Kidneys are organs which we take for granted. Most of us would be aware of heart disease, cancer, diabetes but fail to acknowledge the importance of kidneys. Kidneys have a very crucial role in health and disease.
Kidneys: What are they?
Kidneys are two small bean-shaped structures present below the diaphragm at the lower back of the size of a human fist, connected to the urinary bladder through ureters that transfer the filtered urine into the bladder. Later on, the urine is excreted out of the body through the urethra. The size of the kidney should not be used as a measure of its importance in human body.
The building blocks of kidneys are called nephrons, a functional unit of kidney where urine production takes place approximately 2 million in number.
What are the functions of the kidney?
Kidneys serve many functions. They are involved in maintaining the concentration of the electrolytes (Na, K, Mg, etc). Any increase or decrease in the concentration levels of these ions can lead to disturbance of the internal milieu which then can have catastrophic effects.
Kidneys help in regulating the blood pressure. They can prevent the blood pressure from either going too low or too high. It is performed with the help of other organs and high-light the importance of integration of systems in human body.
Kidneys are also involved in the regulation of the production of red blood cells or blood in general. They have some specific sensors which detect the falling levels of oxygen in blood, which when activated releases a hormone (a chemical) known as erythropoietin in the blood. Erythropoietin then stimulates our bones, factory/machinery, to produce more blood.
Kidneys filter all the waste and excess fliud from our body. How effectively they filter 180liters of blood in 24hrs is a marvelous example of their working capacity. In fact it gives us an idea as how effectively things work in conjuncture and hence maintain what we call a normal human body.
Lastly, proper functioning of the kidney is also important for the normal growth of bones of our body. They help in production of active form of vitamin D and hence normal calcium concentration in our bones.
Hence, in a way we can see that kidneys, although seem a “fist-full” organs have some extremely important functions which are very crucial for human body. Any dysfunction can lead to piling up of waste products, decrease in amount of blood, weakening of bones, retention of water and ultimately leading to Renal Faliure [From Latin renes, kidneys.].
What can be done about Kidney failure?
The treatment modalities available for kidney failure start from taking drugs and goes up to the stage of transplantation. If detected on time, it can very well be taken care of by life style modifications and by changing dietary habits. The treatment for acute failure is usually hospital based and in this case prevention is surely better than cure. But in chronic kidney failure measures can be taken very early in the disease process. These measures can be adding fruits and vegetables to the diet, decreasing use of alcohol, maintaining tight regulation of blood sugar and keeping a strict control of once blood pressure.
Why should we care for them?
Because they do all the critical functions mentioned above, like maintain blood pressure, maintain haemoglobin, maintain electrolyte balance, keep bones strong by Vitamin D synthesis and excrete toxins.
That apart, the ratio of the number of Kidney experts(Nephrologists) as compared to its disease prevalence is very low in India, and that is a very good reason as to why we need to protect our kidneys. Considering the data available from USRDS (United States renal data registry) and from few studies from India the prevalence of some form of Kidney disease is 10% in general population and extrapolating this data to the Indian population it turns out to be very huge. And the approximate number of Nephrologists in India is around 1200. Hence it is quite impossible to get expert opinion to all the diseased people. To add to this misery most of the expert centers are available in bigger cities. Few of these kidney disease patients end up into end stage renal failure, hence our individual job is to save our kidneys from getting diseased and if there is minor form of kidney disease find out protect them from going into end stage renal failure.
The cost of treating a disease is one of the major issues we are dealing with in this age of industrialization. It cannot be emphasized anymore that prevention is better than cure and when it comes to kidney failure as well. The cost of going through dialysis is exorbitantly high in India and un-affordable even for upper middle class population.
As kidneys remove waste product from our body the failure of kidney to render these function leads to pilling up of these poisons and finally leading to dysfunction of the body.
The impact of kidney disease is very high in economic terms. Once a person develops kidney disease there are various issues involved with it be it on dialysis in end stage renal (Kidney) failure about three times a week for about three hours per sitting, the person is essentially rendered unproductive on these days and if he is the earning member of the family the impact is amplified. The facility for dialysis may not be available for everyone at all places. In case it is available, the person is most of the time limited in his mobility.
