Disease, Illness and Condition Library
Kidney Disease Most of us, especially in our high school and college years, wanted live life to its fullest. This probably included a round or two of binge drinking. Little did we know that while we were having a good time our kidneys were screaming STOP! Alcohol can damage your kidneys and if for any reason kidney failure occurs your life could be in jeopardy. So what is kidney disease and what steps can be taken to minimize the chances of kidney failure. The primary functions of the kidneys are to regulate the body’s fluid balance and electrolyte levels and to eliminate waste materials from the body. They carry out these important tasks by filtering the blood and removing unnecessary water and soluble wastes, including excess amounts of minerals, which are eliminated in the urine. Approximately twenty times every hour, all or the blood in your body passes through your kidneys. The kidneys are also involved in the regulation of blood pressure. They secrete a hormone called rennin, which causes the formation of another hormone, angiotensin, in the blood. Angitensin is a potent blood vessel constrictor, and acts to increase blood pressure. The kidneys are located at the back of the abdominal cavity, just above the waist, on either side of the spinal column. The right kidney is located under the liver, and the left under the spleen. In the average adult, the kidneys weight about six ounces apiece and are four to five inches long. A renal artery enters each kidney and then branches out into a network of progressively smaller blood vessels, culminating in clusters of tiny capillaries called glomeruli. The term glomerulus comes from the Latin glomus, which, liberally translated means “ball of yarn”. The glomeruli are the main filtering units of the kidney, and each kidney houses many of them. Membranes in these tiny structures filter nutrients and wastes from the blood. The filtering material then passes into structures called tubules. The tubules are surrounded by blood vessels that absorb essential nutrients (amino acids, salt, glucose, and water) from the liquid. Once that has been accomplished, the material that has been removed from the blood is concentrated to become urine. Urine continually trickles down the tubules, through the ureters, and into the bladder, where it is stored until it is eliminated. The cleansed and filtered blood, meanwhile, passes into the renal vein and return to the circulation. Together, glomeruli and tubules form nephrons, which are the basic functional units of the kidneys. During the natural aging process, the number of functioning nephrons declines. A baby enters the world with about a million or more working nephrons, but the average forty year old has only about 400,000 still functioning. By the age of eighty, that number shrinks to about 150,000. It probably comes as not surprise that certain diseases reduce the number of functioning nephrons. The medical term nephritis describes any condition characterized by inflammation of the kidneys. Glomerulonephritis is inflammation of the glomeruli, the filtering units of the kidneys. This condition usually develops because of an immune system response to infection. As an example, infections involving Streptococcus bacteria can precede glomerulonephritis, just as it can lead to rheumatic fever. Symptoms can include fluid retention and bloating, decreased regularity of urination, nausea and vomiting, fever, exhaustion, abdominal and/or lower back pain, elevated blood pressure, and dark bloody urine. Pyelonephritis refers to inflammation of the kidney itself, including the entire kidney to the top of the ureter, the tube that carries urine to the bladder. This condition can cause chills, fever, pain, nausea, and vomiting. Nephrotic syndrome, from a strict point of view, is not a disease, but rather a well defined collection of symptoms. One of the main symptoms is swelling due to fluid retention. This can be generalized throughout the body, but may also be centered in the abdomen, scrotum, knees, ankles, and/or eyelids, and these areas of concentration may shift over the course of the day. If fluid builds up in the chest, it can cause shortness of breath. Other symptoms that are part of the syndrome include appetite loss, abdominal pain, and urine that appears foamy. Blood tests and urinalysis tests normally find other problems, particularly an increase in the level of protein in both the blood and the urine. Because people with this syndrome excrete more nutrients than normal in the urine, they may develop nutritional deficiencies as well. Dehydration and acidosis may also result. Nephrotic syndrome is usually caused by some form of glomerulonephritis, but can also occur as a complication of cancer, lupus, diabetes, severe allergies, HIV disease, or treatment with certain drugs. Sometimes the cause is unknown. The causes of the above kidney diseases include infections that migrate upward from the urinary tract and exposure to certain drugs and toxins. Kidney problems are often a complication of other disorders, such as high blood pressure, diabetes, lupus, and liver disease. If the kidney is damaged to a point where its function is seriously impaired, toxic waste cannot be properly eliminated and may accumulate in the blood stream, resulting in uremic poisoning, a sign of potential kidney failure. Kidney failure can be acute or chronic. Acute failure can itself be split into tree separate types: prerenal, renal, and postrenal. Prerenal failure is also called prerenal azotemia, meaning that there are surplus nitrogen waste materials left in the bloodstream that the kidneys were supposed to have filtered into the urine for removal, but did not. This is a sign of poor filtration due to an inadequate flow of blood reaching the kidney, not disease within the kidney itself. This can be due to dehydration, excessive blood loss, blockage of the artery that serves the kidney, liver disease that inhibits blood flow, heart failure, and the use of certain drugs. The two drugs best known for doing this are angiotensin-converting enzyme (ACE) inhibitors, used to treat high blood pressure, and the type of painkiller known as nonsteroidal anti-inflammatory drugs (NSAIDs). A postrenal failure, or postrenal azotemia, result from blockage of urine after the kidney has finished processing it. This can occur in prostate disease in men, in which the outflow tract can be compressed. Other possible causes include stones in the bladder and severe trauma. These conditions are not common, but they are the most treatable, as they tend to be localized and, as long as the problem is caught early, there is no disease in the kidney itself. If a person experiences failure of the kidney itself it is known as intrinsic failure. Intrinsic failure takes on many different forms, depending on exactly which part of the filtering unit is damaged. Usually it is due to chemical damage or dangerously low blow flow to the kidney. Chemical damage can be a result of using certain drugs, the worst of which are the so call aminoglycoside antibiotics, x-ray contrast material used for visualizing the kidney, and the immune system suppressant cyclosporine (Sandimmune, Neoral). Chronic renal failure is kidney failure that last for weeks to months, with azotemia gradually becoming worse, and can be due to many forms of kidney tissue disease. The symptoms can be wide-ranging and challenging to pin down, and can include fatigue, weakness, itching, easy bruising, chronic hiccups, leg cramps, numbness, shortness of breath, vomiting, nausea, impotence, irritability, and difficulty concentrating. Some forms of kidney disease, multiple cysts – fluid filled cavities of different sizes – form within the kidneys, ultimately destroying the kidney tissue. The condition tends to be more severe and progress more rapidly in children than in adults, and kidney failure is often the eventual result. Other types of hereditary kidney disease include Bartter’s syndrome, Hartnup disease, Liddle syndrome, and Fanconi’s syndrome. Every one of these disorders are characterized by improper functioning of the kidney that results in metabolic problems, principally electrolyte imbalances, which in turn can lead to nutritional deficiencies and blood pressure problems. Test designed to measure kidney function include urinalysis, in which the urine is examined microscopically for blood cells, pus, and infectious agents. Kidney function can also be evaluated by measuring the concentration in the blood of substances, such as urea, that are normally eliminated from the body by healthy kidneys. Four Simple Ideas for Avoiding Kidney Disease * Urinary Tract Infection if left untreated can migrate up through the ureters to the kidneys. If you suspect a urinary tract infection, seek medical treatment promptly. * If you are one of the millions of people prone to kidney infection consider taking 500mg of cranberry extract daily on an ongoing basis. * Drink eight 8oz glasses of water daily. This will flush toxins from the body and ease the workload for your kidneys. * Limit or eliminate alcohol consumption. This will also help to reduce the burden on your kidneys and perhaps improve your overall health as well.
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