By Ahmad Rhodes
Did you know kidney disease is one of the leading causes of death in the United States? Hypertension and diabetes are the leading contributors of kidney disease, according to American Renal Associates. Kidney disease is where the kidneys can no longer effectively clean out toxins in the blood. In America, 15% of people, which is 37 million people, have kidney disease. Some do not even know they have it. There are two types of kidney disease: chronic kidney disease and acute kidney disease.
Chronic kidney disease occurs when the kidneys slowly lose function. This is due to poor diets, poor lifestyle choices, and usually a family history of kidney disease. Acute kidney disease is when the kidneys shut down abruptly. This is usually because of cardiac arrest, sepsis, coronavirus, and dehydration. Unlike acute kidney disease, chronic kidney disease is irreversible.
The glomerulus is a structure in the urinary system that filters out waste, ions, and toxins in the blood. There are also millions of nephrons in the kidneys. Nephrons are structures that filter blood in the glomerulus. The nephrons also filter urea and creatinine, which are waste products from protein breakdown in the liver and breakdown of muscle. The glomerulus does not produce red blood cells or protein, so it should not be found in urine unless the glomerulus is not functioning properly. Protein and blood in urine is a symptom of kidney failure. Glomerular filtration rate (GFR) is used to determine if one has kidney failure. GFR is the rate the glomerulus filters waste, ions, and water in the blood. A normal GFR is greater than 90 ml per minute or higher. In kidney failure, the GFR decreases over time. There are various stages of CKD, with stages 4 and 5 being the most dangerous forms of kidney disease requiring a kidney transplant to survive. Patients in the early stages of kidney disease are asymptomatic.
As stated earlier, diabetes and hypertension are the most influential factors of kidney disease. With diabetes, the patient will have uncontrolled hyperglycemia, which is high blood sugar. Hyperglycemia causes glucose to stick to artery walls and damages the blood supply to the kidneys. Hypertension is another cause of kidney disease. In cases of hypertension, the high pressure to the artery wall damages the kidneys. As a result, the nephrons receive less blood. Angiotensin-converting enzyme (ACE) inhibitors such as lisinopril are given to maintain blood pressure.
For patients with kidney failure, there are two treatments: dialysis and kidney transplants. Dialysis is a process of cleaning out the blood and doing the job of the kidney. A kidney transplant is used to give a new kidney from a dead or living donor. Many patients choose dialysis before they get a transplant. Dialysis cannot cure kidney disease, but a transplant can. Peritoneal dialysis and hemodialysis are two types of dialysis. Peritoneal dialysis uses a fluid that goes into a surgically placed catheter to the peritoneum to work as the kidneys. The hemodialysis uses blood in the body to filter out toxins and act as the kidney. With peritoneal dialysis, patients are more prone to infection if a sterile environment is not maintained. The most common infection is peritonitis. Peritonitis is a deadly infection that causes the peritoneum membrane to be infected. This comes from minor things such as not wiping the exit site, not turning off fans, not washing hands, and not wearing a mask while connecting oneself to the tubing. Hemodialysis has risks. One can get sepsis, which is a blood infection, by not being careful with treatments. Dialysis patients tend to feel more tired than others. Overall, patients can prevent dialysis by living a healthy lifestyle.
References
Kidney Disease: The Basics. (2020, May 15). Retrieved January 31, 2021, from https://www.kidney.org/news/newsroom/factsheets/KidneyDiseaseBasics#:~:text=It%20affects%20an%20estimated%2037,%25
Working together to provide the highest quality care. (n.d.). Retrieved January 31, 2021, from https://www.americanrenal.com/