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by Bettye Humphrey-Sanders, BSN
April 2006
Spring is here and it is time to take evaluation of
your health. The evaluation should include a medical
physical and a weekly exercise regiment. Spring is the
season of renewal and new beginnings. It is wise to
start the season with a good bill of health.
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Your routine checkups normally include blood pressure check
and blood work. Many people equate these activities with maintaining
a healthy heart and not maintaining healthy kidneys. The kidneys
are vital organs that are affected by your blood pressure
and blood chemistry. You should be mindful of your kidneys
and the role they play in your overall health.
The Master Chemists
 Your
kidneys are considered the body’s “master chemists.” They
are bean-shaped organs each about the size of a fist. Your
kidneys are located near the middle of the back, just below
the rib cage.
They are sophisticated reprocessing machines. Every day your
kidneys process about 200 quarts of blood to sift out about
two quarts of waste products and extra water.
The waste in your blood comes from the normal breakdown of
active muscle and from food eaten. Food is energy for your
body. The body takes what it needs from the food, and waste
is sent to the blood. The wastes and extra water become urine,
which flows to the bladder through the ureters. The bladder
stores the urine until you go to the bathroom.
Inside of the kidneys are about a million nephrons that are
where the filtering occurs. A chemical exchange takes place,
as waste materials and water leaves your blood and enters
your urinary system. If your kidneys did not remove these
wastes, the waste would build up in the blood and damage your
body.
Your kidneys also maintain a critical balance of salt, potassium,
and phosphorous and release them back to the blood to return
to the body. It is essential that the right balance be maintained.
Excessive levels may be harmful.
The kidneys release three hormones:
- Hrythropoietin (EPO) that stimulates the production of
red blood cells.
- Renin helps regulate blood pressure.
- Calcitriol is an active form of vitamin D that helps maintain
calcium for bones and normal chemical balance in the body.
They also synthesize the hormones that control tissue growth.
Your kidneys also play a key role in keeping your blood pressure
in a healthy range. When your kidneys become damaged, the
master chemist is unable to keep the necessary chemical balance
and filter the body waste properly. Other organs suffer as
well.
Leading Causes for Kidney Diseases
Approximately 20 million Americans have kidney disease. The
number of people developing kidney failure has doubled each
decade for the last two decades. Kidney failure rates for
African Americans, American Indians, and Hispanics/Latinos
are higher than for Caucasians.
Early kidney disease has no symptom and can become kidney
failure with little or no warning if life undetected. Kidney
diseases attack the nephrons, causing them to lose their filtering
capacity. Blood and urine tests will show whether your kidneys
are removing waste efficiently. Your doctor will order tests
to check for protein and albumin in your urine. Healthy kidneys
take wastes out of the blood but leave protein. Impaired kidneys
may fail to separate protein from the wastes. Your blood pressure
will also be measured. Kidney failure can be effectively treated
if detected early.
The leading causes of kidney diseases are high blood pressure
and diabetes. High blood pressure makes your heart work harder
and, over time, can damage blood vessels throughout your body.
If the blood vessels in your kidney are damaged, they may
stop removing wastes and extra fluid from your body. Extra
fluid in your blood vessels may raise blood pressure even
more. Your blood pressure is considered normal if it stays
below 120/80. Every year, high blood pressure causes more
than 25,000 new cases of kidney failure in the United States.
If you have a kidney disease, you should try to keep your
blood pressure below 130/80.
The National Institutes of Health recommends that people
with kidney disease use whatever therapy is necessary, including
lifestyle changes and medicines to keep their blood pressure
below 130/80. Hypertension can be seen not only as a cause
of kidney disease, but also as a result of damage created
by the disease.
Diabetes is the number one cause of kidney disease and
failure. Nearly 45 percent of new cases of kidney failure
are due to diabetes. Diabetes is a disease that keeps the
body from using glucose 9sugar) as it should. If glucose stays
in your blood instead of breaking down, it can act like a
poison. Damage to the nephrons from unused glucose in the
blood is called diabetic nephropathy. If you keep your blood
glucose levels down, you can delay or prevent diabetic nephropathy.
High blood sugar known as diabetic ketoacidosis (DKA) is a
life-threatening condition that needs to be treated immediately.
