EP 90: Kidney Disease: What You Should Know

You may not feel your kidneys right now, but it is one of the most hard-working organs in the body. And sometimes, we abuse them unknowingly.

Our kidneys function to filter the toxins and other waste products in our bodies. When kidneys are damaged, it can cause various health issues like heart problems, nerve damage, and weak bones. In addition to that, kidney failure, and anemia are also very common in patients with bad kidneys.

In this episode, and in honor of National Kidney Month, we will talk about kidney health and discuss the ways you can protect your kidneys and improve their health. And if you are experiencing kidney issues or are interested in knowing all about kidney function, this episode is for you.

National Kidney Month

About 1 in 3 American adults is at risk of Kidney Disease. 37 million American adults have kidney disease and most don’t know it. Most people know that the kidneys remove waste products and excess fluid from the body, but they function more than that.

The kidneys also produce key hormones that affect the function of other organs. The chemicals that the kidney produce the following functions:

It helps remove waste produces from the body
Aids in balancing the body’s fluids
Removes the drugs and other toxins from the body
Helps release hormones that regulate the blood pressure
Controls the red cell production
Helps produce an active form of Vitamin D that keeps our bones healthy and strong
Keeps the balance of blood minerals (ex. sodium, potassium, phosphorus)

How Do the Kidneys Function?

The kidneys are located on either side of the spine at the lowest level of the rib cage. They are consist of a functional unit called nephrons. There are about one million nephrons in each kidney, and these nephrons are consist of tiny blood vessels called glomerulus attached to a tubule.

When blood enters the glomerulus it is filtered by the kidneys. The remaining fluid then passes to the tubule. In the tubule chemicals and water is either absorbed or reabsorbed according to the body’s needs, to create the final product being urine.

Fun fact: Your kidneys filter 200 quarts of fluid every 24 hours. About two quarts are removed from the body and 198 quarts are returned to the bloodstream for the body to use [1].

8 Problems Kidney Disease Can Cause:

Heart disease – When the kidneys are not working well, your hormone system, which regulates blood pressure, has to work harder to increase blood supply to the kidneys. When this happens, your heart has to pump harder, which can lead to heart disease.
Heart attack and stroke
High blood pressure
Weak bones – Damaged kidneys can’t change vitamin D to the active usable form and this can lead to bone weakness. In kidney disease, too much parathyroid hormone is released to keep calcium levels in the blood balanced. By taking calcium from the bones the bones become weaker.
Nerve damage (neuropathy) – dialysis can lead to neuropathy pain and muscle atrophy. The exact reasons for this are unknown but several possible causes exist. They include vitamin and mineral imbalances, added pressure from dialysis, and overlapping conditions
Kidney failure (end-stage kidney disease, or ESRD)
Anemia – When your kidneys are damaged, they produce less erythropoietin (EPO), a hormone that signals your bone marrow—the spongy tissue inside most of your bones—to make red blood cells

Risk Factors of Kidney Disease

5 Main Risk Factors:

Diabetes (you or your family)
High blood pressure (you or your family)
Heart disease (you or your family
Family history of kidney failure, diabetes, or high blood pressure
Obesity

Additional Risk Factors:

Age 60 or older
Low birth weight
Prolonged use of NSAIDs, a type of painkillers, such as ibuprofen and naproxen
Lupus, other autoimmune disorders
Chronic urinary tract infections
Kidney stones

Different Types and Causes of Kidney Diseases

1. Chronic kidney disease

The most common form of kidney disease is chronic kidney disease (CKD). CKD is defined as having an abnormality or “marker” leading to decreased kidney function for three months or longer. CKD is a long-term process that is commonly caused by high blood pressure.

High blood pressure is bad for the kidneys because it increases pressure in the glomeruli, damaging the tiny blood vessels, and the glomerular filtration rate decreases.

This is the case why people get put in dialysis to help perform the function of removing extra fluid and waste out of the blood.

Diabetes is another major cause of CKD. The increased blood glucose levels in the blood damage the nephrons by slowly thickening them, causing scarring over time. Eventually, the nephrons begin to leak, causing protein (albumin) to pass through the urine.

