The human kidneys are two bean-shaped organs located in the back of our abdominal cavity. They have multiple important roles to our well beings such as removing the metabolic waste products and removing extra fluid in our body, to produce urine. They serve homeostatic functions by maintaining stable levels of acids and electrolytes such as sodium, potassium, and phosphorus. They also produce hormones to stimulate red blood cell production, regulate our blood pressure, and maintain our bone health.
Most patients with either acute or chronic kidney disease do not have specific symptoms until their kidney function is severely impaired. At that advanced disease stage, patients may experience nausea, vomiting, unpleasant taste in the mouth, swelling of the ankles and puffiness around the eyes. They may feel fatique and short-winded, have itchy skin and poorly controlled blood pressure.
Again, most of the time patients do not have any specific symptoms. When the kidney failure is more advanced, patients will make little or no urine, have nausea and vomiting, and feel confused or sleepy. They may have trouble breathing which mimics other heart or lung conditions. They may see worsening swelling in the body and legs.
Your physicians can check your blood to measure levels of BUN (blood urea nitrogen) and creatinine, the main markers of how well your kidneys clean the blood. They can check for abnormal levels of certain blood electrolytes such as potassium and phosphate. Your physicians can also perform urinalysis to check for protein, blood and other abnormal findings in your urine. Sometimes, they use imaging studies such as kidney ultrasound to look for kidney stones, cysts, masses or other structural defects.
The two most import causes are long term diabetes and uncontrolled high blood pressure. Other causes range from structural abnormalities such as polycystic kidney disease, to recurrent infections such as pyelonephritis, to autoimmune disease such as lupus. Also having a blocked renal artery or using a certain medications long term can lead to kidney damage.
According to USRDS 2013 Data Report, there were approximately 29 million Americans with chronic kidney disease. It was determined that over 15% of adult over the age of 20 have chronic kidney disease. There were over 600,000 people on dialysis or had received kidney transplant.
Kidney disease, and thus the need for dialysis, can be prevented or delayed by early detection and timely intervention. Since the two most common causes of kidney disease are diabetes and high blood pressure, aggressively manage diabetes and hypertension with diet, exercise and medications can help to protect your kidneys. If you have already lost some kidney function, or having high risk of kidney damage in the future, a prompt referral to a nephrologist is essential.
In general, if you suffer from a sudden loss of kidney function, or Acute Kidney Injury in medical term, there is a good chance of recovery. This would require specialized treatment from your nephrologist. However, with Chronic Kidney Disease you will suffer progressive loss of kidney function. At some point, the degree of kidney damage is so advanced that dialysis would need to be started or/and a kidney transplant would be necessary.