Renal function and prevention of kidney diseases

What is the function of the kidneys?

The kidneys are two organs that work together to maintain homeostasis-balance of the body so that all body cells function properly in a healthy and balanced environment. To accomplish this, the kidneys perform the following specific functions

Urine output

Volume regulation

Regulation of electrolytes (potassium, sodium, magnesium, calcium, etc.)

Acid-base balance (acids -bases are products of metabolism)

Elimination of toxic substances and drugs

Production of hormones, vitamins

Arterial pressure regulation (renin aldosterone hormones)

Erythropoiesis (production of red blood cells from the bone marrow, erythropoietin)

Regulation of bone metabolism (vitamin D)

How can we protect our kidneys?

From the renal function, it is evident how important it is to be able to secure the kidney’s good health and the proper operation of the other organs of the body. The prevention of the renal disease coincides with the prevention of cardiovascular disease, so it is very important to:

1. To regulate our blood pressure

2. To monitor glucose in our blood

3. To reduce our cholesterol if the cholesterol levels are too high

4. To maintain a healthy weight or lose weight if we are overweight

5. To stop smoking

6. To increase our physical activity

7. To treat anemia

8. To avoid nephrotoxic drugs eg anti-inflammatory

9. To drink water and fluids when and if we are thirsty

10. To treat kidney stones and to take measures to prevent their recurrence

11. To address any urological problems eg prostatic hypertrophy

Are there diseases that can affect kidney function?

However, there are several conditions that adversely affect the function of the kidneys so in these cases the kidneys’ protection requires proper treatment of these diseases. Such -situations or diseases that can cause kidney failure if not noticed or not treated properly are:

Diabetes

Hypertension

Heart Failure-Heart Disease

Various hereditary kidney diseases eg polycystic kidney

Urologic diseases eg prostatic hypertrophy, renal stones

Urinary tract infections (UTIs)

Rheumatic diseases

Hematological diseases

Hormonal disorders

Oncological diseases

Intake of nephrotoxic drugs for any condition

Glomerulonephritis

The proper treatment of these diseases is therefore imperative for the kidney function to be unaffected. In addition, there must be constant vigilance in these cases for the early diagnosis of impaired renal function by performing appropriate laboratory tests.

What are the symptoms of the kidney dysfunction?

If for some reason the kidneys begin to malfunction at early stages usually they don’t give any symptoms, so it is crucial to conduct an asymptomatic control by examining the levels of urea, creatinine, electrolytes and urinalysis. In more advanced stages of renal impairment it is very important to recognize the symptoms in time to prevent - if possible - the appearance of permanent or worsening of existing kidney damage.

Some of these symptoms may be:

1. Changes in urination (urinary frequency, nocturia, polyuria, oliguria)

2. Difficulty or pain when urinating (indicative of UTI)

3. Blood in Urine

4. Urine of sparkling or brown color (coca cola-like)

5. Swelling

6. Excessive fatigue and general weakness - Anemia

7. Dizziness and difficulty concentrating

8. Fever -shiver

9. Skin rash and itching

10. Metallic taste in mouth - uremic exhalation. When there is a problem in the kidneys, then the level of urea in blood is increased (uremia). Urea decomposes into ammonia in the saliva and a distinctive mouthfeel remains.

11. Pain in the ribs

12. Deregulation of blood pressure

13. Cramps

14. Bone pain - osteoporosis - rickets

It is crucial when one detects that suffers from these symptoms to contact his family doctor, who will suggest a series of examinations to detect renal dysfunction and subsequently will refer the patient to a nephrologist who will take appropriate measures to improve renal function.

Eleftheria Maragkaki, Nephrologist at Mesogeios Dialysis Center in Crete

Bibliography

1. Kidney research UK The Kidneys – a Basic Guide INFORMATION LEAFLET

2. Lynelle Moon, Katherine Faulks, Simone Littlewood, Naomi McIntosh, Claire Ryan and Anne-Marie Waters: Prevention of cardiovascular disease, diabetes and chronic kidney disease, Australian Institute of Health and Welfare, 2009

3. Chronic kidney disease: importance of early diagnosis, immediate referral and structured interdisciplinary approach to improve outcomes in patients not yet on dialysis, J Bras Nefrol 2011;33(1):74-87

4. Maarten TaalGlenn Chertow, Philip Marsden, Karl Skorecki, Alan Yu, Barry Brenner: Brenner and Rector's - The Kidney, 9th Edition, 2011

5. Robert W. Schrier, Thomas M. Coffman, Ronald J. Falk, Bruce A. Molitoris and Eric G. Neilson: Schrier's Diseases of the Kidney, 9th Edition, 2012

 

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