2. Glomerulonephritis

Glomerulonephritis is an inflammation of the glomeruli, causing damage to the filtering part of the kidneys. It can occur from infections, drugs, or another disease such as lupus or diabetes.

Some symptoms to watch out for: pink or dark-colored urine from red blood cells in your urine (Hematuria), foamy urine due to excess protein (proteinuria), and/or fluid retention (edema).

3. Kidney stones

Another common kidney problem occurs when too much calcium is absorbed from foods causing obstructions. When stones pass through, they may cause severe pain in your back and side.

In cases when the stones are too large to pass, treatments can be done to remove them or break them down into small pieces that can pass out of the body.

Stone Removal Options

Shock wave lithotripsy – sends shock waves to break up stones in the kidneys.
Cystoscopy and ureteroscopy – cystoscopy looks inside to find the stone and the ureteroscopy removes the stone or breaks it into smaller pieces.
Percutaneous nephrolithotomy – this is ideal for large stones and is done when the doctor inserts a tool directly into your kidney through a small cut made in your back. Doctors can also use a laser to break them into smaller pieces.

4. Polycystic kidney disease

It is characterized by the formation of kidney cysts that enlarge over time and may cause serious kidney damage and even kidney failure.

Keep in mind that individual cysts can be fairly common and usually harmless. Symptoms may be back or side pain, increased abdominal size, blood in urine, and high blood pressure.

5. Urinary tract infections

Urinary tract infections (UTIs) are bacterial infections of any part of the urinary system. UTIs commonly affect the bladder but can travel up and cause fever and pain.

We also have congenital diseases that occur when the baby is developing in the mother’s womb. A common problem with these congenital diseases usually affects the valve mechanisms between the bladder and ureter. Drugs and toxins can also affect the kidneys.

Early Signs of Kidney Disease

Poor appetite
Dry, scalp skin
Frequent urination
Fatigue
Difficulty concentrating
Puffy eyes

Severe Symptoms

Nausea
Vomiting
Changes in urine output
Fluid retention – edema
Anemia
Decreased sex drive
Hyperkalemia
Pink, dark urine (blood in the urine

How is Kidney Disease Detected?

Your healthcare provider will use a blood test to check your kidney function to check your Glomerular filtration rate (GFR).

a GFR of 60 or more is in the normal range.
a GFR of less than 60 may mean you have kidney disease. Learn from the provider how to keep your kidney health at this level.
a GFR of 15 or less is called kidney failure. Most people below this level need dialysis or a kidney transplant. Talk with your health care provider about your treatment options.

Creatinine is another lab test to check to evaluate kidney disease, the normal level being 0.6-1.2mg/dL. This is a waste product formed by the normal breakdown of muscle cells.

If a person has one kidney, a normal level may be about 1.8 or 1.9. As kidney disease gets worse, the levels of creatinine go up.

Another lab test that is checked to evaluate the risk of kidney disease is urine albumin. A healthy kidney doesn’t let albumin pass into the urine.

A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria.

If you’re in the hospital, a doctor may order a urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample.

Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of [2]:

30 mg/g or less is normal
More than 30 mg/g may be a sign of kidney disease

How to Stay Healthy and Keep Your Kidneys Going

People with kidney disease should do:

Lower high blood pressure
Manage blood sugar levels
Reduce salt intake
Avoid NSAIDs
Moderate protein consumption

Things everyone should do:

Exercise regularly
Control weight
Follow a balanced diet
Quit smoking
Drink only in moderation
Stay hydrated
Monitor cholesterol levels
Get an annual physical

How is Kidney Failure Treated?

Kidney failure may be treated with hemodialysis, peritoneal dialysis, or kidney transplantation. In a critical setting, the patient may be unstable for hemodialysis and will require Continous Renal Replacement Therapy (CRRT).

Know more about your kidney’s health and watch the full episode here 👇

TIME STAMPS:

0:00 Intro
0:41 Plugs
2:24 Episode Introduction
6:08 How do the kidneys function?
7:26 8 Problems Kidney Disease Can Cause
16:10 Risk factors of kidney disease
18:19 What are the different types and causes of kidney disease?
27:29 Early signs of kidney disease
28:27 How is kidney disease detected?
31:49 How to stay healthy
34:54 Things everyone should do