14 Nov Kidney Disease
At the back of your abdomen, one either side of your spinal column, are two smallish but very important organs; the kidneys. Their job is to filter your blood to remove excess fluid and waste products which are then excrete via your bladder in the urine. The kidneys have other functions as well, such as maintaining the correct levels of various substances in your body, such as calcium and phosphate needed for bones. Kidneys also help maintain the amount of fluid in your body and help keep your blood pressure to within normal levels.
There are a range of conditions and diseases that can damage the kidneys. Some cause damage quickly, over days or weeks, this is ‘acute’ kidney disease; and some are ‘chronic’; that is, they cause damage over a longer period, over months or years. Acute conditions can go on to become chronic, especially if they are not treated promptly.
Diseases that causes damage to kidneys include:
- Kidney stones—these are lumps of minerals that form inside your kidneys, made of calcium, urate and other material.
- Infections—these are usually from urinary infections that reach the kidneys and cause the kidneys to become inflamed and (in chronic cases) scarred.
- Diabetic kidney disease; this involves diseases of the arteries in the kidneys that stop it functioning properly (similar to diseases of the arteries that occurs elsewhere in the body in diabetes.)
- Polycystic kidney disease—this is an inherited condition that causes cysts to form in the kidneys, destroying normal kidney tissues.
- Glomerulonephritis—this is a less common form of inflammation of the kidney caused not by bacteria but by the body’s own immune system attacking kidney tissue.
- Kidney cancer—this is rare but can happen.
Since the kidneys are responsible for filtering out wastes from your blood, damage to the kidney means that waste products build up in your blood. This can happen gradually so the first signs of this can be quite vague, like feeling tired. As the wastes build up in your blood, other symptoms can develop such as nausea and loss of appetite, changes in your urine flow, itchy skin, swollen or numb hands and feet, darkened skin and muscle cramps. Your blood pressure may become abnormally high which can affect the functioning of your heart. Eventually, if the condition is not rated, your kidneys can fail altogether and without treatment this can be life-threatening.
Diagnosis
Your doctor will do tests that can determine how your kidney is functioning. These tests might include:
- Measuring your blood pressure
- Urine tests, to look for substances in the urine that might indicate kidney diseases, such as white blood cells (suggesting possible infection), traces of blood (indicating possible infection, inflammation, or kidney stones) or albumin (a protein that is excreted by damaged kidneys).
- Blood tests—these measure the levels of waste products in your blood, such as creatinine and urea; if they are elevated, it may indicate the kidneys are not functioning properly.
- A test called the Glomerular Filtration Rate (GFR). This is a test that measures the rate at which measures how effectively (or not) the kidney is filtering the blood. A lower than normal GFR may indicate kidney disease.
- Imaging tests such as x rays, ultrasound or CT or MRI scans. These produce an image of your kidneys in the body and can show up abnormalities.
Treatment
The treatment of kidney disease depends on what is causing it. Acute kidney disease can usually be successfully treated.
For example, infections can usually be successfully treated with antibiotics. Kidney stones can be treated by procedures that remove or destroy the kidney stones, such as lithotripsy or surgery.
In chronic kidney conditions, treating the underling condition (such as diabetes or high blood pressure) will slow the progress of the kidney disease. Some chromic conditions such as glomerulonephritis, may respond to steroid medications. Some of the symptoms arising from kidney disease, such as high blood pressure, can be treated with medications.
However, if the chronic kidney disease progresses, and kidney function eventually becomes too diminished to maintain health, then the person will need dialysis—removal of the body’s wastes from the bloodstream via a dialysis machine. Or, if the person is healthy enough and a donor kidney is available, they may benefit from a kidney transplant, in which the diseased kidney is replaced by a healthy one from a donor.
More info
Kidney Health Australia
Chronic Kidney Disease—Australian Government Department of Health
https://www1.health.gov.au/internet/main/publishing.nsf/Content/chronic-kidney
Chronic Kidney Disease—Australian Institute of Health and Welfare
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