I had the opportunity to educate my fellow colleagues in the Akatakyie fraternity on measures to take good care of their kidneys, identify the risk factors that predispose them to the development of various kidney diseases, and measures they could employ to reduce these risks to the progression of kidney diseases. The purpose of this post is educate my readers who could not join the session last night on the various kidney disorders, signs and symptoms you could look for, if you suspect a person has a kidney disease for prompt referral to the hospital for a resolution of these symptoms.
I remember back in primary school, usually on my way from home, we used to fill our journeys with stories. Random stories children of today would not talk about. It was a myth that people who traveled long distances from Ghana to Libya drank their urine as they passed through the desert. This happened when they had ran out of water to drink and felt very thirsty. I had wondered why anyone in his right senses would take in something so bitter and toxic without cringing. As I passed through medical school, I got to understand the composition of urine and this probed me to understand their motives in these times of crisis.
Why a kidney? Do you need two kidneys at all? Why are the kidneys positioned in your abdomen and not near your neck? The kidneys play a vital role in ensuring you have the best of health. It works by basically filtering your blood. By this I mean it absorbs all the toxins you have ingested from the different kinds of drinks and food you have consumed, and makes sure your blood has the right composition at all times. The right composition of blood makes sure your hormones, electrolytes and cells work optimally at all times.
This is done by employing the use of the nephron- the basic functional unit of the kidney. It is said the kidney has about 1 million nephrons which work day and night to make sure your kidneys produce urine continuously even when you are asleep. A part of the nephron known as the glomerulus plays its role by acting as the bodyguard at a party who ensures people either enter or leave the party without an invite. This invite is their respective sizes. The glomerulus does not restrict the movement of water and some proteins; however larger molecules and other blood components which include white blood cells and platelets are not allowed entry through the glomerulus. If these are found in your urine, it could signify an underlying renal damage for which you would need urgent intervention by a renal specialist.
The kidney also produces a hormone known as erythropoietin which is vital in the production of red blood cells, in instances where your blood oxygen level is low. Lung diseases such as pneumonia and pulmonary edema (fluid in the lungs) could reduce these oxygen levels so require the production of an increased amount of red blood cells. These red blood cells are needed to trap oxygen from your lungs. Conditions such as Chronic Kidney Disease result disrupt the synthesizing ability of the kidneys in producing erythropoietin thereby cause anemia.
Some people with kidney diseases also present with weak bones mainly caused by a deficiency of calcium. This is termed hypocalcemia.
After urine is produced, it has to move from the kidney to the bladder by means of a long pipe called the ureter. Because there are two kidneys, there are two ureters. But there is only one bladder. These ureters run their course and end in the bladder located at the groin region. Kidney stones located in the ureters can prevent urine from reaching the bladder. However if this happens in one kidney, the other ureter can compensate for the extra function of the malfunctioned ureter. This could be seen on imaging (X-ray) as a dilated ureter. Kidney stones also known as renal calculi can impact themselves along various aspects of the urinary tract and cause severe pain which initially begins at the region of the kidney, and moves along to the groin. It could manifest as blood in the urine. This is termed as hematuria.
Blood in the urine should always be reported at the hospital because this could signify any underlying pathology from the kidney to the urethra. However certain medications used in the treatment of tuberculosis, and certain foods which includes blackberries and beet could cause a red discoloration of the urine. A test known as a urine dipstick can be used to differentiate the red discoloration being caused by the presence of blood from that due to other causes.
The National Academies of Sciences, Engineering, and Medicine has determined that an adequate daily fluid intake for men should be 3.7L and 2.7L for women. But the water that is taken should match or possibly exceed your daily losses through urine. In the presence of a dry atmosphere, there might be the need to consume more water to prevent dehydration which could have an adverse reaction on organs in your body which includes your brain.
Some people pass a lot of urine in a day. For this to be a problem, the amount should be greater than 3L per day. This is termed as polyuria. The opposite on the spectrum is known as oliguria where people pass scanty urine a day (500mls or less). Causes of oliguria include an acute renal failure or an obstruction along the point of the urinary tract. Anuria is the condition where no urine is passed at all, in 24 hours. This is an emergency so there is the need for swift presentation to a clinic for evaluation of its cause and treatment.
Most people present to the clinic with signs of infection which could be caused by either infections of the kidney and its associated tract. This is known as a urinary tract infection. If this infection happens from the kidney to the ureter, it is termed as an upper urinary tract infection. If it occurs below, it is known as a lower urinary tract infection. Their presentations differ, so it is essential the health professional identifies the symptoms and signs based on the story told by the individual and the findings elicited on examining the patient.
Based on the symptoms, signs and doctor’s discretion, he might order tests which include a renal function test to evaluate the functional capability of your kidney, a full blood count to assess the blood cells or identify any underlying infection, an ultrasound of the kidneys to estimate the sizes of the kidney and a CT scan in extreme cases.
The risk factors differ for the diverse forms of the kidney diseases. Being at risk means it is more likely you will get kidney disease. But this is not absolute. Risks factors that predispose to the development of kidney diseases include a family history of kidney disease and being hypertensive or diabetic. Africans are known to have an elevated risk for kidney disease notably chronic kidney disease, compared with European Americans. Much of this risk is due to genetic variations in a gene that creates a specific protein in the body. As you progress in age, your predisposition to diseases increases, mainly due to a weakened immune system. This could result in having a kidney disease.
In addition, taking alcohol in extreme amounts and smoking have been shown to be risk factors of kidney disease. Obesity further compounds these problems and worsens your protection from illnesses of the kidney. The use of herbal preparations for different reasons is a disturbing cause for presentation of most of our energetic guys to the hospital with kidney disease for which they might require dialysis.
It is therefore essential you protect yourself against these risk factors because Prevention is better than Cure. Because high blood pressure and diabetes are the most common causes of kidney failure, many of the prevention tips are related to managing these two conditions. Ways you prevent kidney diseases include
1. Managing your blood sugar
2. Managing your blood pressure
3. Maintaining a healthy weight
4. Eating a heart-healthy diet
5. Reducing salt intake
6. Drinking enough water
7. Limiting alcohol
8. Cutting down smoking
9. Limiting over-the-counter pain medication
11. Exercising regularly
Life is meant to be enjoyed and enjoyed to the longest extent. Protect your kidneys because Healthy Kidneys are a Healthy You.
Thanks for reading. Have a lovely weekend!