{"id":25,"date":"2015-02-02T20:21:38","date_gmt":"2015-02-03T01:21:38","guid":{"rendered":"https:\/\/my.vanderbilt.edu\/kidney\/?page_id=25"},"modified":"2018-08-31T08:57:57","modified_gmt":"2018-08-31T13:57:57","slug":"the-human-kidney","status":"publish","type":"page","link":"https:\/\/my.vanderbilt.edu\/kidney\/the-human-kidney\/","title":{"rendered":"Kidney Disease"},"content":{"rendered":"

What Are Kidneys?<\/strong><\/span><\/h3>\n

Kidneys are vital organs<\/strong>,<\/em> like the heart and the liver. You cannot live without them. \u00a0Most people have two kidneys, one on each side. Some people only have one kidney because the missing kidney didn’t form in infancy, or was injured. \u00a0Usually it makes little difference if you have one or two kidneys. \u00a0The only real consideration is keeping the one kidney safe: no contact sports or high-risk activities like rock climbing or skydiving. \u00a0Kidneys sit behind your belly where your intestines and stomach are, but in front of the big muscles in your back that allow you to stand upright. Each kidney is about the size of your fist, but maybe a little taller and thinner. \u00a0 \u00a0Like all organs, kidneys receive blood from the heart through arteries and return blood to the heart through veins. \u00a0 Urine<\/em> drains from each kidney to your urinary bladder<\/em> through thin muscular tubes called ureters. <\/em> Ureters are thin muscular tubes resembling arteries or veins, but carry urine instead of blood. \u00a0Urine trickles into your bladder until the bladder is full enough that you have the urge to go to the bathroom.<\/p>\n

What Do Kidneys Do?<\/strong><\/span><\/h3>\n

The short answer is your kidneys do a lot.<\/p>\n

    \n
  1. Your kidneys get rid of the wastes<\/em><\/strong> that are left over from the food that your body uses, especially the wastes from metabolizing proteins<\/em><\/strong>.<\/span><\/li>\n
  2. Your kidneys also get rid of excess salt <\/em><\/strong>that you eat. \u00a0Salt is necessary to live but uncommon in nature unless you are by the sea. \u00a0As a result, you and many other animals crave salt when you can get it. \u00a0In our modern world, salt is mined and abundantly available, so we tend to eat too much of it. \u00a0Your kidneys dump what you do not need.<\/span><\/li>\n
  3. There are other minerals<\/em><\/strong> your body needs besides regular table salt, sodium chloride<\/em>. These include potassium<\/em> (nerve conduction), calcium<\/em> (bones), and magnesium<\/em> (bones and teeth and many metabolic functions) and phosphorus<\/em> (bones, teeth, metabolism, energy stores). \u00a0Your kidneys closely regulate all of these to balance what you eat from day to day with what our body needs. \u00a0It can be life-threatening if some of these minerals have concentrations in the blood that are too high or two low. <\/span><\/li>\n
  4. All that water<\/em><\/strong> you drink has to go somewhere! \u00a0You know from your own experience that the more you drink, the more you go. \u00a0Your kidneys not only get rid of the extra water, but very precisely regulate the balance between salt and water<\/em>. <\/span><\/li>\n
  5. Baking soda? Vinegar? \u00a0Your kidneys regulate the acidity<\/em><\/strong> of your blood and body. \u00a0Most plants are slightly alkaline<\/em> (more like baking soda) compared to you; most meat proteins are more acidic<\/em> (like vinegar) than \u00a0you are. \u00a0Kidneys keep this balance even regardless of whether you devoured a steak or nibbled a salad.<\/span><\/li>\n
  6. Blood pressure<\/em><\/strong> is a complicated thing. \u00a0Your kidneys regulate blood pressure through controlling salt balance and by secreting hormones that affect your blood vessels. \u00a0 This is one reason why most kidney doctors are also asked to treat blood pressure, just as heart doctors also treat blood pressure. <\/span><\/li>\n
  7. Red blood<\/strong><\/em>. \u00a0Your blood is red because the cells that carry oxygen around your body are bright red in color. \u00a0These cells are produced in your bone marrow<\/em> as are most cells in your blood circulation. Your kidneys secrete the hormone erythropoetin<\/em> (“eh-rith-row-poe–it-in”) that stimulates the bone marrow to make more red cells.<\/span><\/li>\n<\/ol>\n

