February 08, 2014

Kidney Issues - Basics

The kidneys perform the essential function of removing waste products from the blood and regulating the water fluid levels. 

The kidneys receive blood through the renal artery. The blood is passed through the structure of the kidneys called nephrons, where waste products and excess water pass out of the blood stream. 

Functions
  • Maintain a balance of water and concentration of minerals, such as sodium, potassium, and phosphorus, in your blood
  • Remove waste by-products from the blood after digestion, muscle activity, and exposure to chemicals or medications
  • Produce renin, an enzyme that helps regulate blood pressure
  • Produce erythropoietin, which stimulates red blood cell production
  • Produce an active form of vitamin D, needed for bone health
Types
Kidney failure can occur from an acute situation or from chronic problems.

In acute renal failure, kidney function is lost rapidly and can occur from a variety of insults to the body. The loss of kidney function is called acute kidney injury, also known as acute renal failure (ARF). This can occur following a traumatic injury with blood loss, the sudden reduction of blood flow to the kidneys, damage to the kidneys from shock during a severe infection called sepsis, obstruction of urine flow, or damage from certain drugs or toxins. Obstruction of urine flow such as with an enlarged prostate, also can lead to acute kidney injury. Acute kidney injury can also occur from pregnancy complications, such as eclampsia and pre-eclampsia, or related HELLP Syndrome.

Chronic renal failure develops over months and years. Chronic kidney disease is particularly dangerous, because you may not have any symptoms until considerable, often irreparable, kidney damage has been done. Diabetes (types 1 and 2) and high blood pressure are the most common causes of chronic kidney disease (CKD). Other causes are Immune system conditions, such as lupus, and chronic viral illnesses such as HIV/AIDS, hepatitis B, and hepatitis C.


Symptoms for Chronic kidney disease
  • Nausea and vomiting
  • Passing only small amounts of urine
  • Swelling, particularly of the ankles, and puffiness around the eyes
  • Unpleasant taste in the mouth and urine-like odour to the breath
  • Persistent fatigue or shortness of breath
  • Loss of appetite
  • Increasingly higher blood pressure
  • Muscle cramps, especially in the legs
  • Pale skin
  • Excessively dry, itchy skin
  • In children: increased fatigue and sleepiness, decrease in appetite, and poor growth
Dietary Guidelines
  • Salt (or sodium) is a major cause of CKD, high blood pressure and heart disease. High salt intake causes fluid retention. Low-salt substitutes are no good either, since they contain high levels of potassium
  • A low-protein diet slows disease progression and avoids build-up of excess urea. Protein is however essential for growth, muscle building and tissue repair. So consume enough protein to stay healthy
  • Potassium levels can be high in severe renal failure or for those on dialysis. Very high levels are dangerous and can cause cardiac arrest. Restrict intake only after consulting your dietician and checking your potassium level. This is necessary because potassium is present in many healthy foods
  • Phosphorus levels must also be controlled. Excess phosphorus can cause total kidney failure as well as bone disease and heart ailments. Since most foods contain phosphorus, it's necessary to take a medication called phosphate binder. When you consume phosphate binders like sevelamer carbonate during or immediately after meals, it binds like a magnet to the phosphorus in your food. This prevents phosphorus from being absorbed by your body
  • Calcium is another concern for kidney patients, causing serious bone disease in later years if not controlled
  • Fluid intake must also be monitored. If not on dialysis, however, do not restrict fluids unless there is a fluid overload problem. Drink water only when you are thirsty. If fluid retention is a problem, limit salt intake. Fluid intake cannot be controlled if you consume too much salt – you will keep feeling thirsty
  • Healthy eating controls blood pressure, weight, cholesterol and blood sugar levels, slowing the progression of kidney disease. While diet control is critical, the portion size also matters. If you eat in excess, the nutritional value changes considerably
  • Cigarettes and alcohol must also be avoided or reduced. If you follow these guidelines strictly, your life will never be completely knocked down by CKD.
References

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