The kidneys are two of the smallest, yet most important organs in your body. Most of the time, they do their job silently, so we hardly notice their value. However, if the functioning of these kidneys is even slightly impaired, the entire body starts to feel the effects. Today, let's talk about these kidney diseases, just like talking to a friend.
What is really happening to these kidneys?
Think of your kidneys as two of the most powerful filters in your body. They are located on either side of your spine, just above your waist. They are not just filters, they do much more than that. Simply put, these are some of the main things that healthy kidneys do.
| Kidney function | Simply explained |
|---|
| Blood purification | Waste products (waste) that accumulate in the blood due to the food we eat, medications, and bodily processes are filtered and excreted as urine. |
| Balancing water and minerals | It maintains the body's required amount of water and keeps the body balanced by expelling excess water and minerals like sodium and potassium. |
| Blood Pressure Control | It produces a hormone called renin, which helps control blood pressure. |
| Helping to make red blood cells | It produces a hormone called erythropoietin, which helps in blood formation and prevents anemia. |
| Vitamin D activation | Vitamin D, which is essential for bone strength, is activated by the kidneys so that it can be used by the body. |
When the kidneys are damaged, they can't do this job properly. Then, waste products and excess water build up in the body, causing things like swollen ankles, nausea, fatigue, insomnia, and difficulty breathing. If left untreated, this damage can progress to complete kidney failure. That's a very serious, even life-threatening condition.
What are the main types of kidney disease?
Kidney disease can be divided into two main types. One is a disease that develops gradually over time, and the other is a condition that occurs suddenly.
Chronic Kidney Disease (CKD)
This is the most common type.
CKD is a condition in which the kidneys are unable to filter blood properly for more than 3 months. It does not develop suddenly. It develops gradually, over many years. The most dangerous thing is that there are no symptoms in the early stages. That is why many people do not know that they have this disease.
Diabetes and high blood pressure are the two main causes of CKD. Although treatment cannot completely cure the disease, it can control its worsening.
Other types of kidney disease
In addition to CKD, there are several other types of kidney disease.
- Polycystic Kidney Disease : This is a genetic disease. Cysts, filled with fluid, form on the kidneys . This reduces the function of the kidneys.
- Glomerulonephritis: Damage to the tiny blood-filtering units (glomeruli) inside the kidneys. This condition can also occur after some throat infections (strep infections).
- Lupus Nephritis: Lupus is an autoimmune disease that attacks the body's own healthy cells. This condition occurs when the kidneys are attacked.
- Pyelonephritis : This is a urinary tract infection that affects the kidneys. If this infection occurs frequently, it can cause permanent damage to the kidneys.
What are the causes of kidney disease?
There are different causes of kidney disease. Let's look at each of them separately.
Causes of Acute Kidney Injury
This is when the kidneys suddenly lose function within a few days. This can be caused by:
- Excessive bleeding due to a major accident.
- Severe dehydration of the body.
- Sepsis (shock) caused by a severe infection.
- Some medications, such as painkillers , antibiotics , and toxins.
- Blockage of the urethra due to urinary stones or an enlarged prostate gland in men.
Causes of Chronic Kidney Disease
The main reasons why the kidneys gradually weaken over time are:
- Diabetes: Uncontrolled high blood sugar levels over many years directly damage the kidneys.
- High Blood Pressure: When blood pressure is left uncontrolled for a long time, it damages the delicate blood vessels that supply blood to the kidneys.
- Long-term use of painkillers: Continuous use of painkillers, especially NSAIDs (e.g., Ibuprofen, Naproxen), without the advice of a doctor is very harmful to the kidneys.
- Genetic causes: If someone in your family has had kidney disease, you may also be at risk.
Alcohol and the kidneys: Remember, alcohol also puts extra strain on the kidneys. Excessive alcohol consumption can cause sudden kidney failure, and long-term alcohol consumption increases the risk of developing chronic kidney disease (CKD).
