Most kidney diseases attack the nephrons, causing them to lose
their filtering capacity. Damage to the nephrons may happen
quickly, often as the result of injury or poisoning. But most
kidney diseases destroy the nephrons slowly and silently. It may
take years or even decades for the damage to become apparent.
The two most common causes of kidney disease are diabetes and
high blood pressure. If your family has a history of any kind of
kidney problems, you may be at risk for kidney disease.
Diabetes is a disease that keeps the body from using sugar as it
should. If sugar stays in your blood instead of breaking down, it
can act like a poison. Damage to the nephrons from unused sugar in
the blood is called diabetic nephropathy. If you
keep your blood sugar levels down, you can delay or prevent
High blood pressure
High blood pressure can damage the small blood
vessels in your kidneys. The damaged vessels cannot filter poisons
from your blood as they are supposed to.
Your doctor may prescribe blood pressure medication. A group of
blood pressure medicines called ACE inhibitors appears to give
extra protection to the kidneys in patients with diabetes.
Inherited and 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.
Some kidney problems may show up when a child is still
developing in the womb. Examples include autosomal
recessive PKD, a rare form of PKD, and other developmental
problems that interfere with the normal formation of the nephrons.
The signs of kidney disease in children vary. A child may grow
unusually slowly, may vomit often, or may have back or side pain.
Some kidney diseases may be "silent" for months or even years.
If your child has a kidney disease, your child's doctor should
find it during a regular checkup. Be sure your child sees a doctor
regularly. The first sign of a kidney problem may be high blood
pressure, a low number of red blood cells (anemia), or blood or
protein in the child's urine. If the doctor finds any of these
problems, further tests may be necessary, including additional
blood and urine tests or radiology studies. In some cases, the
doctor may need to perform a biopsy--removing a piece of the kidney
for inspection under a microscope.
Some hereditary kidney diseases may not be detected until
adulthood. The most common form of PKD was once called "adult PKD"
because the symptoms of high blood pressure and renal failure
usually do not occur until patients are in their twenties or
thirties. But with advances in diagnostic imaging technology,
doctors have found cysts in children and adolescents before any
Other causes of kidney disease
Poisons and trauma, for example a direct and forceful blow to your
kidneys, can lead to kidney disease.
Some over-the-counter medicines can be poisonous to your kidneys
if taken regularly over a long period of time. Products that
combine aspirin, acetaminophen, and other medicines such as
ibuprofen have been found to be the most dangerous to the kidneys.
If you take painkillers regularly, check with your doctor to make
sure you are not putting your kidneys at risk.
Many factors that influence the speed of kidney failure are not
completely understood. Researchers are still studying how protein
in the diet and cholesterol levels in the blood affect kidney
Acute renal failure
Some kidney problems happen quickly, like an accident that injures
the kidneys. Losing a lot of blood can cause sudden kidney failure.
Some drugs or poisons can make your kidneys stop working. These
sudden drops in kidney function are called acute renal
ARF may lead to permanent loss of kidney function. But if your
kidneys are not seriously damaged, acute renal failure may be
Chronic renal failure
Most kidney problems, however, happen slowly. You may have "silent"
kidney disease for years. Gradual loss of kidney function is called
chronic renal failure or chronic renal
End stage renal disease
The condition of total or nearly total and permanent kidney failure
is called end-stage renal disease (ESRD). People
with ESRD must undergo dialysis or transplantation to stay
People in the early stages of kidney disease may not feel sick
at all. The first signs that you are sick may be general: frequent
headaches or feeling tired or itchy all over your body.
If your kidney disease gets worse, you may need to urinate more
often or less often. You may lose your appetite or experience
nausea and vomiting. Your hands or feet may swell or feel numb. You
may get drowsy or have trouble concentrating. Your skin may darken.
You may have muscle cramps.
If your kidneys stop working completely, your body fills with
extra water and waste products. This condition is called
. Your hands or feet may swell. You will feel tired
and weak because your body needs clean blood to function
Untreated end-stage renal disease may lead to seizures or coma
and will ultimately result in death. If your kidneys stop working
completely, you will need to undergo dialysis or kidney
The two major forms of dialysis are hemodialysis
and peritoneal dialysis. In hemodialysis, your blood is sent
through a machine that filters away waste products. The clean blood
is returned to your body. Hemodialysis is usually performed at a
dialysis center three times per week for 3 or 4 hours.
A donated kidney may come from an anonymous donor who has recently
died or from a living person, usually a relative. The kidney that
you receive must be a good match for your body. The more the new
kidney is like you, the less likely your immune system is to reject
it. Your immune system protects you from disease by attacking
anything that is not recognized as a normal part of your body. So
your immune system will attack a kidney that appears too "foreign."
Special drugs can help trick your immune system so it does not
reject a transplanted kidney.
- Your kidneys are vital organs, keeping your blood clean and
- The progression of kidney disease can be slowed, but it cannot
- End-stage renal disease (ESRD) is the total loss of kidney
- Dialysis and transplantation can extend the lives of people
- Diabetes and high blood pressure are the two leading causes of
- You should see a nephrologist regularly if you have renal
If you are in the early stages of renal disease, you may be
able to save your remaining renal function for many years by
- Controlling your blood sugar.
- Controlling your blood pressure.
- Following a low-protein diet.
- Maintaining healthy levels of cholesterol in your blood.
- Taking an ACE inhibitor if you have diabetes.