Kidney Health Northern Ireland Kidney Research Fund KIDNEY DISEASE

Your Kidneys and How They Work

The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine.

Your kidneys are as important to your health as your heart or lungs.

The main function of the kidneys is to remove waste products and excess fluids from the body through urine.

The kidneys perform many crucial functions, including:

Maintaining overall fluid balance
Regulating and filtering minerals from blood
Filtering waste materials from food, medications, and toxic substances
Creating hormones that help produce red blood cells, promote bone health, and regulate blood pressure

CHRONIC KIDNEY DISEASE

Chronic kidney disease (CKD) is a long-term condition where the kidneys don’t work as well as they should.

Symptoms of CKD

There are usually no symptoms of kidney disease in the early stages. It may only be diagnosed if you have a blood or urine test for another reason and the results show a possible problem with your kidneys. At a more advanced stage, symptoms can include:

Tiredness
Swollen ankles, feet or hands
Shortness of breath
Feeling sick
Blood in your pee (urine)

See a GP if you have persistent or worrying symptoms that you think could be caused by kidney disease.

Causes of CKD

Chronic kidney disease is usually caused by other conditions that put a strain on the kidneys. Often it’s the result of a combination of different problems.

CKD can be caused by:

High blood pressure – over time, this can put strain on the small blood vessels in the kidneys and stop the kidneys working properly
Diabetes – too much glucose in your blood can damage the tiny filters in the kidneys
High cholesterol – this can cause a build-up of fatty deposits in the blood vessels supplying your kidneys, which can make it harder for them to work properly
Kidney infections
Glomerulonephritis – kidney inflammation
Polycystic kidney disease – an inherited condition where growths called cysts develop in the kidneys
Blockages in the flow of urine – for example, from kidney stones that keep coming back, or an enlarged prostate
Long-term, regular use of certain medicines – such as lithium and non-steroidal anti-inflammatory drugs (NSAIDs)

You can help prevent CKD by making healthy lifestyle changes and ensuring any underlying conditions you have are well controlled.

Tests of CKD

CKD can be diagnosed using blood and urine tests. These tests look for high levels of certain substances in your blood and urine that are signs your kidneys aren’t working properly.

Treatments of CKD

There’s no cure for CKD, but treatment can help relieve the symptoms and stop it getting worse.

Your treatment will depend on how severe your condition is.
The main treatments are:

Lifestyle changes to help you remain as healthy as possible
Medicine to control associated problems such as high blood pressure and high cholesterol
Dialysis – treatment to replicate some of the kidney’s functions; this may be necessary in advanced CKD
Kidney transplant – this may also be necessary in advanced CKD

Who to contact

In the first instance, contact your GP if you have any symptoms or concerns.

DIABETES & KIDNEY DISEASE

Diabetes – A Major Risk Factor for Kidney Disease

What does diabetes do to the kidneys?

With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.

Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.

Diabetic Nephropathy

Diabetic Nephropathy – kidney disease that results from diabetes – is the number one cause of kidney failure.

Kidney disease in type 1 diabetes is slightly different than in type 2 diabetes. In type 1 diabetes, kidney disease rarely begins in the first 10 years after diagnosis of diabetes. In type 2 diabetes, some patients already have kidney disease by the time they are diagnosed with diabetes.

Symptoms of Diabetic Nephropathy

There are often no symptoms with early diabetic nephropathy. As the kidney function worsens, symptoms may include:

Swelling of the hands, feet, and face
Trouble sleeping or concentrating
Poor appetite
Nausea
Weakness
Itching(end-stage kidney disease) and extremely dry skin
Drowsiness (end-stage kidney disease)
Abnormalities in the hearts’ regular rhythm, because of increasedpotassium in the blood
Muscletwitching

Risk Factors

If you’re living with diabetes, factors that can increase your risk of diabetic nephropathy include:

Uncontrolled high blood sugar (hyperglycemia)
Uncontrolled high blood pressure (hypertension)
Being a smoker
High blood cholesterol
Obesity
A family history of diabetes and kidney disease

How Is Diabetic Nephropathy Diagnosed?

Certain blood tests that look for specific blood chemistry can be used to diagnose kidney damage. It also can be detected early by finding protein in the urine. Treatments are available that can help slow progression to kidney failure. That’s why you should have your urine tested every year if you have diabetes.

How Is Diabetic Nephropathy Treated?

Lowering blood pressure and maintaining blood sugar control are absolutely necessary to slow the progression of diabetic nephropathy. There are medications available which have been found to slow down the progression of kidney damage.

If not treated, the kidneys will continue to fail and larger amounts of proteins can be detected in the urine. Advanced kidney failure requires treatment with dialysis or a kidney transplant.