The kidneys play a vital role in eliminating waste products, controlling various bodily functions, and supporting overall health. Their key functions include:
Kidney diseases can disrupt these functions, resulting in issues such as the inadequate removal of waste products, leakage of blood or protein into urine, or an excessive buildup of potassium in the bloodstream.
Frequent urination does not necessarily indicate normal kidney function. The process of urination involves the kidneys filtering waste products from the blood, transporting them to the bladder, and ultimately expelling them. When the bladder fills with urine, it triggers the urge to urinate. In some cases, individuals with severe kidney disease may produce urine that is primarily composed of water with minimal waste products. Consequently, blood tests for these individuals may reveal elevated waste product levels while other parameters, such as potassium levels, may not be within the normal range.
It’s important to distinguish between urinary frequency stemming from bladder issues and kidney-related concerns. This differentiation can be achieved through blood and urine tests, and occasionally, medical imaging.
As many kidney diseases remain asymptomatic in their early stages, physicians utilize screening tests to assess kidney health. Key tests for kidney disease include:
Individuals at risk for kidney disease, such as those with diabetes, high blood pressure, or a family history of kidney disease, should undergo regular screenings.
Relatively few kidney diseases cause kidney pain. Conditions that may lead to kidney-related pain include polycystic kidney disease (PKD), kidney stones, or severe kidney infections. However, most kidney diseases progress slowly and often do not involve noticeable pain.
Diabetes and high blood pressure are the leading causes of kidney disease. It’s essential to note that not everyone with diabetes or high blood pressure will develop kidney disease, but regular check-ups are crucial for those with these risk factors. Other causes of kidney disease encompass:
Typically, kidney diseases lead to gradual damage over several years, a condition referred to as chronic kidney disease (CKD). Diagnosing CKD involves a combination of blood and urine tests, a comprehensive physical examination, and, occasionally, a kidney biopsy.
High blood pressure, or hypertension, is never considered normal. Hypertension is often referred to as the “silent killer” because it gradually damages blood vessels in vital organs, including the brain, heart, and kidneys, over an extended period. Regardless of age, high blood pressure can cause vascular damage, stress the heart, and harm the kidneys. Conversely, kidney disease can either cause or worsen high blood pressure. Effective management of blood pressure, often requiring multiple medications, is crucial to reducing kidney and organ damage.
Your physician can assess kidney function by measuring creatinine levels through a straightforward blood test. A normal creatinine level for adults is around 1.0, irrespective of age. Creatinine levels are used to determine the glomerular filtration rate (GFR), indicating how efficiently the glomeruli (tiny kidney filters) remove waste products from the blood. Another relevant test is the 24-hour urine test, known as creatinine clearance, which is similar to GFR.
Kidney function typically decreases with age. A higher GFR implies better kidney function. A GFR ranging from 60 to 100 is generally considered normal, adjusted for age and gender. Many people do not experience symptoms of reduced kidney function until the GFR falls to 20-30 or lower, and some remain asymptomatic until it drops to 10-15. For individuals with kidney disease, knowing their GFR is crucial. Additionally, you can calculate your own GFR using the americandialysiscenters.com GFR Calculator once you have your blood creatinine level.
Symptoms of kidney disease may include:
– Swelling in the ankles and legs.
– Foamy or bloody urine.
– Fatigue.
– Decreased appetite.
– Nausea.
– Generalized itching.
– An unpleasant taste in the mouth.
– Confusion.
The presence of these symptoms suggests uremia, a condition where waste products accumulate in the bloodstream. Some individuals may develop these symptoms with a GFR of 20-30, while others may remain asymptomatic until it drops below 15. The presence of symptoms can also be influenced by the presence of anemia.
Anemia refers to a deficiency of red blood cells in the bloodstream. Since red blood cells are responsible for delivering oxygen to various tissues, including the heart, muscles, and brain, anemic individuals do not receive sufficient oxygen. Anemia is prevalent in many individuals with reduced kidney function and can exacerbate fatigue. Treating anemia can boost energy levels and enhance overall well-being in individuals with kidney disease.
Your healthcare provider will periodically inquire about uremic symptoms. If uremia is suspected, your nephrologist (kidney specialist) will assess whether any interventions can mitigate kidney damage. It’s vital to inform your healthcare provider about all medications you are taking, including over-the-counter and herbal supplements.
As kidney function declines, various blood test results may deviate from the norm, and nutritional status may deteriorate. When laboratory tests indicate a deterioration in nutrition, it may be time to initiate dialysis. Ideally, healthcare providers aim to prepare patients for dialysis or transplantation well in advance of the onset of uremic symptoms and nutritional decline. This proactive approach ensures timely intervention, preventing severe illness.
