GRENADA NATIONAL PATIENT KIDNEY FOUNDATION
KIDNEY DISEASE - INTRODUCTION
What is kidney failure?
The majority of people are born with two kidneys; they are about the size of our own clenched fist. The kidneys are situated towards the back of your body, below the chest cavity, one on each side of the spine, tucked under the lower ribs, which protects them from injury. The kidneys are responsible for filtering the blood in the body. They remove waste products and impurities and help to maintain the fluid balance in the body. The excess water, which contains the waste products, is called urine.
Healthy kidneys are very efficient organs, in fact one kidney is capable to doing all the work, and this is why healthy donors can give one of their kidneys to another person. If one kidney is damaged in one way or the other, you still live a healthy life without noticing that anything is wrong.
About one in every 10 people has some abnormality in the kidneys. Not everyone develop kidney failure, only a few people with kidney disease develop serious problems to their kidneys, which is called kidney failure. The term 'kidney failure' or 'renal failure' means that they kidneys are working on 30% or a third of it normal function which means that 70% of the kidneys are damaged. The function of the kidneys many remains stable for many years in some people even if renal failure is being diagnosed. At this stage individuals may be diagnosed as having 'kidney failure', although dialysis treatment is not yet required. Some people many still pass urine as normal, only a blood test that will indicate there is a build-up of chemical in the blood that should be eliminated by the kidneys. When 90% of the kidney function is lost, the person is likely to feel ill, breathless, lethargic/tired and nauseous. At this stage the person will shortly need some kind of replacement therapy to replace the work of the kidneys.
The body and kidney failure
There are three main problems that affect the body when the kidneys fail.
1. Chemical build-up
The kidneys are responsible to get rid of chemical waste from the body. In kidney failure the kidneys are unable to get rid of the chemicals and the level get too high, this causes tiredness, sickness, itching, poor appetite, weight loss, anaemia and breathlessness. The build up of this chemical waste can also cause irritability, or loss of concentration and mental wellness and alertness. Many individuals will notice this changes or symptoms, but family, friends and relatives may be aware of this.
2. Fluid control
The kidneys control the amount of fluid in the body. In kidney failure the body can have too much fluid of too fluid. Too much fluid causes swelling, it can be evident in lower legs and ankles. It may also affect breathing, this is because there are too much fluid in the lungs. In most individuals it this happened, they may have to sleep propped up rather than lying flat to avoid feeling breathless. Too much fluid may also causes high blood pressure. Too little fluid is also dangerous. It causes low pressure, which can make the person feel dizzy, lethargic and weak. As I have mentioned earlier, healthy kidneys control the amount of water in the body. However, if the kidney is not working properly, they can no longer control the body fluid, there the individual with kidney failure have to monitor the amount. This usually means having a very strict fluid input. The aims is to ensure that the water balance is equal prevent the body of have too much or too little. What do we mean by 'fluids'? This means all types of drinks and food that have high water content. (Soups, gravy, sauces, ice cream etc.)
3. Blood pressure
Blood pressure is commonly too high in kidney failure. Most individual will be prescribed medication to control their blood pressure. Good blood pressure control is vital to long-term health. High blood pressure puts strain on all the blood vessels in the body. It is important to remember that when the kidney is damage it can make the vessels faster. It can also damage the heart and predispose individuals to have a stroke at some time. Sometimes high blood pressure can cause headache nut sometimes there are no symptoms at all. A simple step to control high blood pressure is by monitoring and making sure the amount of fluid in the body is correct and also medications is take. It is important to take blood pressure medications.
What causes kidney failure?
There are many different problems that cause kidney failure and also some rare ones. Most kidney failure could not be avoided, even if they are diagnosed early, neither you nor your doctor or kidney specialist could have prevented kidney failure.
Common causes are:
1. Inflammation of the kidneys or Nephritis
(inflammation of the nephron a functioning unit if the kidney)
This can occur for a number of reasons. Prolonged inflammation of the kidneys causes the nephron to become scarred and shrunken. Depends on the kind of inflammation some may respond to treatment but the inflammation may recur causing further damage to the kidney.
2. High Blood pressure:
If blood pressure is not well controlled and managed over a long period this can damaged the kidneys and is a common cause of kidney failure, especially in older people.
3. Renal Vascular disease:
If the blood supply to the kidney is blocked or partially blocked by the narrowing of the blood vessels, the poor supply of blood to the kidney gradually cause damage to the kidney and shrinks in size.
4. Diabetes:
Diabetes causes damage to small blood vessels, which may affect the vessels to the kidneys. This condition is called diabetic nephropathy, which is the fibrotic thickening of the glomeruli (a function on the nephron). It is caused by hypefiltration and accumulation of glycosolated or 'caramelized' proteins. As the disease progresses, the glomeruli lose their ability to filter blood effectively, causing the accumulating of waste products such as urea and creatinine in the body.
5. Obstruction:
Any blockage in the kidney, ureters, bladder or urethra can interfere with the flow of urine, causing mechanical damage or infection. These obstruction can be due to kidney stones, tumours or in some male an enlarge prostate gland.
6. Polycystic kidneys:
Polycystic kidney disease is the commonest inherited cause of kidney failure. It can by passed on by both male and female. If either parent has the disease, there is a 50% chance of any of the children being affected. Although it is congenital, it does not give any problems until adult life when the myriads of tiny cysts in the kidneys start to grow and compress the normal kidney tissue. It is commonly presents as pain, hematuria (blood in the urine) or a palpable renal mass. As the cysts get bigger the kidneys may become very enlarged, leading to renal failure and eventually chronic kidney failure.
Most types of kidney failure are not inherited but as mentioned about the most common one is polycystic kidneys. There are few cases when kidney failure runs in families. In a number of cases, the cause of the kidney damage is unclear.
I will be covering different aspect of kidney failure, treatment, diet and general well being. The series is written as an information guide about kidney failure for The Grenada National Patient Kidney Foundation (G.N.P.K.F)
Yolande Jessamy
Founder
G.N.P.K.F
For further information and queries you can contact me on yolande.jessamy@virgin.net