What are the symptoms of this?
This is the most important thing.
In chronic kidney disease, there may be no visible symptoms until 70%-80% of the kidneys are damaged. That is why this disease is also called a "silent killer." When the disease is a little more severe, symptoms such as:
- Swelling of the ankles, feet, and sometimes the face.
- Feeling extremely tired and lifeless.
- Frequent nausea and vomiting.
- Loss of appetite and a metallic taste in the mouth.
- Itchy skin.
- Insomnia or difficulty sleeping.
- Change in the frequency of urination (increased or decreased).
- Difficulty breathing.
- Difficulty controlling blood pressure.
If you have one or more of these symptoms,
it is very important to see a doctor immediately for advice. How to diagnose the disease?
Your doctor will first ask about your family history, the medications you take, and your symptoms. Then, they will order several tests to confirm the diagnosis, such as:
- Blood tests: In particular, the Serum Creatinine test measures the amount of waste products in the blood and calculates kidney function (eGFR).
- Urine tests:The urine is checked for protein or blood particles. Healthy kidneys do not excrete protein.
- Ultrasound Scan: This can check the size, shape of the kidneys, and whether there are any urinary stones.
- Kidney Biopsy: In some cases, a very small piece of tissue is taken from the kidney to determine the exact cause of the disease.
How is it treated?
Chronic kidney disease (CKD) cannot be cured. However, if detected early,
proper treatment and lifestyle changes can stop or significantly slow down further kidney damage. The main goals of treatment are: 1. Controlling the cause of the disease (e.g., diabetes, high blood pressure). 2. Controlling the symptoms. 3. Preventing further kidney damage.
Medications
Your doctor may prescribe medications like
ACE inhibitors or
ARBs to control your blood pressure. These medications not only control your blood pressure, but also help protect your kidneys by reducing the amount of protein you pass in your urine. They may also prescribe medications to control your blood sugar, lower your cholesterol, and treat anemia.
Most importantly: A person with kidney disease should never take any medication, especially painkillers, without consulting a doctor. Inform your doctor about all medications you are taking.
Diet
This is very important. Kidney patients need a special diet. Usually, you have to limit foods high in salt (sodium), potassium, and phosphorus. You may also have to limit your protein and water intake. A dietitian can give you the best advice on this. Your doctor will refer you to one.
Dialysis
When the kidneys' function has greatly decreased and they reach the end-stage renal disease (ESRD), the work that the kidneys are supposed to do, which is to purify the blood, has to be done with the help of a machine. This is called
dialysis .
- Hemodialysis: This involves connecting your body to a machine that filters your blood and returns it to your body. You will need to go to the hospital or dialysis center 2-3 days a week to do this.
- Peritoneal Dialysis: This is a method that can be done at home. A special fluid is inserted through a tube placed in the abdominal cavity, and the fluid is used to absorb waste products from the blood.
Kidney Transplant
The best treatment for end-stage kidney disease is a healthy kidney transplant. This can be done from a living person (family member or someone else) or from a deceased person. After a successful transplant, you will be able to live a normal life without dialysis.
Take-Home Message
- Chronic kidney disease (CKD) is a "silent" disease that often shows no symptoms in the early stages.
- The main causes of kidney disease in Sri Lanka are uncontrolled diabetes and high blood pressure . If you have these conditions, take special care of your kidneys.
- It is very important for people in risk groups (those with diabetes, high blood pressure, or a family history) to have their blood and urine tested at least once a year and consult a doctor about the condition of their kidneys.
- If you have symptoms like ankle swelling, extreme fatigue, or loss of appetite, don't ignore them. See a doctor immediately.
- If you have kidney disease, do not use any painkillers, supplements, or herbs without your doctor's advice.
Kidney Disease, Chronic Kidney Disease, Diabetes, High Blood Pressure, Dialysis, Kidney Transplant, Kidney Disease Sinhala
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