Dr Dulcy on why kid­neys may fail


The Citizen (KZN) - - Front Page - HEALTHY LIV­ING Dr Dulcy Raku­makoe

The kid­neys are a pair of bean-shaped or­gans on ei­ther side of your spine, be­low your ribs and be­hind your belly, roughly the size of a large fist.

The kid­neys’ job is to fil­ter or clean your blood. They re­move wastes, con­trol the body’s fluid bal­ance, and keep the right lev­els of elec­trolytes. All of the blood in your body passes through them sev­eral times a day.

The process starts with blood com­ing into the kid­ney, waste gets re­moved and salt, wa­ter, and min­er­als are ad­justed, if needed. The fil­tered blood goes back into the body. Waste gets turned into urine, which col­lects in the kid­ney’s pelvis – a fun­nel-shaped struc­ture that drains into a tube called the ureter to the blad­der.

Each kid­ney has around a mil­lion tiny fil­ters called nephrons. You could have only 10% of your kid­neys work­ing, and you may not no­tice any symp­toms or prob­lems. If blood stops flow­ing into a kid­ney, part or all of it could die. That can lead to kid­ney fail­ure. Chronic kid­ney fail­ure is the grad­ual loss of kid­ney func­tion de­scribed above. When chronic kid­ney dis­ease reaches an ad­vanced stage, dan­ger­ous lev­els of fluid, elec­trolytes and wastes can build up in your body.

In the early stages of chronic kid­ney dis­ease, you may have few signs or symp­toms. Chronic kid­ney dis­ease may not be­come ap­par­ent un­til your kid­ney func­tion is sig­nif­i­cantly im­paired. Treat­ment fo­cuses on slow­ing the pro­gres­sion of the kid­ney dam­age, usu­ally by con­trol­ling the un­der­ly­ing cause. It can progress to end-stage kid­ney fail­ure, which could kill you if ar­ti­fi­cial fil­ter­ing (dial­y­sis) or a kid­ney trans­plant is not done.

If you have a med­i­cal con­di­tion that in­creases your risk of kid­ney dis­ease, your doc­tor is likely to mon­i­tor your blood pres­sure and kid­ney func­tion reg­u­larly.

Make an ap­point­ment with your doc­tor if you have any signs or symp­toms of kid­ney dis­ease. Symp­toms are of­ten non­spe­cific, mean­ing they can also be caused by other ill­nesses. Be­cause your kid­neys can com­pen­sate for lost func­tion, signs may not ap­pear un­til ir­re­versible dam­age has oc­curred.


Signs and symp­toms of kid­ney dis­ease may in­clude:



Loss of ap­petite.

Fa­tigue and weak­ness.

Sleep prob­lems.

Changes in how much you uri­nate.

De­creased men­tal sharp­ness.

Mus­cle twitches and cramps.

Swelling of feet and an­kles.

Per­sis­tent itch­ing.

Chest pain, if fluid builds up around the lin­ing of the heart.

Short­ness of breath, if fluid builds up in the lungs.

High blood pres­sure (hy­per­ten­sion) that’s dif­fi­cult to con­trol.


Chronic kid­ney dis­ease oc­curs when a dis­ease or con­di­tion im­pairs kid­ney func­tion, caus­ing dam­age over months or years. Dis­eases that cause it in­clude:

Type 1 or type 2 di­a­betes.

High blood pres­sure.

Glomeru­lonephri­tis), an in­flam­ma­tion of the kid­ney’s fil­ter­ing units (glomeruli).

In­ter­sti­tial nephri­tis, an in­flam­ma­tion of the kid­ney’s tubules and sur­round­ing struc­tures.

Poly­cys­tic kid­ney dis­ease. Pro­longed ob­struc­tion of the uri­nary tract, from con­di­tions such as en­larged prostate.

Vesi­coureteral re­flux, a con­di­tion that causes urine to back up into your kid­neys.

Re­cur­rent kid­ney in­fec­tion.

Risk fac­tors

Fac­tors that may in­crease your

risk in­clude:


High blood pres­sure.

Heart and blood ves­sel (car­dio­vas­cu­lar) dis­ease.



Ab­nor­mal kid­ney struc­ture.

Older age.


Com­pli­ca­tions in­clude:

Fluid re­ten­tion, which could lead to swelling in your arms and legs, high blood pres­sure, or fluid in your lungs (pul­monary oedema).

A sud­den rise in potas­sium lev­els in your blood (hy­per­kalaemia), which could im­pair your heart’s abil­ity to func­tion and may be life-threat­en­ing.

Pic­tures: iS­tock

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