In recent months, CHB has recorded number of cases with kidney problems, three recent cases of kidney failure needing transplant; this is becoming increasingly difficult due to strict control over donor organs etc.  Patients have to undergo regular dialysis, which is costly and a strenuous process.

Kidneys  have  a  very  important  function  because  they  filter  waste  products  out  of  the  body.  As  blood  passes  through  the  kidneys,  all  the  body’s  natural  toxins  are  removed.  The  waste  products  and  extra  water  become  urine,  which  the  kidneys  send  to  the  bladder  for  storage  until  urination.   

Kidneys  also  regulate  the  levels  of  certain  substances  in  the  body,  such  as  the  chemicals  sodium  and  potassium,  and  also  produce  vitamin  D  and  some  important  hormones  called  erythropoietin  and  calcitriol.   

A  person  can  live  with  only  one  healthy  kidney,  but  if  both  kidneys  fail  then  the  condition  is  very  serious.  Toxins  and  fluids  will  build  up  in  the  body,  and  the  blood  cannot  function  normally  because  it  is  not  being  cleaned  properly.  If  untreated,  this  can  lead  to  seizures,  coma  and  eventually  death.   

Usually  kidney  failure  is  a  gradual  process.  Kidneys  can  carry  out  their  normal  functions  even  if  only  one  is  working,  or  if  they  are  partially  damaged.  This  means  it  can  take  a  long  time  for  any  effects  to  be  felt.  When  symptoms  do  appear,  they  are  quite  variable  between  people,  and  often  it  is  hard  to  pinpoint  the  cause.  

If  kidney  failure  has  been  caused  by  a  sudden  injury,  these  symptoms  can  appear  rapidly,  and  may  progress  quickly  to  seizures,  coma  and  potentially  death.  

The  most  common  causes  of  kidney  failure  are  diabetes  and  high  blood  pressure.  More than 40 percent of all new cases of kidney failure are attributed to diabetes. Diabetes  can  cause  kidney  failure  if  your  blood  pressure  is  not  well  controlled,  if  you  do  not  manage  your  diabetes  properly  or  if  you  smoke  cigarettes.  If  too  much  glucose  is  in  the  blood,  it  can  attack  tiny  units  inside  the  kidney  called  nephrons.  It  is  these  nephrons  that  carry  out  the  filtering  process,  so  if  they  do  not  work,  the  kidney  will  stop  functioning.  High  blood  pressure  causes  damage  by  putting  strain  on  the  small  blood  vessels  in  the  kidneys. 

Basics Of Kidney Function:

The kidneys are a pair of fist-size organs shaped like kidney beans that remove waste products from the blood. The kidneys are located below the rib cage on either side of the spine. They perform the following major functions:

Creatinine and blood urea nitrogen (BUN) are among the waste products filtered by the kidneys. They are the result of the normal breakdown of active muscle and dietary protein.

Water-soluble toxins are also filtered from the blood. Tiny units called nephrons provide the filtering in the kidneys. There are about 1 million nephrons in each kidney. Filtering prevents waste substances from building up in the blood and damaging the body. 

The kidneys also remove excess water from the blood, which has three benefits:

• Keeps blood pressure from rising too high
• Prevents the heart from becoming overloaded
• Allows chemicals in the blood to remain undiluted and in balance

·         Conversely, when the body becomes dehydrated, the kidneys conserve water by excreting less of it into urine.

About 200 quarts of blood passes through the kidneys daily. The kidneys remove about 2 quarts a day of waste products, toxins and excess water in the form of urine. Urine collects in the kidneys, then travels out of the kidneys through long tubes called ureters, and ends up in the bladder. Once the bladder fills with urine, the walls are ready to contract and push the urine through the urethra and out of the body during urination.

The kidneys use several mechanisms to keep certain chemicals in the blood in balance. These include electrolytes, acids and bases. The kidneys perform this chemical balancing act by excreting excess chemicals into the urine, and conserving other chemicals when they are lacking in the blood.

The kidneys are also responsible for releasing three key hormones:

• Renin. Released when blood pressure is low, it causes blood vessels to constrict and brings the pressure back to normal.
• Erythropoietin. Directs bone marrow to make red blood cells. These cells carry oxygen throughout the body.
• Calcitriol. The active form of vitamin D, it helps maintain calcium for the bones.

For people with diabetes, control of glucose (blood sugar) and blood pressure is crucial in maintaining kidney function. Excess glucose (hyperglycemia) and high blood pressure can lead to diabetic nephropathy.

In addition, recent studies link obesity to impaired kidney function. High levels of LDL “bad” cholesterol can impair kidney function, but recent research into type 1 diabetes suggests that HDL “good” cholesterol can protect the kidneys.

Health Check-up & Methods Of Assessing Kidney Function:

If a physician suspects that a patient’s kidney function is impaired, a number of diagnostic tests can be performed. Waste product tests measure how effectively the kidneys filter and transport waste materials from the blood into the urine. Protein tests reveal renal damage by detecting the leakage of proteins in the urine.

Major tests of kidney function include:

• Serum creatinine test. A blood test that measures the level of the waste product creatinine in the blood. Creatinine comes from two sources: meat products in the diet and from wear and tear on the muscles. Almost all of it eventually ends up in a person’s urine.
• Blood urea nitrogen (BUN) test. A blood test that determines the level of urea nitrogen in the blood. Urea nitrogen is produced from a breakdown of food Protein.
• Creatinine urine test. Measures the amount of creatinine in the urine.
• Creatinine clearance test. A 24-hour urine test that measures the amount of blood being filtered each minute by the kidneys.
• Microalbuminuria test. Patients are advised to request a special urine test for microalbuminuria (presence of small amounts of protein in the urine) rather than a urinalysis for proteinuria (larger amounts of protein in urine). A microalbuminuria test can reveal kidney disease earlier, leading to treatments that can maximize kidney function.
• Glomerular filtration rate (GFR). A measurement of the amount of glomerular filtrate (a substance similar to plasma but without proteins) formed in the kidneys each minute. GFR is estimated indirectly through other tests such as creatinine clearance, serum creatinine, inulin clearance (test involving time urine collections after intravenous administration of a sugar) or equations such as the Modification of Diet in Renal Disease (MDRD) equation.

People who have or are at risk for cardiovascular disease should consider undergoing tests of kidney function, especially the MDRD, because kidney disease is a major risk factor for diseases of the heart and blood vessels.