FAQ’s about Kidney failure and dialysis – 1

FAQ's about kidney failure and dialysis

Frequently Asked Questions- FAQ about Kidney failure and dialysis

1. What are kidneys?

The kidneys are a pair of organs located in the left and right side of the spine. Each kidney is about 4 o5 5 inches long – about the size of a fist. Each kidney contains a million units called nephrons, each of which is a microscopic filter for blood. Nephrons are the structural and functional unit of kidneys. Any damage to nephrons lowers down the efficiency of kidneys to perform their functions.

What are Kindeys

2. What are the functions of kidneys?

Kidneys are two bean shaped structures present below the rib cage in the body of an individual. Kidneys are responsible for filtering the blood to get rid of excess fluid, waste products, many drugs and regulate the composition of body fluids and salts. Kidneys are also responsible for blood pressure control, salt and water balance, erythropoietin (a hormone) production, vitamin D metabolism. The kidneys secrete hormones called renin for controlling blood pressure, and erythropoietin which helps control the production of red blood cells.

3. How does the kidney function?

The kidneys receive blood through the renal artery. The blood is passed through the structure of the kidneys called nephrons, where waste products and excess water pass out of the blood stream. When the venom induces clotting, the fibrin is deposited in the tubules. As the tubules are blocked, the kidneys are not able to remove the same amount of waste products from the blood, and urea and creatinine begin to accumulate in the blood. If these chemicals are not removed, the concentrations become lethal.

4. Explain the blood supply of the kidneys?

The kidneys receive blood from the renal arteries, left and right, which branch directly from the abdominal aorta. Despite their relatively small size, the kidneys receive approximately 20% of the cardiac output. Each renal artery branches into segmental arteries, dividing further intointerlobar arteries which penetrate the renal capsule and extend through the renal columns between the renal pyramids. The interlobar arteries then supply blood to the arcuate arteries that run through the boundary of the cortex and the medulla. Each arcuate artery supplies several interlobular arteries that feed into the afferent arterioles that supply the glomeruli. The interstitium is the functional space in the kidney beneath the individual filters (glomeruli) which are rich in blood vessels. The interstitum absorbs fluid recovered from urine. Various conditions can lead to scarring and congestion of this area, which can cause kidney dysfunction and failure. After filtration occurs the blood moves through a small network of venules that converge into interlobular veins. As with the arteriole distribution the veins follow the same pattern, the interlobular provide blood to the arcuate veins then back to the interlobar veins which come to form the renal vein exiting the kidney for transfusion for blood.

5. What is renal function?

Renal function is the synonym term used for kidney function. Health professionals use the term “renal function” to talk about how efficiently the kidneys filter blood. Kidney function is now calculated using a blood sample and a formula to find the estimated glomerular filtration rate (GFR).

6. Why do kidneys fail?

Most kidney diseases attack the nephrons, causing them to lose their filtering capacity. Damage to the nephrons can happen quickly, often as the result of injury or poisoning. But most kidney diseases destroy the nephrons slowly and silently. Only after years or even decades will the damage become apparent. Most kidney diseases attack both kidneys simultaneously. Most common reasons include : Diabetes and high blood pressure.

7. How does diabetes lead to kidney failure?

Diabetes is a disease that keeps the body from using glucose, a form of sugar, as it should. If glucose stays in the blood instead of breaking down, it can act like a poison. Damage to the nephrons from unused glucose in the blood is called diabetic kidney disease. Keeping blood glucose levels down can delay or prevent diabetic kidney disease. Use of medications called angiotensin-converting enzyme inhibitors or angiotensin receptor blockers to treat high blood pressure can also slow or delay the progression of diabetic kidney disease.

8. How does high blood pressure lead to kidney failure?

High blood pressure can damage the small blood vessels in the kidneys. The damaged vessels cannot filter wastes from the blood as they are supposed to. A doctor may prescribe blood pressure medication. ACE inhibitors and ARBs have been found to protect the kidneys even more than other medicines that lower blood pressure to similar levels. It is recommended that people with diabetes or reduced kidney function keep their blood pressure below 130/80.

9. How does other factors except diabetes and high blood pressure lead to kidney failure?

Glomerular Diseases : Several types of kidney disease are grouped together under this category, including autoimmune diseases, infection-related diseases, and sclerotic diseases. As the name indicates, glomerular diseases attack the tiny blood vessels, or glomeruli, within the kidney. The most common primary glomerular diseases include membranous nephropathy, IgA nephropathy, and focal segmental glomerulosclerosis. The first sign of a glomerular disease is often proteinuria, which is too much protein in the urine. Another common sign is hematuria, which is blood in the urine. Some people may have both proteinuria and hematuria. Glomerular diseases can slowly destroy kidney function. Blood pressure control is important with any kidney disease. Glomerular diseases are usually diagnosed with a biopsy—a procedure that involves taking a piece of kidney tissue for examination with a microscope. Treatments for glomerular diseases may include immunosuppressive drugs or steroids to reduce inflammation and proteinuria, depending on the specific disease.

