Dr Dulcy on why kidneys may fail
BEWARE: LOOK OUT FOR SYMPTOMS SUCH AS SWELLING OF FEET AND ANKLES
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.
Symptoms
Signs and symptoms of kidney disease may include:
Nausea.
Vomiting.
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.
Causes
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:
Diabetes.
High blood pressure.
Heart and blood vessel (cardiovascular) disease.
Smoking.
Obesity.
Abnormal kidney structure.
Older age.
Complications
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.