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Kidney Concerns

Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Dec 07, 2018
Last Modified Date: Dec 07, 2018
Published Date: Aug 25, 2017

What you should know about your kidneys

Located at the back of the abdomen and on the same level as the first lumbar vertebra, the two kidneys are dark red in color; about 4.5 inches long and are often described as shaped like a bean. Their primary function is to serve as a filter for the body, producing and removing waste products, or byproducts, known as metabolites.

The kidneys’ purification system cleans the blood of unwanted byproducts through elimination of fluid. Normal urine output is a clear, pale yellow with only a slight odor that results from its chemical composition. Changes in color, odor and clarity can indicate a kidney or urinary tract disease or disorder.

But the kidhow to tell if you have kidney problemsneys serve other functions too. They help keep blood pressure from dropping too low, regulate blood acidity, help control red blood cell rate and regulate phosphate which determines bone structure. Many of the body’s essential functions depend on healthy kidneys.

Though considered vital organs, typically only one functioning kidney is needed to survive in a healthy person.

Physicians who specialize in working with patients who have kidney disease are called nephrologists.


What do we mean by kidney disease?

Kidney disease includes any condition that affects the organs’ ability over time to do its job. Every year, millions of people are affected by debilitating kidney disease, some with chronic disorders that result in billions of dollars for healthcare costs and lost productivity. Classified into five stages, each represents a level of declining kidney function, with stages one and two considered mild. Stages four and five are considered advanced. About 550,000 Americans suffer from kidney failure in its advanced stages and require dialysis or transplantation to survive.

People with kidney disease are usually classified as having “acute” or “chronic.” Acute kidney disease refers to conditions that worsen quickly, over hours or days. Chronic kidney disease (CKD) is change in function that occurs over weeks or months and can be long-lasting. More than 26 million Americans are living with CKD.

What are some of the most frequent causes of kidney disease?kidney x-ray

The four main causes of kidney disease are:

  • Genetic factors – mutations in genes can result in kidney disease including the most common - polycystic disorder (PKD).
  • Environmental factors – includes improper diet, lack of exercise and obesity. Toxic exposure to chemicals and certain medications can also affect kidney function.
  • Diabetes – a devastating disease that can affect numerous organs, including the kidneys, by increasing its workload and causing inflammatory changes; a leading cause of kidney failure.
  • Hypertension – also known as high blood pressure, it is the second most common cause of kidney disease in the U.S. especially among African-Americans. Kidneys are designed to handle normal blood pressure levels, so uncontrolled high blood pressure causes inflammatory changes and extra stress on the kidneys.

What are the signs and symptoms of kidney disease?

Your body usually sends you a signal when the kidneys are in distress. However, some kidney disease patients have reported little to no clear symptoms until their kidney dysfunction is advanced. The following are important signs to note and have checked right away:

  • Changes in color or consistency of urine – including reddish or dark that indicates the presence of blood (hematuria); bubbly or frothy that can mean protein leakage (proteinuria). Bloody urine, in particular, should never be ignored.
  • Difficulty with urination – for men, it can be maintaining a steady flow stream and frequent urination at night (nocturia) which can point to either prostate trouble or kidney disease; for women it can be high frequency and a burning sensation, indicating urinary tract infection (UTI) or possibly an early stage of kidney infection.
  • Edema – swelling in the legs, feet, ankles, hands, around the eyes and in the abdomen, caused by excess fluid when the kidneys are unable to properly eliminate water and salt.
  • Uremic symptoms – a level of severity in kidney dysfunction that can cause nausea, vomiting, extreme fatigue, no appetite, food tasting “metallic,” itching, among other symptoms.

What are the more common kidney tests performed and why?

Some healthcare providers advocate that even if no symptoms are present have an annual physical with blood work, the primary means of determining kidney disease. In fact, a routine blood test can reveal a great deal about how your kidneys are working. Among typical blood work report values:

  • Glomerular Filtration Rate (GFR) – shows how well your kidneys are doing their filtering job. The small filters within the kidneys are called glomeruli.
  • Creatinine Level – a kidney-specific blood test of the material (creatinine) produced by muscles and filtered by the kidneys; a good indicator of kidney function along with GFR rates.
  • Blood Urea Nitrogen (BUN) – high levels can mean severe dehydration; when used in combination with other tests can help determine overall kidney function.

In addition to blood work, a urinalysis is generally administered. A simple but effective test involving a urine sample, the urinalysis can identify presence of blood, bacteria, protein and glucose (a sign of diabetes). Even when the urine color and consistency appears normal to the naked eye, microscopic changes are not visible, so a urinalysis can detect early signs of kidney disease.

If further studies are warranted, additional blood work may be ordered, along with imaging tests that may include a CT scan or an MRI. Comprehensive screenings for early detection of kidney disease are also available through the National Kidney Foundation (NKF). Visit https://www.kidney.org/news/keep for details.

What is kidney failure?

Kidney, or renal failure, is a condition in which the kidneys fail to adequately filter waste products from the blood. It comes in two main forms: acute injury (usually treatable and reversible with treatment) and chronic kidney disease (CKD), often not reversible. There are underlying causes for both, including serious health problems such as diabetes and certain inherited diseases, as well as lifestyle and behavioral choices.

What is dialysis?explanation of dialysis components

Dialysis is an artificial means of filtration prescribed by healthcare providers to allow toxin removal, thereby doing the job that kidneys normally perform. Dialysis also removes excess water from the body. As a general rule, dialysis is usually prescribed when kidney function is less than 10 percent and about 15 percent when the kidney disease is diabetes-related. However, decisions are made on an individual basis in consultation with your healthcare provider.

What are some other complications from kidney disorders?

With declined kidney function, there is an increase risk for other health conditions. For example, kidney disease increases the risk for heart attacks, similar to high cholesterol and smoking risks.

Fluid build-up, called edema, may result, impairing breathing and raising blood pressure. Low levels of red blood cells, or anemia, is another complication. Loss of kidney function can also lead to blood acidity, causing bad breath; low levels of vitamin D, causing brittle bones; or high levels of potassium that can lead to a heart attack.

The good news is that the two leading causes of kidney failure – diabetes and hypertension – are preventable.

How important is diet and lifestyle to kidney disease?

Since diabetes, obesity and hypertension play a leading role in developing kidney disease, diet and lifestyle are critical to the health of your kidneys, as well as to your overall health. 

So what can I do to help prevent kidney disease?

Though every situation is different, there are some common guidelines to follow that can help improve your lifestyle and your health status. Among them:

  • Maintain a healthy weight and exercise. At the least, improve your diet by adding more fruits and vegetables; walk 4- 5 times a week and monitor your weight to avoid obesity.
  • Read food labels to reduce salt and potassium intake, both of which, in excess, can be detrimental to blood pressure. Limit fat intake to help with weight loss and cholesterol levels.
  • Manage your blood pressure through regular check-ups.
  • Consider you risk factors and decide if a blood test to check the status of your kidney function and to watch for diabetes might be helpful.
  • Don’t smoke or if you do, stop. Smoking is not only toxic to the kidneys but it can raise blood pressure; inflammation levels and increases your risk of developing cancer.
  • Reduce everyday stress (exercise helps); consider yoga, tai chi or other forms of meditation. Use the power of laughter and music to help relax. Remember that preventative care and healing go beyond the physical.
  • Get plenty of rest. The body restores itself through sleep. If you have sleep apnea, follow-up on a treatment plan and be sure to discuss your sleep problems with a healthcare provider.