop kidney failure and this is known as ‘acute on chronic kidney failure’.
Kidney Failure Symptoms
Symptoms of kidney failure may appear gradually, especially in chronic kidney failure. However, if they are unrecognised, they can become life-threatening. The symptoms occurring result from a lack of normal kidney function and include:
|Reduce kidney filtering and urea build-up in the blood||Reduced urination, loss of appetite, nausea, vomiting.|
|Water levels unregulated in blood||Swelling due to fluid build-up in the tissues.
Fluid build-up in the lungs causing breathing difficulties.
|Mineral levels in blood dysregulated||Itching, heart arrhythmias, muscle paralysis, bone damage, seizures and coma.|
|Reduced production of red blood cells||Anaemia (low haemoglobin levels) may lead to tiredness, dizziness, low blood pressure, breathlessness, and problems concentrating or with memory.|
When To See A Doctor
Make an appointment to see your doctor if you notice these symptoms to determine what is causing them and if you need treatment. If kidney disease, hypertension or diabetes runs in your family, then you might need regular testing to check you kidneys are working properly.
Kidney Failure Diagnosis
Several tests are used to diagnose kidney failure including:
- Urine sample - Looks for large amounts of protein, sugar or blood cells leaking through your kidney filter into your urine
- Urine output measurement - Changes may help to identify possible causes
- Blood samples - Looks at levels of waste products which should be filtered out of your blood. Trends can help distinguish if the disease is acute or chronic.
- Imaging tests - To look for abnormalities or obstruction of the urinary system.
- Tissue biopsy - A sample of kidney tissue taken by a needle from your kidney is examined for any abnormal tissue or signs of infection.
Stages of Chronic Kidney Disease
Chronic disease can be ‘staged’ from one (mild with few symptoms) to five (requires treatment to stay alive) by your ‘glomerular filtration rate’ which shows how well your kidney filters are working.
Kidney Failure Treatment
Your doctor will choose a treatment for you, depending on the cause. Treatment often involves changing your diet and taking medications.
You may need dialysis if your kidney function is very low; this involves a machine filtering your blood, as your kidneys normally would. Dialysis is not a cure for kidney failure but it does keep you alive.
A life-saving kidney transplant might be an option in some cases of kidney failure, but usually involves a long wait and has many associated risks.
Kidney Failure Prevention
You can reduce your risk of kidney failure by maintaining a healthy lifestyle and, if you have a chronic disease, such as hypertension or diabetes, by ensuring tight medication control. It is also important to avoid taking too higher dose of over-the-counter medication, as well as taking complete courses of prescribed medication for any kidney or urinary tract infection.
If you're at all concerned about your kidneys, have a family history of kidney problems, or think you are experiencing any symptoms mentioned in this article, it is always best to get checked out by a doctor (just to be on the safe side).
By Ayala Shirazi