    With all this, is it any wonder that people with kidney failure feel crummy?<\/p>\n

    Who Gets Kidney Failure? Why Do People Get Kidney Failure?<\/strong><\/span><\/h3>\n

    Kidney diseases affect young and old, man and woman, and people of any family origin.<\/p>\n

    In the Western industrialized world, the two most common causes of kidney failure are diabetes<\/em><\/strong> and high blood pressure<\/em><\/strong>. \u00a0 It is not completely clear how these diseases cause kidney failure, but there are some clues. \u00a0Diabetics tend to have problems with all their blood vessels: feet, eyes, heart, and kidneys too. \u00a0The kidney is all about blood and blood vessels, so any disease that affects blood vessels will affect the kidney. \u00a0High blood pressure is the same; it causes diseases in many blood vessels, including heart attacks and strokes, and kidneys are no different.<\/p>\n

    There are a large number of autoimmune diseases<\/em><\/strong> that cause kidney failure. Many have cumbersome names that represent how the kidney tissue visually appears to the pathologist when she or he examines kidney tissue. \u00a0Names such as membranous glomerulopathy, minimal change disease, focal and segmental glomerulosclerosis, membranoproliferative glomerulonephritis, and other even rarer diseases may be discussed with your doctor. \u00a0Lupus erythematosis and vasculitidies (inflammations of the blood vessels) are also relatively common causes of kidney disease. \u00a0Cancers<\/strong><\/em> can also cause kidney failure.<\/p>\n

    Many people today routinely are treated with surgeries<\/strong><\/em> that were experimental even a few years ago, and survive infections<\/em><\/strong> and heart attacks<\/strong><\/em> that would have been fatal in their parents’ generation. \u00a0Kidneys can become stunned or injured in these extreme, life-and-death situations, and many kidneys do not recover completely.<\/p>\n

    The kidneys are one of the ways your body eliminates drugs<\/strong><\/em>. \u00a0Prescription and over-the-counter medicines<\/strong><\/em> can cause kidney failure.<\/p>\n

    There are genetic<\/strong><\/em> causes of kidney failure. \u00a0The most common are polycystic kidney disease and Alport’s Syndrome. \u00a0 In genetic diseases, the DNA code that tells your body how to assemble parts of the kidney has a mistake in it that leads to trouble. \u00a0 Its worthwhile noting that many patients with these diseases represent new mutations<\/strong><\/em> in the DNA. \u00a0If you child has one of these diseases, and neither parent does, it doesn’t mean that one parent has been unfaithful.<\/p>\n

    Finally, blockages<\/strong><\/em> to the flow of urine can cause kidney disease. Men with enlarged prostates, men and woman with kidney stones, and patients who have received radiation treatments can have mechanical obstructions to the flow of urine, and the back pressure eventually causes damage to the cells of the kidney.<\/p>\n

    There are other causes<\/p>\n

    How Can I Tell If My Kidneys Are Healthy?<\/strong><\/span><\/h3>\n

    Unfortunately, kidney disease is a silent killer<\/strong><\/em>. \u00a0Healthy kidneys have about 10 times as much cleaning function as is absolutely needed to sustain life. People who donate a kidney are (obviously) missing half of their kidneys, yet they are healthy. \u00a0A lot of damage can occur without anyone knowing it. \u00a0Plus, who likes to talk about bathroom things? <\/span><\/p>\n

    There are a few red flags<\/em><\/strong> that should prompt you to visit your doctor, and sooner is nearly always better than later. Blood<\/strong><\/em> in the urine, pink<\/strong><\/em> urine, dark, tea-colored<\/strong><\/em> urine or very foamy<\/strong><\/em> urine are signs of trouble. \u00a0Did you know eating red beets can cause pink urine? \u00a0Puffy eyes or ankles<\/strong><\/em> can also be a sign or trouble. \u00a0Any change, even gradual, in urinary habits, could signal kidney troubles.<\/p>\n

