Kidney disease, how kidney failure causes damage to other organs, prevention, and treatment.

Prevention and treatment of kidney disease

 

Kidney

Humans have 2 kidneys located at the back, under the ribcage, at the lumbar region, which is shaped like a bean with the length about 12 centimeters.

• The kidneys compose of many capillaries called the “kidney unit” (nephron).

• Kidney units will deteriorate with age.

 

What is the function of the kidneys?

1. Remove waste.

2. Absorb useful substances for the body.

3. Maintain the water balance of the body.

4. Maintain the electrolyte balance of the body.

5. Maintain the acid-base balance of the body.

6. Regulate blood pressure.

7. Produce hormones.

 

1. Remove waste, including urea and creatinine

• When the body receives nutrients, it will decompose and use the useful substances. After that, it releases waste into the bloodstream, passing through the kidneys, which is excreted with urine.

• Excrete drugs and other foreign substances.

 

2. Absorb useful substances for the body

• Substances that are beneficial to the body will be reabsorbed by kidney cells such as water, phosphate, and protein.

 

3. Maintain the water balance of the body

• If there is excess water than the body needs, kidneys will excrete water through the urine.

• If the body is in a state of dehydration, kidneys will try to preserve water for the body. The urine will be small volume and concentrated.

 

4. Maintain the mineral salt balance of the body

• Normal kidneys always excrete excess salt.

• If kidneys are deteriorated, patients will be swelling when they eat too much salt.

 

5. Maintain the acid-base balance of the body

• The body produces acids every day from protein metabolism.

• If the kidneys function normally, there will be no acid retention.

• if kidneys are dysfunction, the body will secrete acidic urine.

 

6. Regulate blood pressure

• High blood pressure is caused by the water and electrolyte (salt) imbalance, including some certain substances.

• Patients with kidney disease often have high blood pressure because the kidneys are stimulated to produce substances that cause high blood pressure.

• If the blood pressure is very high, it will cause heart diseases or stroke, leading to paresis and paralysis at last.

 

7. Create hormones.

• Normal kidneys can produce many types of hormones.

• If you have kidney disease, hormone production will be impaired.

 

Hormones produced by the kidneys

• Erythropoietin hormone acts to create red blood cells. Therefore, the patient will have paleness, weakness, lack of strength, heart workload, dizziness, faint, and tired.

• Vitamin D (Calcitriol type) acts to help regulate calcium absorption. The low levels of vitamin D and calcium in blood lead to the hormone hypersecretion from parathyroid glands. It is a negative effect on many organs in the body, especially the bones.

 

Renal impairment causes negative effects on various organs.

 

Who is at risk for kidney disease?

1. Age over 60 years

2. High blood pressure

3. Heart disease, such as coronary artery disease

4. Stroke

5. Diabetes

6. Gout

7. Different types of nephritis, such as childhood nephritis, SLE nephritis, gallstones, tumors, and capillary inflammation

8. Family member with kidney disease

9. Infectious urinary tract disease

10. Using painkillers or exposing with chemicals for a long time

 

How do you know it's kidney disease?

• Symptoms

• Research

 

Symptoms of kidney disease

1. Swollen eyelids, face, feet, legs, and body, respectively

2. Abnormal urine such as cloudy, frothy, bloody, and dark brown

3. Abnormal urination such as frequent, burning, scrubbing, and small amount

4. Back pain, feeling a lump in the kidney area

5. High blood pressure

6. pale, tired, low energy

7. Flatulence, nausea, vomiting

8. Loss of appetite, taste changes

9. Headache, insomnia

 

Symptoms observation of kidney failure

 

Early stage of kidneys failure

• Swelling

• Pale

• Fatigue

• Tired easily

• High blood pressure

 

Chronic Kidney failure

• More pale

• Loss of appetite

• Irritation whole body

 

Symptoms observation of kidney failure

1. Swelling of the face and eyelids

2. Leg swelling

3. Swelling of the feet

4. Bloody urine

 

Kidney failure

 

Acute kidney failure

            Kidney deteriorates rapidly within a day or a week. It shows much more symptoms and high death rate than in chronic kidney disease. However, if it is in non-severe, the kidneys can be normal.

 

Chronic kidney disease

• The kidneys are permanently destroyed, causing the gradual shrinkage of kidneys. Although the symptoms are stable, but the kidneys will gradually deteriorate and eventually turn into chronic renal failure.

 

Causes of chronic kidney disease

Currently, patients with kidney disease turn into late stage of chronic kidney disease with the causes as follows:

 

1. Diabetes.

2. High blood pressure and capillary nephritis, such as Systemic Lupus Erythematosus disease.

3. Other causes include

• Kidney stones

• Chronic nephritis due to infection.

• Gout

• Kidney disease due to continuous taking painkillers for a long time.

• Hereditary polycystic disease

 

These various causes often cause disease on both kidneys at the same time.

 

Written by Prof. Dr. Leena Ongartyuth,

Department of Nephrology, Department of Internal Medicine

Faculty of Medicine Siriraj Hospital, President of the Kidney Association of Thailand