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Your kidneys have many life sustaining functions. They are involved in blood pressure control, maintaining
electrolyte balance (sodium, potassium, phosphorous, calcium, etc), removing excess fluid from your body
and clearing acids and medications from your blood. The kidneys have important hormonal functions as
well, and are involved in the control of red blood cell and vitamin D production.
What are the parts of the kidney?
You have two kidneys, each about the size of a fist, located on either side of the spine at the bottom of the
rib cage. Each kidney contains about one million functioning units called nephrons. A nephron consists of
a filtering unit of tiny blood vessels, called a glomerulus, which is attached to a tubule. When blood enters
the glomerulus, it is filtered and the remaining fluid then passes through the tubule. In the tubule,
chemicals and water are either added to or removed from this filtered fluid according to the body's needs.
The final product is urine, which we excrete.
The kidneys perform their life-sustaining job of filtering and returning to the bloodstream about 200
quarts of fluid every 24 hours. Approximately two quarts are eliminated from the body in the form of
urine, and about 198 quarts are retained in the body. The urine we excrete has been stored in the
bladder anywhere from 1 to 8 hours.
What is Creatinine?
Creatinine is a waste product that comes from the normal wear and tear on muscles of the body, and is
then excreted by the kidneys. Everyone has creatinine in their bloodstream. Men have more muscle mass
than women and therefore will have a higher creatinine level. Usually, a low (in the normal range) serum
creatinine indicates good kidney function and a high creatinine is a sign of poor kidney function, there are
exceptions to the rule but your doctor will explain. Blood urea nitrogen (BUN) is a measure of protein
metabolism and varies based on fluid intake, medications and protein intake. A urinalysis with protein,
blood, or glucose may indication you have a kidney problem and/or systemic disease.
What is GFR?
GFR - Glomerular Filtration Rate is the best test to measure your level of kidney function and determine
your stage of kidney disease. Your doctor can calculate it from the results of your blood creatinine test,
your age, body size and gender. Your GFR tells your doctor your stage of kidney disease and helps the
doctor plan your treatment. If your GFR number is low, your kidneys are not working as well as they
should. The earlier kidney disease is detected, the better the chance of slowing or stopping its
How do I know if I have kidney disease?
Usually, a person’s kidneys only “hurt” if there is a kidney infection, kidney stone or if the patient has
polycystic kidney disease. Patients with chronic kidney disease often do not feel badly until their kidneys
have almost completely failed.
Your primary care doctor will determine if you have kidney disease based on blood work, urine studies
and/or imaging of the abdomen. A high serum creatinine (blood test) and/or high blood urine nitrogen
(BUN) may indicate you have kidney disease. You may be referred to a kidney doctor (nephrologist) for any
of the above issues or to help care for kidney stones, rare autoimmune or genetic diseases of the kidney.
What can I do to prevent kidney disease?
Diabetes and hypertension (high blood pressure) are the number one and two causes of kidney disease in
the United States. While certain genetic factors do play a role in the development of diabetes and
hypertension people can decrease their risk by maintaining a healthy body weight, exercising and
following a low sodium diet.
What are the warning signs of kidney disease?
Kidney disease usually affects both kidneys. If the kidneys' ability to filter the blood is seriously damaged
by disease, wastes and excess fluid may build up in the body. Although many forms of kidney disease do
not produce symptoms until late in the course of the disease, there are six warning signs of kidney
High blood pressure.
Blood and/or protein in the urine.
A creatinine and Blood Urea Nitrogen (BUN) blood test, outside the normal range. BUN and
creatinine are waste that build up in your blood when your kidney function is reduced.
A glomerular filtration rate (GFR) less than 60. GFR is a measure of kidney function.
More frequent urination, particularly at night; difficult or painful urination.
Puffiness around eyes, swelling of hands and feet.
Can kidney disease be successfully treated?
Many kidney diseases can be treated successfully. Careful control of diseases like diabetes and high
blood pressure can help prevent kidney disease or keep it from getting worse. Kidney stones and urinary
tract infections can usually be treated successfully. Unfortunately, the exact causes of some kidney
diseases are still unknown, and specific treatments are not yet available for them. Sometimes, chronic
kidney disease may progress to kidney failure, requiring dialysis or kidney transplantation. Treating high
blood pressure with special medications called angiotensin converting enzyme (ACE) inhibitors often helps
to slow the progression of chronic kidney disease. A great deal of research is being done to find more
effective treatment for all conditions that can cause chronic kidney disease.
What happens when your kidneys fail?
Healthy kidneys do many important jobs. They keep your whole body in balance. They remove waste
products and extra water from your body, help make red blood cells, and help control blood pressure.
When you have kidney failure it means your kidneys are damaged. They cannot do these important jobs
well enough. Having kidney failure means that:
85-90% of your kidney function is gone
Your kidneys don't work well enough to keep you alive
How is kidney failure treated?
Kidney failure may be treated with hemodialysis, peritoneal dialysis or kidney transplantation. Treatment
with hemodialysis (the artificial kidney) may be performed at a dialysis unit or at home. Hemodialysis
treatments are usually performed three times a week. Peritoneal dialysis is generally done daily at home.
Continuous Cycling Peritoneal Dialysis requires the use of a machine while Continuous Ambulatory
Peritoneal Dialysis does not. A kidney specialist can explain the different approaches and help individual
patients make the best treatment choices for themselves and their families. Kidney transplants have high
success rates. The kidney may come from someone who died or from a living donor who may be a
relative, friend or possibly a stranger, who donates a kidney to anyone in need of a transplant.
What is hemodialysis?
Hemodialysis is a treatment that removes wastes and extra fluid from your blood. It can be done at home
or at a dialysis center. During hemodialysis, the blood is pumped through soft tubes to a dialysis machine
where it goes through a special filter called a dialyzer (also called an artificial kidney). After your blood is
filtered, it is returned to your bloodstream.
What is peritoneal dialysis?
In peritoneal dialysis (PD), your blood is cleaned inside your body, not outside your body. The lining of
your abdomen (the peritoneum) acts as a natural filter. A cleansing solution flows into your abdomen
(your belly) through a soft tube called a PD catheter. Wastes and extra fluid pass from your blood into the
cleansing solution. Peritoneal dialysis is a home-based treatment and can be done at home, at work, at
school or even during travel. Because of this, peritoneal dialysis may allow for greater flexibility.