    The United States Preventive Services Task Force publishes guidelines for screening<\/strong><\/em> patients for different sorts of diseases. Screening means looking for a disease before it causes symptoms and is hopefully at an early enough stage that treatment can avoid trouble. \u00a0The USPSTF says<\/p>\n

    No guidelines from primary care organizations recommend screening all adults for CKD. The National Kidney Foundation recommends assessing risk for CKD in all patients and doing the following for those at increased risk: measure blood pressure, test serum creatinine levels, test urine albumin levels, and examine urine for erythrocytes and leukocytes8<\/a><\/sup>. The American Diabetes Association recommends annual screening of all persons with diabetes using urine albumin and serum creatinine testing9<\/a><\/sup>. The National Institutes of Health’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that all persons diagnosed with hypertension should have urinalysis and serum creatinine testing; urine testing for albumin is optional10<\/a><\/sup>. (USPTF Website<\/a>)<\/em><\/p>\n

    What does this mean? \u00a0 If you are healthy and don’t have any special reason to worry about kidney disease, going ahead and testing you for it is unlikely to uncover a hidden disease. \u00a0If you have some reason to worry: you have high blood pressure or diabetes, or a family member with kidney trouble, it may be worthwhile considering some testing and you and your doctor should discuss what to do. <\/span><\/p>\n

    What Can I Do If My Kidneys Are In Trouble? What Should I Do?<\/strong><\/span><\/h3>\n

    First, take a deep breath and remember that most patients with kidney disease do not ever progress to having kidney failure. \u00a0 Your doctor will likely send you to see a kidney specialist. The kidney specialist \u00a0may order some blood and urine tests. Usually, some sort of imaging is ordered, such as an ultrasound<\/strong><\/em>, to show the size and shape of your kidneys. \u00a0Your doctor might recommend that a kidney biopsy<\/em><\/strong> be performed to diagnose the cause of kidney disease. <\/span><\/p>\n

    Depending on the exact disease, your doctor may prescribe some medicines to treat the disease or slow its progression.<\/p>\n

    What Will Happen To Me If My Kidneys Do Fail?<\/strong><\/span><\/h3>\n

    There are many options available and many choices to be made. \u00a0Most patients with kidney failure choose some form of dialysis<\/strong><\/em> to sustain their lives. Very briefly, dialysis uses a salt water solution to clean the blood of waste products. \u00a0This can happen inside the body, using\u00a0peritoneal dialysis<\/strong><\/em>, or outside the body, using\u00a0hemodialysis<\/strong><\/em>.\u00a0 The National Kidney Foundation<\/a> has terrific resources for patients and families, as does the American Association of Kidney Patients<\/a>.<\/p>\n

    The best treatment for kidney failure is a new kidney. \u00a0Kidney transplantation<\/strong><\/em> is the surgical removal of a kidney from one person and sewing it into another. \u00a0 Despite its low cost and great results, transplant is limited by scarcity<\/strong><\/em> of donor organs. \u00a0The United Network for Organ Sharing<\/a> publishes information and statistics about organ transplant.<\/p>\n

    The goal of The Kidney Project is to overcome the scarcity problem in kidney failure by engineering a limitless supply of artificial kidneys.<\/span><\/strong><\/h3>\n

    Donate Now<\/a><\/strong><\/em><\/h3>\n","protected":false},"excerpt":{"rendered":"

    What Are Kidneys? Kidneys are vital organs, like the heart and the liver. You cannot live without them. \u00a0Most people have two kidneys, one on each side. Some people only have one kidney because the missing kidney didn’t form in infancy, or was injured. \u00a0Usually it makes little difference if you have one or two…<\/p>\n","protected":false},"author":3604,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"tags":[],"class_list":["post-25","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/pages\/25","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/users\/3604"}],"replies":[{"embeddable":true,"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/comments?post=25"}],"version-history":[{"count":22,"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/pages\/25\/revisions"}],"predecessor-version":[{"id":266,"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/pages\/25\/revisions\/266"}],"wp:attachment":[{"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/media?parent=25"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/my.vanderbilt.edu\/kidney\/wp-json\/wp\/v2\/tags?post=25"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}