Congenital Kidney Diseases : Some kidney diseases result from hereditary factors. Polycystic kidney disease (PKD), for example, is a genetic disorder in which many cysts grow in the kidneys. PKD cysts can slowly replace much of the mass of the kidneys, reducing kidney function and leading to kidney failure.

10. What are the signs and symptoms of chronic kidney disease?

Patients with chronic kidney disease shows following signs and symptoms:

  • need to urinate more often or less often
  • feel tired
  • lose their appetite or experience nausea and vomiting
  • have swelling in their hands or feet
  • feel itchy or numb
  • get drowsy or have trouble concentrating
  • have darkened skin
  • have muscle cramps

11. What are the stages of chronic kidney disease?

A person’s GFR is the test that indicates how well the kidneys are working. A GFR of 90 or above is considered normal. A person whose GFR stays below 60 for 3 months or longer has CKD. As kidney function declines, the risk of complications rises.

Moderate decrease in GFR (30 to 59) : At this stage of CKD, hormones and minerals can be thrown out of balance, leading to anemia and weak bones. A health care provider can help prevent or treat these complications with medicines and advice about food choices.

Severe reduction in GFR (15 to 29) : The patient should continue following the treatment for complications of CKD and learn as much as possible about the treatments for kidney failure. Each treatment requires preparation. Those who choose hemodialysis will need to have a procedure to make veins in their arms larger and stronger for repeated needle insertions. For peritoneal dialysis, one will need to have a catheter placed in the abdomen. A catheter is a thin, flexible tube used to fill the abdominal cavity with fluid. A person may want to ask family or friends to consider donating a kidney for transplantation.

Kidney failure (GFR less than 15) : When the kidneys do not work well enough to maintain life, dialysis or a kidney transplant will be needed.
In addition to tracking GFR, blood tests can show when substances in the blood are out of balance. If phosphorus or potassium levels start to climb, a blood test will prompt the health care provider to address these issues before they permanently affect the person’s health.

12. What are the different tests to analyze the functioning of the kidneys?

The usual blood test which checks that the kidneys are working properly measures the level of urea, creatinine, and certain dissolved salts.

Urea is a waste product formed from the breakdown of proteins. Urea is usually passed out in the urine. A high blood level of urea indicates that the kidneys may not be working properly, or that you are dehydrated (have a low body water content).

Creatinine is a waste product made by the muscles. Creatinine passes into the bloodstream, and is usually passed out in urine. A high blood level of creatinine indicates that the kidneys may not be working properly. Creatinine is usually a more accurate marker of kidney function than urea.

glomerular filtration rate (GFR) provides a guide to kidney function. Although the level of creatinine in the blood is a useful guide to kidney function, the GFR is a more accurate measure. Blood creatinine can be used to estimate the GFR using age, sex, and race. This is often calculated by computer and reported with the creatinine blood test. The normal value for GFR is 90-120 ml/min. An GFR below 60 ml/min suggests that some kidney damage has occurred. The value becomes lower with increasing severity of kidney damage.

Dissolved salts that are routinely measured are sodium, potassium, chloride and bicarbonate. They are sometimes referred to as ‘electrolytes’. Abnormal blood levels of any of these may be due to a kidney problem.

13. Why to go for a blood test of kidney function?

Routine kidney function is one of the most commonly performed blood tests. It may be done:
• As part of a general health assessment.
• If you have suspected dehydration (when the urea level increases).
• If you have suspected kidney failure. The higher the blood levels of urea and creatinine, the less well the kidneys are working. The level of creatinine is usually used as a marker as to the severity of kidney failure. (Creatinine in itself is not harmful, but a high level indicates that the kidneys are not working properly. So, many other waste products will not be cleared out of the bloodstream.)
• Before and after starting treatment with certain medicines. Some medicines occasionally cause kidney damage as a side-effect. Therefore, kidney function is often checked before and after starting treatment with certain medicines.

14. What are the treatment options available for kidney failure?

Dialysis and herbal treatment of kidney failure are available treatment options for kidney failure. Dialysis is under allopathy treatment of kidney failure while herbal treatment is under natural treatment of kidney failure.

15. Which herbal remedies are used for kidney failure ( Renal failure ) treatment?

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