By Dr. Nina Radcliff
In reality, it’s likely that you don’t think too much about your kidneys. In fact many people are not certain about their size, or what they do “exactly” – or too, where they are actually located.
Our kidneys play a crucial role in maintaining our health but are rarely appreciated until they become damaged and can no longer do their jobs. It is very important to make sure we take good care of them – as they are vitally essential organs to our overall health and well-being.
It is estimated that more than 26 million Americans have Chronic Kidney Disease (CKD) and millions more are at risk. In fact, according to the American Journal of Kidney Diseases the prevalence of CKD is expected to substantially rise in the United States by 2030 with over 50% of people currently aged 30-60 developing it in their lifetime. Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy. These statistics are staggering and we all need to be informed as it translates to striking our own life or those we love around us.
Furthermore, we want to take action to shift focus from managing chronic kidney disease in the future to taking steps to preventing it, now. Using studies as evidence, experts and the health community at large encourage changes in individual lifestyle choices and behaviors to ultimately prevent people from developing kidney disease.
Our kidneys are amazing, hardworking, behind-the-scene organs – let’s take a closer look to key understandings and steps you can take to help keep your kidneys healthy!
Dr. Nina’s What You Need To Know: About Kidney Disease
What are kidneys? Most people are born with two kidneys as the functional components of what is called the renal system, which also includes two ureters, a bladder and a urethra.
Kidneys are bean-shaped organs about the size of a computer mouse or your fist – and to locate your kidneys, put your hands on your hips, then slide your hands up until you can feel your ribs (one on the right and one on the left).
What do our kidneys do? A lot! They are mostly known for their important roll in filtering our blood to remove waste products, including medications, that are then excreted in the urine. And this is no small feat—they filter nearly 200 liters a day in adults. They also:
- Balance electrolytes—sodium, potassium, calcium, magnesium, phosphate
- Maintain acid-base balance
- Regulate blood pressure
- Balance fluid
- Play a roll in converting vitamin D into its active/usable form. This fat-soluble vitamin is important in keeping our bones strong.
- Produce erythropoietin, a hormone that controls red blood cell production
What happens when our kidneys are not working properly?
We see the above functions go awry. For example, our electrolytes become imbalanced, body develops fluid overload, blood gets acidotic, blood pressure elevates, bones weaken, and red blood cell counts drop. Additionally, the risk for developing heart disease and having a heart attack or stroke increase. It is important to note too, that damage can occur over many years, without any symptoms.
Is all kidney disease or injury the same?
No. It is often stratified as acute, meaning an event (or “insult”) that leads to malfunction, or chronic from a long-term disease that slowly leads to damage. Unlike chronic renal failure, in some situations, acute failure can be reversed.
What are risk factors for kidney disease?
- Non-modifiable– African-American descent, advancing age, history of low birth weight, and family history
- Chronic illnesses–poorly controlled diabetes mellitus and high blood pressure; as well as HIV, hepatitis C, cardiovascular disease, hyperlipidemia, cancer
- Smoking, heavy alcohol consumption
- Blockage of the urinary tract from prostate or bladder cancer; an enlarged prostate; or kidney stones cause increased pressure in the kidneys
- Exposure to heavy metals, certain medications (medical term is drug-induced nephrotoxicity)
- Shock (low blood pressure) can result from severe dehydration; blood loss; or allergic reaction
What symptoms can kidney disease cause?
Some experts call it a “silent disease” because symptoms often do not manifest until there is advanced disease. This underscores the importance of routine blood and urine testing in order to detect it early and take steps to stop or slow down further damage. Some symptoms include:
- Fatigue, dizziness, faint, weak
- Shortness of breath
- Feeling cold
- Swelling in hands, feet/ankles, face
- Nausea, vomiting
- Loss of appetite
- Urine changes—volume, bloody, pale, foamy
- Food tastes like metal
- Breath smells like ammonia
What are tests you can take to screen for kidney disease?
- Urine albumin-to-creatinine ratio. Albumin is a protein in the blood that does not pass into the urine, unless there is damage to the kidneys.
- Glomerular filtration rate (GFR). This is a blood test that measures how well our blood is being filtered. Specifically, it is a calculation based on the results of blood creatinine—a breakdown product of muscle that is produced at a constant rate—as well as age, sex, and race.
Leading organizations and professional societies recommend that if you have risk factors for chronic kidney disease–diabetes, hypertension, heart disease, family history of kidney failure—that you should get screened annually. And, too, you may need these checked if you are experiencing symptoms of kidney disease.
How can I keep my kidneys healthy?
While we cannot change our genetics and, in some cases, our environment, we do have control over a number of lifestyle choices and can take action to optimize chronic illnesses (diabetes, hypertension) that can elevate our risk.
Poor eating habits, smoking and obesity are associated with increased risk for kidney disease – and the National Kidney Foundation, a leading organization in the U.S. dedicated to the awareness, prevention and treatment of kidney disease for hundreds of thousands of healthcare professionals, millions of patients and their families, and tens of millions of Americans at risk – offer these suggestions:
Risk Reduction Tips from the National Kidney Foundation include keeping an eye on:
- Cutting sodium: Americans today consume 50% more than the recommended daily quantity of sodium – recommending 2,300 mg of sodium, about one teaspoon of salt, should be the daily limit.
- Moderation red meat: High protein diets, especially those containing large quantities of animal protein, may harm the kidneys. Red meat is also high in saturated fat.
- Cutback on sodas: Sugar-sweetened beverages, such as sodas are high calorie and contain no nutritious value. Colas also have phosphorus additives which can harm the kidneys.
- Pass on processed foods: Crackers, potato chips, deli meats, cheese spreads, and instant potato mix are all examples of processed foods that are high in sodium and phosphorus additives – both which can have negative effects on the kidneys.
- Slow down with sugar: An overdose of sugar can lead to diabetes and obesity, which are linked to kidney disease.
- Stop or, don’t smoke: Smoking slows the blood flow to important organs like the kidneys and can make kidney disease worse. Uncontrolled or poorly controlled high blood pressure is a leading cause of kidney disease – and too, smoking can affect medicines used to treat high blood pressure.
Our kidneys are the most important organs that play a vital role in excreting drugs and toxins from your body. Unlike family history of kidney failure, poor diet, smoking, and obesity are modifiable lifestyle factors that we can all control. By steering wisely through the risk reductions issued by the National Kidney Foundation and taking action to eating well (including fruit, legumes, nuts, whole grains and low-fat dairy), maintaining a healthy weight, in addition to taking time to relax, staying hydrated and exercising regularly — you can help to protect your kidneys.
Dr. Nina Radcliff is dedicated to her profession, her patients and her community, at large. She is passionate about sharing truths for healthy, balanced living as well as wise preventive health measures.
She completed medical school and residency training at UCLA and has served on the medical faculty at The University of Pennsylvania. She is a Board Certified Anesthesiologist and a member of the American Society of Anesthesiologists where she serves on committees for Young Physicians and Communications. Author of more than 200 textbook chapters, research articles, medical opinions and reviews; she is often called upon by media to speak on medical, fitness, nutrition, and healthy lifestyle topics impacting our lives, today.