As kidney damage develops, blood pressure often rises as well.
Early detection and treatment of even mild hypertension are
essential if you are a diabetic. You should regularly check
your blood glucose levels to keep it under control.
Two Types of Diabetes
Type I diabetes usually occurs suddenly and normally in children.
The symptoms include frequent urination, excessive thirst,
extreme hunger, dramatic weight loss, irritability, weakness
and fatigue, along with nausea and vomiting.
Symptoms of type II diabetes may include any of these same
symptoms, but they usually occur less suddenly and may be
unnoticed or ignored. Type II symptoms include recurring hard
to heal infections (infections of the skin, gums, or bladder),
drowsiness, blurred vision, tingling or numbness of the hands
and feet, and itching. More over-weight children are being
diagnosed with type II diabetes in the United States.
If you have type I diabetes, you will have daily injections
of insulin at set times. Regular exercise and well-balanced
meals that limit sugar, fat, and salt are recommended. If
you have type II diabetes and are overweight, you will first
need to bring your weight under control, restrict sugar intake
and follow an exercise plan to control your blood glucose.
Pills or tablets may be needed to help produce more insulin
or use that insulin more effectively if diet and exercise
are not enough. Daily insulin injections may also be needed.
Diabetic kidney diseases take many years to develop. Kidney
damage rarely occurs in the first 10 years of diabetes, and
usually 15 to 25 years will pass before kidney failure occurs.
For people living without any signs of kidney failures, the
risk of ever developing it decreases.
Diet
If you have reduced kidney function, you need to understand
how normal food may speed up kidney failure.
Some doctors recommend to their patients to limit the amount
of protein so that the kidneys have less work to do. Protein
is important to your body. It helps your body repair muscles
and fight disease. You cannot avoid protein entirely.
Knowing your cholesterol level is important. High levels
of cholesterol may result from a high fat diet. Cholesterol
can build up on the inside walls of your blood vessels. n
You should limit foods that contain high levels of sodium.
High sodium foods include canned or processed foods like frozen
dinners and hot dogs.
Diseased kidneys may fail to remove excess potassium, and
with very poof kidney function, high potassium levels can
affect the heart rhythm. Potassium is found in many fruits
and vegetables, like oranges, potatoes, and bananas, dried
beans, peas, and nuts. Your doctor will advise you which foods
need to be avoided or eaten at a limited amount.
If Your Kidney Fails
If your kidneys stop working completely, your body fills
with extra fluid and waste products. This condition is called
uremia. Your hands or feet may swell. Your body will feel
weak because the kidneys are not able to clean the blood to
function properly. The medical options that are available
to you are dialysis or kidney transplant. There are two major
forms of dialysis: hemodialysis and peritoneal dialysis.
In hemodialysis your blood is sent through a filter
that removes waste products. The clean blood is returned to
your body. Hemodialysis is usually performed at a dialysis
center three times per week for three to four hours.
With Peritoneal dialysis, a fluid is put into your
abdomen. This captures the waste products from your blood.
After a few hours, the fluid containing your body’s waste
is drained away. Then a fresh bag of fluid is dripped into
the peritoneal cavity. Patients can perform peritoneal dialysis
themselves.
For Transplantation, a donated kidney may come for an anonymous
donor. The donor may be a living related or non-related donor.
A donor can live with only one kidney. The transplantation
process is a lengthy one and requires a medical work-up. The
kidney that you receive must be a good match for your body.
The more the new kidney is like you, the less likely your
immune system is to reject it.
Points to Remember:
- Your kidneys are the “master chemist” that keeps your
blood clean and chemically balanced.
- Diabetes and high-blood pressure are the two leading causes
of kidney failure.
- The progression of kidney disease can be slowed, but it
cannot always be reversed.
If you are in the early stages of
kidney disease, you may be able to save what remains of your
(renal) kidney function for year by:
- Controlling your blood glucose
- Controlling your blood pressure
- Following a low-protein diet
- Following a low sodium diet
- Maintaining healthy levels of cholesterol in your blood
- Regularly visiting your nephrologists
- Quit smoking.
As this spring progresses, remember to take care of your
health and not to neglect your regular doctor visits.
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