A little perspective on CKD for everyone

Steve Smyth

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Feb 27, 2002
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www.stevesmyth.com
Courtesy of Davita.com, a great support and knowledge-bank organization.
I get these e-mails from them every month, but they finally had an article I felt was worth sharing with you all.My hope is to give you guys a perspective on how many different things your kidneys do, and how many ways they can fail on you as well.I'm not trying to scare anyone, just provide a little insight.This shit is very real, and can happen to anyone. BTW, my failure is listed as the last subject, under birth defects, and obstruction as well, though mine was not described as a tumor to me, rather scar tissue.Only difference is, I was born with one kidney,not two, to add to the "double whammy" of Murphy's Law here.
Just thought I would share...

What kidneys do and how they fail

Although kidneys are relatively small (each one is about the size of your fist), when they are healthy, they process 100% of the body’s blood supply about every 5 minutes. Kidneys also perform many important functions.

Cleaning wastes from the blood
One important job of the kidneys is to filter waste products and excess water from the blood. The kidneys work in the same way as a water filter does to take impurities from your drinking water. The “cleaned” blood stays in the body, while the waste products leave the body in urine.

Managing fluid in the body
The balance of water (fluid) in your body needs to be just right – not too much, and not too little. The kidneys help maintain this fluid balance. Too much water in the body and the kidneys make more urine. Too little water and the kidneys produce less urine.

Controlling blood pressure
Kidneys help control blood pressure by releasing an enzyme called renin. When blood pressure drops and kidneys don’t receive enough blood, renin is released; causing blood vessels to contract (tighten). When blood vessels contract, blood pressure goes up.

Making red blood cells
Your kidneys produce a hormone called erythropoietin that signals the bone marrow to make red blood cells. Red blood cells carry oxygen to all the cells in the body. This is important because the body needs oxygen for life.

Balancing acidity and mineral composition
Your kidneys are master chemists that help maintain the proper balance of acid and minerals, including sodium, calcium, potassium and magnesium, in the blood. Without this balance, bones can become weak and break easily. It also keeps our hearts beating normally.

Kidney Failure
Kidneys fail when they are no longer able to clean waste from the blood and balance fluid and mineral levels. Let’s take a look at some of the most common causes of kidney failure.

Diabetes
Diabetes can cause damage to the kidneys, which is called diabetic nephropathy, is the most common cause of kidney disease in the United States.

In diabetes the body is not able to process sugar properly. As levels of sugar build up in the body, it causes damage to blood vessels, including those in the kidney. The high levels of sugar cause more blood to flow through the kidneys and this puts an added strain on the tiny blood vessels and raises blood pressure.

Damaged kidneys are not able to remove waste products and excess fluid well, so these build up in the blood. As the waste build-up continues, the damage gets worse, and the kidneys eventually fail. Because kidney failure in diabetics occurs slowly, the patient may not notice symptoms until the kidneys actually start to fail.

High blood pressure
High blood pressure can cause damage to the kidneys. It is interesting too that kidney damage can also cause high blood pressure.

If high blood pressure damages the blood vessels in the kidneys, the kidneys will not be able to remove wastes and extra fluid. The extra fluid can cause blood pressure to rise even more.

If kidneys produce too much of the enzyme, renin, blood pressure will rise too high. Over time, high blood pressure can cause blood vessels in the kidneys to thicken and narrow. This can lead to reduced blood supply and reduced kidney function. As with diabetes, eventually, the damage may become so great that the kidneys fail.

High blood pressure is the second leading cause of kidney failure. Every year in the United States, there are about 15,000 new cases of kidney failure due to high blood pressure.

Glomerular diseases
The kidneys contain about a million little clusters of looping blood vessels. Each cluster is called a glomerulus. When we talk about more than one glomerulus, we call them glomeruli.

Each glomerulus is connected to a small tube called a tubule, and each glomerulus and tubule unit is known as a nephron. The body has about one million nephrons in each kidney. The glomeruli work to filter the blood, and then waste products and fluid travel through the tubule and become urine.

When someone suffers from a glomerular (kidney) disease, it means that their glomeruli are no longer working the way they should. Waste products build up and cause extra fluid in the body. As a result, a person’s face, hands, ankles or feet may swell.

