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Your kidneys work as the filters of your bloodstream, removing waste materials and excess substances such as water while retaining things that your body needs, such as red blood cells and proteins. When blood enters your kidneys, it goes through structures called nephrons that filter out the waste products. These waste products exit your body in the form of urine, while the filtered blood returns to circulation. Kidney failure occurs when your kidneys are no longer able to filter your blood properly.
Kidney failure results in things that you need, such as proteins, calcium, and red blood cells, escaping in your urine while urea and other wastes continue to circulate in your bloodstream. This imbalance interferes with other systems in the body by potentially causing anemia and proteinemia while waste products continue to build up.
Kidney disease can lead to edema, cardiovascular disease, anemia, weak bones, poor immune response to infections, and even personality disorders or seizures. Your kidneys play a huge role in keeping your body healthy and functional!
Kidney Failure Symptoms
Unfortunately, there are no black-and-white symptoms of kidney disease or kidney failure. Patients may show no signs at all until the kidneys have undergone extensive damage and can no longer compensate. Symptoms that do occur are generic and can be caused by various other conditions. That said, these symptoms may indicate kidney failure:
- Fatigue. This could be attributed to poor oxygenation of tissues due to anemia, or the buildup of wastes.
- Nausea and vomiting.
- Changes in urination. You might find yourself needing to visit the restroom more often that usual, or only rarely.
- Edema. Because the kidneys are not able to properly control the amount of water in the body, excess water may stay in the bloodstream. This water then pools in areas of the body such as the feet and ankles, or around the heart and lungs.
- Shortness of breath. Fluid buildup in or around the lungs will make it difficult to breathe.
- Chest pain. Fluid buildup around the heart makes it more difficult for the heart to pump.
- Loss of appetite.
Diagnosing Kidney Failure
As you might expect, it is best to catch kidney disease early before too much damage has been done. While symptoms that you notice at home are not the most reliable signs, routine exams and lab work done by your doctor can catch kidney disease early.
Kidney problems are often found during routine urinalysis. Every time your doctor asks you to pee in a cup, your kidney function is being evaluated. Urinalysis checks for protein, glucose, blood, and other cells present in the urine, plus any foreign invaders such as bacteria or yeast. If there are a lot of blood cells or high levels of protein in your urine, your doctor will know to investigate further. For patients with predisposing factors, such as diabetes or high blood pressure, even a slight increase in urine protein levels may be cause for concern.
Blood tests to evaluate kidney function measure the levels of creatinine and blood urea nitrogen (BUN). Elevated creatinine and/or BUN indicate kidney damage.
If your doctor suspects that you have kidney disease, you may also need an ultrasound and/or kidney biopsy. Ultrasound allows the doctor to view your kidneys to evaluate their health and measure them. Kidney stones and obstructions can often be viewed via ultrasound. A kidney biopsy involves removing a small piece of the kidney so that it can be viewed under a microscope. There are two types of kidney biopsy: needle or open. A needle biopsy is done with a local anesthetic to numb the area so that the clinician can insert a needle into the kidney. Often an imaging technique such as ultrasound or CT scan is used to guide needle placement. An open biopsy requires general anesthesia so that the clinician can make an incision in the skin to access the kidney. As kidney biopsies are the most invasive diagnostic method, they are generally reserved for cases where it is difficult to determine the cause of the kidney damage.
What to Expect
If you are diagnosed with kidney disease, your doctor will advise you on lifestyle changes and medications to slow the progression. High blood pressure should be treated to reduce strain on the kidneys, and high cholesterol levels should be addressed. Eating a healthy diet with restricted salt and protein and balanced minerals will decrease the kidney’s workload.
In advanced kidney failure, it may become necessary to start dialysis to artificially filter your blood or to get a kidney transplant to replace the damaged kidneys.
Preventing Kidney Failure
There are several steps you can take to protect your kidneys. Keep active and eat a healthy diet to keep off excess weight. Follow the instructions on all medications, including over-the-counter drugs, and don’t smoke—your kidneys are involved in the excretion of many drugs and also filter out the waste products from smoking. If you have a serious health problem, particularly one that predisposes you to kidney damage, keep up with appointments and medications to keep yourself in your best health. And even if you are generally healthy, don’t skip your annual physical—routine exams are the best way to catch developing problems early!
This article was originally published in 2018. It is regularly updated.