Everyone knows that kidneys are important organs we can’t live without, but most of us don’t know everything our kidneys do for us. Besides making urine, kidneys play a vital role in fighting anemia, maintaining blood pressure, and healthy bone maintenance.
Those bean-shaped, fist-sized organs are located near the middle of the back, just below the rib cage, on both sides of the spine. They are made up of millions of nephrons; tiny filtering units that can clean 200 quarts of blood and produce about two quarts of urine per day.
Within the nephrons are the glomeruli (tiny blood vessels) that are intertwined with tubules (tiny urine-collecting tubes). These very tiny structures are where the complicated filtering actually takes place. The glomeruli must keep normal proteins and cells in the blood, but allow the wastes and extra fluids to pass into the tubules and enter the urinary system.
The wastes are the results of normal cell function and the food and medications we consume. If the glomeruli are unable to remove all of the wastes, they build up in our blood and damage our bodies.
Do you know how well your kidneys are functioning? Most people do not. Kidney disease is a silent disease, causing no noticeable symptoms until it is quite advanced.
Fortunately, there are ways of detecting kidney disease that should be performed routinely, especially for people with conditions such as diabetes, that put them at higher risk for its development.
Kidney Function Tests
eGFR is the acronym for estimated glomerular filtration rate. It is a calculation of how well those little glomeruli are able to filter the blood. In the laboratory, a person's blood is tested for creatinine levels. Creatinine is a waste product created by normal breakdown of muscle cells. A patient’s age, sex and race are taken into consideration when calculating the eGFR. This number estimates how well the glomeruli are clearing wastes from the body.
Chronic Kidney Disease
eGFR is our best indicator of how well the kidneys are working. An eGFR of 90 or higher is considered normal. If the eGFR stays below 60 for three months or longer, a person is considered to have chronic kidney disease (CKD).
eGFR 30-59: This stage of CKD is considered moderate. At this stage, hormones and minerals are thrown out of balance, causing anemia and weak bones.
eGFR 15-29: This is considered severe, and serious consideration must be given to treating the complications of CKD. A patient's doctor may refer a patient to a nephrologist (kidney specialist) who can discuss treatment options.
eGFR < 15: At this point, the kidneys can no longer filter well enough to maintain life. Dialysis or a kidney transplant must be done.
Dialysis consists of being hooked up to a machine that cleans the blood for about four hours a day, three days a week for the rest of a person's life. If a patient travels for work or pleasure, the schedule must be maintained. The patient must arrange ahead of time to travel somewhere where there is a dialysis center.
Prevention — Our Best Medicine
Hypertension: Hypertension (high blood pressure) damages the blood vessels in the kidneys. Keeping blood pressure under control helps to preserve kidney function. A patient with hypertension may be prescribed medication to lower the blood pressure and help protect the kidneys.
Keep blood glucose under tight control: Research has shown that keeping average glucose levels below 150mg/dL (A1C less than 7 percent) can result in a 50 percent decrease in the development and progression of CKD.
Points To Remember
- Get regular screenings
- Control blood pressure
- Control blood glucose
- Know your numbers
Chronic Kidney Disease (CKD) is stealthy. It provides us with no obvious warning signs. It takes us by surprise. Diabetes is the leading cause of CKD, accounting for about 44 percent of kidney failure in the United States.