Glomerular diseases, the third leading cause of kidney failure, come in many forms, but they fall into two major categories:

Glomerulonephritis happens when the glomeruli are inflamed (swollen).
Glomerulosclerosis takes place when the glomeruli become scarred or hardened.
Glomerular disease has many causes, including other diseases such as diabetes, lupus and HIV. Toxic drugs and infection also can result in glomerular disease. In some cases, the cause is not known.

Polycystic Kidney Disease (PKD)
Polycystic kidney disease (PKD) is an inherited disorder, although it may not be diagnosed until adulthood. PKD causes large, fluid-filled cysts to grow within the kidney. The cysts press against the kidney tissue until finally the kidney stops working effectively. It usually takes many years before kidney failure happens.

Other causes of kidney disease
Birth defects can occur that affect kidney function. One is a narrowing of the ureters that can prevent the normal outflow of urine, causing it to flow back up into the kidneys. This often causes infections and may damage the kidneys.

Autoimmune diseases including lupus and affect the body's immune system and can damage organs, including the kidneys.

Obstructions caused by problems such as kidney stones, tumors or an enlarged prostate gland can also prevent normal urine flow, leading to infections and kidney damage.

Repeated urinary tract infections may also cause permanent damage to the kidneys.

Summary
Regardless of the cause of chronic kidney failure, there is no cure. However, hemodialysis or peritoneal dialysis can be a life-saving solution. Dialysis along with certain medicines and a careful diet does what the damaged kidneys can no longer do: it removes the wastes and extra fluid from the blood. A kidney transplant is another option for some people with kidney failure. Researchers are hopeful that someday all causes of kidney failure may be prevented.
 
Thanks for posting this Steve! It was a really good read! Hopefully in a few years medicine will get to the point to prevent all genetic transmitted diseases.
Hope you get a transplant soon and you get better!

As far as I read that, I'm not exposed to most of the causes of kidney failure. I have a history of blood pressure in my family, but none of my relatives had kidney failure.
 
Thanks for posting this Steve! It was a really good read! Hopefully in a few years medicine will get to the point to prevent all genetic transmitted diseases.
Hope you get a transplant soon and you get better!

As far as I read that, I'm not exposed to most of the causes of kidney failure. I have a history of blood pressure in my family, but none of my relatives had kidney failure.

Right on LOTS. Yes, hopefully within the next few decades we can see a lot of headway made in the organ donor program not only in the US, but in the world, to match the situations that are currently found only in the "black market", but obviously with the advances and ethics practiced in today's medicine. Things like cross match donations, like what went down in Baltimore a few weeks ago( quintuple transplant), though apparently "not completely ethical", are things that are already being practiced in other parts of the world( i.e. Canada and the UK). The US could stand to pick up in that area, I believe. We have all the advances in medicine here, except this area falls by the wayside for some reason, and this is the area that could get thousands off_ dialysis, and offer others a chance where they may not have one, ever.

The second part of what you said, I can directly relate to as well. A history of high blood pressure, yes, but no history of kidney failure in my family, anywhere, and they had me go back a few generations. It can happen as a result of poor diet, reckless lifestyle, those are things that if an individual does, they can put themselves in this position. Or, like me, you could just be born with a "bad roll of the dice", so to speak, and be born with a congenital birth defect. Not trying to preach, just hoping to awaken a few minds.
 
Luck is really important in genetics. One example of how weird and random genetics are is the one when a white couple had 2 twins and one of them was black and the other was white. They traced back the family tree of the parrents and none of them had relatives of African descent. We are all Africans to some extent (even the grim and true blond metal heads from Scandinavia), due to our genetic heritage, since life started in Africa, over the years humans just turned off some genes to adapt.

Another weird genetic thing is that 10% the Caucasian population of the world is immune to HIV infection and AIDS. They traced it with people who had ancestors that 500 years ago were infected by the virus causing the Black Death/Plague of Western Europe, but survived it, because it shaped the immune system that now, there immune cells cannot get infected by HIV.
 
Fascinating stuff. The human body is capable of amazing things as well as the bizarre. It is unfortunate that politics play such a heavy role in medical advancements. Imagine where we could be if that was not the case.
 
wow steve, i didn't know the kidney can do that all that stuff!

i am at high risk of diabetes so i have to watch that...thats a slap to the liver! or kidney...whichever is funnier....

thx for the info