What You Need to Know about kidney disease
Kidney disease is a growing problem in the United States, affecting over 20 million adults of all ages and races. The following questions and answers are designed to help increase your understanding of this important health issue.
The kidneys are two “bean-shaped” organs located at the back of the abdomen just below the rib cage. Healthy kidneys filter the blood by removing waste and excess water. The resulting liquid waste (urine) drains into a hollow portion of the kidneys, funnels into the bladder, and then is passed out of the body. Each day the kidneys process and excrete about six to eight cups of urine. In addition, the kidneys help control the balance of certain salts and minerals in the body. They also produce important hormones that stimulate the production of red blood cells, which carry oxygen to the tissues and then transport carbon dioxide from the cells.
When kidneys are diseased, they stop doing their jobs, progressively losing the ability to excrete waste and urine. If not treated, kidney disease can lead to kidney failure. Once the kidneys fail, the only treatment options are dialysis, a mechanical system that performs the work of the kidneys, or transplantation.
Diabetes accounts for about 40 percent of all new cases of kidney disease. High blood pressure is the second leading cause. In fact, erratic blood sugar levels and uncontrolled high blood pressure, as well as smoking, can irreparably damage the kidneys over a relatively short period of time.
Along with those suffering from diabetes or high blood pressure, people with a family history of kidney disease or kidney failure are at greater risk. Even if only one member of your family has had a kidney problem, you should be tested for kidney disease. The elderly and African Americans with any of these risk factors have an even greater chance of developing kidney disease.
In the early stages of kidney disease people may not feel sick at all. They often do not know they are losing kidney function until they start experiencing symptoms associated with advanced stage kidney disease. For example, they may begin to tire easily, have trouble sleeping, and feel itchy or nauseous. That’s why, if any of the risk factors mentioned previously apply to you or someone you know, it is vital to have a doctor test for early signs of kidney disease.
Medication and proper diet can slow kidney damage and may prevent kidney failure if the problem is detected in its early stages. In advanced cases, patients with kidney failure may require dialysis. Over 200,000 Americans receive ongoing dialysis, which acts as an artificial kidney, removing wastes and extra fluids from the blood.
There are two types of dialysis: hemodialysis and peritoneal dialysis. About 90 percent of patients receive hemodialysis, a procedure in which the blood is circulated outside the body and cleaned by a dialysis machine before returning it to the patient. Peritoneal dialysis uses the patient’s own peritoneal membrane, a sac around the abdominal organs, as a filter. A cleansing fluid (dialysate) is passed into the abdomen by means of a surgically implanted catheter. As the patient’s blood is exposed to the dialysate through the peritoneal membrane, impurities are drawn through the membrane walls and into the fluid. The patient drains out the dialysate after three or four hours and replaces it with fresh fluid.
Dialysis is not a cure. If a person’s kidneys are temporarily damaged, dialysis can give them a chance to rest and recover. Dialysis is also used to maintain a patient who is awaiting a kidney transplant. In the last stages of kidney disease, a kidney transplant is the only long-term solution. Transplants may come from a living donor, often a family member, or from an individual who has died. The average long term success rate tends to be somewhat higher with living donor trans¬plants. The good news is that results of kidney transplantations are improving steadily with advances in surgical techniques, preservation of donated kidneys, and drugs used to prevent rejection of the transplanted organs.