Kidney Disease

The main job of kidneys is to keep a constant internal balance in the body at all times: homeostasis. By choosing what to reabsorb and what to release into urine, kidneys help keep a tight balance of water and minerals int he blood. To maintain homeostasis, the kidneys:

• Remove water and wastes
• Keep salt and other electrolytes in balance
• Control blood pressure
• Make hormones
• Maintain acid-base balance

Acute kidney injury (AKI), is a sudden, severe loss of kidney function, which can cause acute kidney failure. Causes of AKI may include:

1. Dehydration or loss of fluid (i.e. vomiting, diarrhea, water pills or severe blood loss)
2. Toxins (i.e. medicines, contrast used in CT scans, heavy metals, or pesticides)
3. Sepsis (severe blood infection)
4. Blockage of urine (i.e. kidney stone, tumor or enlarged prostate)

Frequently AKI is a complication of another potentially life-threatening illness or injury. Treatment is focused on removing the cause of the kidney failure. If the kidneys do not respond to treatment and adequate kidney function does not return, dialysis is the only option.
Most people with AKI improve when the cause of kidney failure is removed or treated and don't require dialysis. Normal kidney function is usually restored, though in some cases, residual damage only allows partial restoration of the kidney function. These patients may not require dialysis but may need medicines to supplement lost kidney function.

Millions of people in the United States have chronic kidney disease. CKD is characterized by a gradual loss of kidney function over time. Anyone can get CKD at any time. While CKD is highly prevalent, most people are unaware they have it and remain undiagnosed.  As a consequence of this lack of awareness, CKD has been labeled the "silent epidemic" by the National Kidney Foundation. Some people are more likely to develop kidney disease. You have an increased risk for kidney disease if you:

1. have diabetes.
2. have hypertension (high blood pressure).
3. have an inherited kidney disease (i.e polycystic kidney disease, Alport syndrome, reflux nephropathy, hyperoxalria, glomerulonephritis).
4. have a family history of kidney failure.
5. are older.
6. are African American, Hispanic American, Asian, Pacific Islander or American Indian. This population groups has a high rate of diabetes or high blood pressure.

Early detection through routine medical exams that include a urine test and blood pressure check are good screening tools for CKD. A blood test for creatinine ( a waste that healthy kidneys remove) may find CKD early. Treatment and collaboration with your nephrologist  may keep your kidney disease from progressing.  As kidney disease progresses it  may lead to kidney failure, which includes dialysis or kidney transplant.
People with CKD can help slow the loss of kidney function if they:

• Keep their blood sugar in the target range
• Keep their blood pressure in the target range
• Avoid pain pills call NSAIDS (non-steroidal anti-inflammatory medicines, like naproxen and ibuprofen)
• Quit smoking, if they smoke
• Ask the doctor to take steps to protect their kidneys if they need imaging tests with contrast (dye) like x-rays or CT scans

• 30 million people are estimated to have CKD. 
• 1 in 7 Americans has chronic kidney disease, but most of them are not aware of their disease.
• The United States has the 3rd highest rate of new cases of kidney failure in the world.
• High blood pressure and diabetes are the main causes of CKD. 
• Kidney disease often has no symptoms in its early stages and can go undetected until it is very advanced. For this reason, kidney disease is often referred to as a "silent disease".
• Kidney disease usually gets worse over time though treatment has been shown to slow progression
• Having kidney disease increases the changes of also having heart disease and stroke.
• CKD is estimated to be more common in women than in men.
• CKD is more common in African American, Native Americans,  Hispanic Americans, & Asian Americans than in Caucasians. 
• Only one functioning kidney is needed to live a healthy life.

Kidney disease can affect anyone but some people are more at risk than others. 

• Diabetes mellitus
• Hypertension (high blood pressure
• Being African American, Native American, Hispanic or Asian 
• Being over 60
• Having a family member with kidney disease