Kidneys are an amazing organ in our body. They are like a super filter system in our body. But most of the time we don't realize their value until something goes wrong. Do you sometimes feel like your legs are swollen, you're always tired, and you don't want to eat? Maybe these are signals coming from your kidneys. So today we will talk about kidney disease in simple terms.
What exactly is kidney disease?
Simply put, kidney disease is when your kidneys can't do their main job, which is to filter the blood. These kidneys are located on either side of your back, just above your waist.
When the kidneys are damaged , they are unable to remove waste products and excess fluid from the body. This can lead to symptoms such as swelling in the legs and ankles , nausea , fatigue , insomnia , and difficulty breathing . If this condition is not treated properly, the damage can continue to worsen and eventually lead to complete kidney failure. This is a very serious, even life-threatening, condition.
What service does a healthy kidney provide?
Let's take a look at some of the things healthy kidneys do for our bodies.
- It maintains a balance of water and minerals like sodium, potassium, and phosphorus in the blood.
- It filters and removes waste products that accumulate in the blood after we digest the food we eat, after muscle activity, and after the medications we take.
- It produces a hormone called renin, which helps control blood pressure.
- It produces a chemical called erythropoietin, which signals the body to make red blood cells.
- It produces the active form of vitamin D, which is essential for bone health.
- Imagine, every 30 minutes, all the blood in our entire body is filtered by these kidneys.
What are the main types of kidney disease?
There are several types of kidney disease. Let's look at some of the most common types.
| Disease Name | Simply put… |
|---|---|
| Chronic Kidney Disease (CKD) | This is the most common type. It is caused by a gradual loss of kidney function over time. Diabetes and high blood pressure are the main causes. |
| Polycystic Kidney Disease | This is a genetic disease that causes fluid-filled cysts to form in the kidneys, interfering with their function. |
| Lupus Nephritis | In the autoimmune disease called lupus, our own body's immune system attacks the kidneys. |
| Glomerulonephritis | Damage to the tiny filters (glomeruli) in the kidneys. This can also happen after some throat infections (strep infections). |
| Pyelonephritis | A urinary tract infection that affects the kidneys. If this happens frequently, it can damage the kidneys. |
What are the causes of kidney disease?
The causes of kidney disease can be divided into two main categories.
Causes of sudden kidney failure (Acute Kidney Injury)
Sometimes the kidneys suddenly stop working. This can be caused by:
- There was a major accident and there was a lot of bleeding.
- Severe dehydration of the body.
- The body goes into shock due to a severe infection (sepsis).
- Obstruction of urine flow due to urinary stones or an enlarged prostate gland in men.
- Ingestion of certain medications or toxins.
- Complications during pregnancy.
Chronic Kidney Disease (CKD)
This is the problem that many people have. If the kidney function is poor for more than 3 months, we call it CKD. The most dangerous thing here is that there are no symptoms in the early stages.
The two main causes of CKD in Sri Lanka are diabetes and high blood pressure.
High blood sugar levels over time can damage the kidneys. Similarly, high blood pressure can damage the delicate blood vessels that supply blood to the kidneys.
In addition to this, prolonged use of painkillers (especially NSAIDs like Ibuprofen and Diclofenac) without any reason can also cause permanent damage to the kidneys.
How do I know if I have kidney disease? – Symptoms
The biggest challenge here is that kidney disease often doesn't show any symptoms until it's very advanced. You may not notice anything until about 50% of the damage to your kidneys has occurred. But as the disease progresses, symptoms like these may appear:
- High blood pressure
- Nausea and vomiting
- Appetite
- Feeling a metallic taste in the mouth
- Constant fatigue and weakness
- Difficulty concentrating
- Sleep problems
- Muscle twitching and pain
- Swelling of the feet and ankles
- Persistent skin itching
- Chest pain (if fluid accumulates around the heart)
- Difficulty breathing (if fluid accumulates in the lungs)
How does the doctor diagnose the disease exactly?
When you go to see a doctor, he will ask about your family medical history, what medications you are taking, and then he will do a physical exam. In addition, he may order these tests.
| Test | What are you looking at? |
|---|---|
| Blood Tests | Kidney function (eGFR) is calculated by looking at the amount of waste products (such as creatinine) in the blood. |
| Urine Tests | The urine is checked for protein (especially albumin). Healthy kidneys do not excrete protein. |
| Ultrasound Scan | Check the size and shape of the kidneys and whether there are any obstructions such as urinary stones. |
| Kidney Biopsy | A very small piece of tissue is taken from the kidney and examined under a microscope to determine the exact cause of the disease. |
What are the treatments for kidney disease?
The most important thing we all need to understand here is that chronic kidney disease (CKD) cannot be completely cured. However, the main goal of treatment is to slow down the progression of the disease and control the symptoms.
1. Medications
Your doctor may prescribe medications like ACE inhibitors or ARBs to control your blood pressure. These lower your blood pressure and protect your kidneys by reducing the amount of protein you lose in your urine. Also, if you have diabetes, you should take your medication exactly as prescribed.
Medications to Avoid: If you have kidney disease, never take painkillers (especially NSAIDs – Ibuprofen, Naproxen, Diclofenac) without consulting a doctor. Do not buy these even from a pharmacy. Also, inform your doctor about all medications you take, even vitamins.
2. Diet
This is very important. When the kidneys are damaged, it is difficult to remove things like sodium (salt), potassium (found in bananas, oranges, etc.), and phosphate (found in milk, cheese, and nuts) from the blood. Therefore, the doctor advises you to go on a special diet that is low in these. It is very important to get the help of a dietitian for this.
3. Dialysis
When the kidneys are very weak, that is, when they fail, the work that the kidneys are supposed to do, that is, purify the blood, has to be done with the help of a machine. This is called dialysis. There are two main methods for this:
- Hemodialysis: Blood is cleaned by connecting it to a machine in a hospital or at home.
- Peritoneal Dialysis: A special fluid is inserted through a tube inserted into the abdominal cavity to remove waste products from the blood.
4. Kidney Transplant
The best treatment for end-stage renal disease is a kidney transplant. A kidney from a healthy person (living or deceased) is surgically transplanted. After a successful transplant, dialysis is no longer needed. However, the patient will need to take medication for the rest of their life to prevent the body from rejecting the new kidney.
Take-Home Message
- Chronic kidney disease (CKD) is a disease that often progresses silently, without showing any symptoms .
- Diabetes and high blood pressure are the main risk factors. If you have these conditions, take care of your kidneys as well.
- If there is a risk, it is very important to see a doctor periodically and have your urine and blood tested.
- Do not use painkillers (NSAIDs) for a long time without a doctor's advice, for any reason.
- If you are diagnosed with kidney disease, the goal of treatment is not to cure it, but to control the disease from getting worse. To do this, follow your doctor's instructions exactly.
Kidney Disease, CKD, Diabetes, High Blood Pressure, Dialysis, Kidney Transplant
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