Cost involved
Most countries cannot afford to provide free dialysis treatment in contrary to develop nations where the cost is borne by the government and hence the patients have to bear the cost themselves which is anywhere between 700 to 2500 rupees per dialysis session depending on the dialysis centre.
The dialysis is not the end, patient will be on regular medications and regular medical tests he/she has to undergo which add to the cost of the treatment and hence economic condition in particular.
Infections:
Patients with kidney failure are immunocompromised(less ability to fight diseases) and hence prone for infection and recurrent hospitalizations, the treatment of which adds to the cost of care and not to mention the time factor associated with it.
These are the few important and sufficient reasons among many others why we should care for our kidneys.
What is a kidney failure and how can it be detected?
Like any other organ of the body, kidneys are also prone for a number of abnormalities in its function.. Conditions like increase in blood sugar (diabetes), increase in blood pressure (hypertension), stones and infections are the major causes of damage to the kidney. Drugs (like pain killers), toxic chemicals in water or spurious medicines or any inborn defect constitute a minor conditions that can result in kidney failure over a period of time.
Most of the time patient is asymptomatic. Few might present with swelling in ankle and feet, lethargy and fatigue, vomiting, etc. To begin with, symptoms are very negligible but as the disease progresses the gravity of the disease gets obvious. What is relieving is the fact that by proper screening from time to time, kidney failure can be detected at the very inception and hence the treatment or rather prevention can be started before these appear making a dent on your economic conditions.
What are the forms of kidney disease?
If the failure occurs in hours and days, it can be called as Acute Kidney Failure but if it occurs over a period of time which can be months, then it is known as Chronic Kidney failure. Most of the time, it has been seen that diabetes and hypertension (among others) are the two major causes of chronic kidney failure in developing as well as developed nation.
Acute kidney failure-
Diarrhoea
Malaria (common in African and Asian countries)
Schistosomiasis (common in African countries)
Severe infection (Sepsis)
Inadvertent medicine intake
To prevent kidneys going into failure, first aid the patient with lots of fluids when he or she has loose stools and immediate medical care. Never try for common home remedies which may lead to complications and you may end up paying more price. Same with other infections take immediate medical help.
Chronic form-
Kidney disease develops slowly and the patients might not know the onset till he develop the complications. The common myth associated with general population is that they believe passing good amount of urine is an indicator of healthy kidneys. But this belief is wrong and it is often the last stage of kidney failure where urine ceases to form.
What are the potentially preventable causes of chronic kidney failure ?
Various causes of chronic kidney failure can be enumerated but those relevant to common public will be enlightened here.
Diabetes mellitus
Hypertension
These 2 are the most common diseases prevalent in the population and most of the time undetected and often neglected. But these 2 along with causing health problem like stroke, heart attack, form a major bulk of causes for chronic kidney failure and the ensuing problem as enlisted in previous section hence prevention is better than cure.
Many a times, it is seen that these two are the neglected ones and many forms of home remedies are tried.
What are the other causes?
Other common ones are smoking, infections, malnutrition, long term drug abuse and possibly environmental pollution with heavy metals. Infections causing kidney disease and potentially preventable are Hepatitis B and C and HIV by safer sex practices and policy regarding usage of blood and blood products. Many infections like throat and skin infections can lead to kidney problems and hence such infections seemingly minor should not be neglected. Various herbal products used as food can cause kidney and liver damage like Chappparral tea used and as herbal medicine, djengkol beans, fruit of hard wood tree areknut, aristolochic acid used as slimming medicine and various laxative herbals like senna, cascara sagrada, rhubarb. The use of these should be avoided. If these simple steps are followed then most of the kidney diseases can be prevented for a better and productive life.
Take home message:
Regular health check up for diabetes and high blood pressure.
Immediate medical attention even for problems which can appear minor to prevent progression of these into major health issues.
Avoid self medication and over the counter medicine intake
Proper balance diet, hygiene avoidance of alcohol, smoking and safe sex practices.
Further Reading:
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