Kidney And Its Complications

In order to stay healthy and free from all diseases, we have to ensure that equilibrium is maintained among all our body organs and processes. Every organ of our body (except vestigial) has crucial roles to play and any kink in between can lead to a disorder progressing to other disorders. On this World Kidney Day, let’s get to understand one such organ in detail - Kidney.

The primary role of a Kidney is to purify our blood, remove all toxins and waste products from our body. Kidney controls the electrolytic balance and blood pressure of the body also assists the conversion of vitamin D into its activated form (calcitriol) and maintain the body’s fluid. These two bean-shaped organs are situated below our rib-cage, on each side of the spine behind our belly. Each kidney has millions of micro-filters called nephrons. The main waste products removed by kidneys are urea, uric acid, creatinine and electrolytes like sodium, potassium and phosphorus (if present in excess quantity). The rate at which millimetres of blood gets filtered by our kidneys per minute is termed as Glomerular Filtration Rate (GFR). This rate can be used to estimate the efficiency of our kidneys. In adults, the GFR rate of greater than 90 indicates a healthy kidney. 

Source: National Kidney Foundation

The above mentioned chart shows the average GFR on the basis of age. Now, what if the number goes below 90. With the decreasing rate, kidney’s efficiency also worsens.

Source: National Kidney Foundation

Various diseases may affect the kidney and disrupt its normal functioning. Now we will further study about some of the conditions which may arise due to impaired renal functioning.

  1. GLOMERULONEPHRITIS

Glomerulonephritis means inflammation of nephrons. Sometimes it is also referred to as nephritis. It is characterized by a group of diseases which affects the glomeruli (that part of the kidney which filters blood). This condition can be of two types - acute and chronic. Acute glomerulonephritis usually occurs as a result of a streptococcal infection, lupus and certain other autoimmune diseases. Viral infections, hepatitis, AIDS and autoimmune disorders may result in chronic glomerulonephritis. The glomerular damage is caused by the deposition of the streptococcal antigen-antibody complex which binds to glomeruli. This leads to the release of chemicals and activation of white blood cells (leukocytes) which injures the glomeruli wall. Symptoms of glomerulonephritis include haematuria (blood in urine) and proteinuria (presence of excess protein in the urine). It is important to keep a check on blood pressure in case of glomerulonephritis. Typical symptoms include loss of appetite, nausea, vomiting, lethargy, muscle cramps, insomnia and dry itchy skin. Consult a doctor in case any of the symptoms appear, this is because if left untreated then glomerulonephritis may progress of kidney failure.

2. NEPHROTIC SYNDROME

Nephrotic syndrome occurs as glomerulonephritis progresses. It can also be a result of other illnesses like lupus and diabetes. There is inflammation of nephrons accompanied by severe symptoms like heavy proteinuria, hypoalbuminemia (low albumin levels in the blood) and oedema (water retention causing swelling). Immense oedema consequences to ascites (accumulation of fluid in the abdomen) and hypertension. The rise in blood cholesterol levels and fatty droplets are found in the urine as well. Breakdown of tissue protein and serum protein losses results in malnutrition. Even if treated under expert medical supervision nephrotic syndrome might sometimes progress to renal failure.

3. ACUTE RENAL FAILURE

 This condition is characterized by the sudden stoppage of kidney function. It is also called acute kidney failure. It is usually reversible but needs immediate medical attention the condition is life-threatening. Some of the common causes are - 

  • Loss of blood due to an injury, trauma or during pregnancy complication.
  • Loss of fluid during severe vomiting, diarrhoea, diabetic coma and excessive sweating.
  • Infections like septicaemia.
  • Acute haemolytic (destruction of red blood cells) disorders.
  • Prolonged hypotension or diabetes.
  • Liver disorders.

Acute renal failure is exhibited in two phases - Oliguric and Diuretic Phase.  In the oliguric phase, the person has a reduced urine output. Sometimes the volume of urine can go as low as 20-200 ml/ day. After approx. two weeks, this phase is followed by the diuretic phase, in which urine output gradually increases to 3-5 litres/day. There is a significant electrolytic imbalance of the body. Taking good care of kidneys may help prevent acute kidney failure.   

4. CHRONIC RENAL FAILURE

Chronic kidney failure might occur as a result of many diseases like -

  • Glomerulonephritis
  • Diabetes
  • Hypertension
  • Heart diseases
  • A family history of kidney diseases
  • Prolonged urinary infections
  • Polycystic kidney disease

Chronic renal failure also tends to affect other body processes resulting in complications like uremia, anaemia, heart diseases, bone diseases, hyperkalemia (high potassium levels), hypercalcemia (high calcium levels) and fluid retention. If the condition deteriorates then it may lead to permanent kidney damage. This is referred to as End Stage Renal Disease (ESRD) and a person may need to undergo dialysis or a transplant to survive.

5. RENAL DIALYSIS

 Dialysis is a treatment given under a condition when a person’s kidney fails (approx. 85-90%) to perform the required function efficiently. This process removes all the toxins, salt, waste products and extra water from the body to prevent any accumulation. It helps to purify the blood, maintain electrolytic balance and keep the blood pressure under control. Dialysis can be performed in two ways -

  • Haemodialysis - It uses a dialysis machine called as Hemodialyzer. Access to blood vessels of a patient is given through a small surgery by creating a fistula or a graft. This process is performed either in a hospital or dedicated clinic.
  • Peritoneal Dialysis - It can be done at home or at work, as the catheter is placed in the peritoneal cavity of the patient. A cleansing fluid passes the catheter and filters waste products from the blood. After a stipulated time, fluid-filled with waste products is discarded.

Apart from medical treatments, nutritional therapy also plays a critical role in maintaining kidney health. The nutritional requirement varies from person to person depending upon the clinical symptoms, diagnosis and biochemical parameters.

 TIPS TO KEEP KIDNEYS HEALTHY

  • We need to take good care of our kidneys in order to prevent the onset of above-listed disorders of the kidney.
  • Maintain a required fluid intake to keep the body hydrated. This also flushes out toxins and promotes kidney health.
  • Avoid consuming excess salt and fat.
  • Avoid smoking and consumption of alcohol.
  • Have a regular physical activity schedule of at least 45-60 minutes per day.
  • Undergo regular medical check-ups.
  • In case of any uneasiness and related symptoms, consult an expert.
  • Eat a well-balanced healthy diet.

 

REFERENCES

  • National Kidney Foundation.(n.d.).Estimated Glomerular Filtration Rate.

   Retrieved from https://www.kidney.org/atoz/content/gfr

  • Khanna, K., Gupta, S., et al. (2003). Nutrition in Renal Diseases. Textbook of Nutrition and Dietetics. New Delhi, Delhi, Phoenix Publishing House Pvt Ltd.

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