You are more likely to develop kidney disease if you have
high blood pressure
a family history of kidney failure
What can I do to keep my kidneys healthy?
You can protect your kidneys by preventing or managing health conditions that cause kidney damage, such as diabetes and high blood pressure. The steps described below may help keep your whole body healthy, including your kidneys.
During your next medical visit, you may want to ask your health care provider about your kidney health. Early kidney disease may not have any symptoms, so getting tested may be the only way to know your kidneys are healthy. Your health care provider will help decide how often you should be tested.
See a provider right away if you develop a urinary tract infection (UTI), which can cause kidney damage if left untreated.
Make healthy food choices
Choose foods that are healthy for your heart and your entire body: fresh fruits, fresh or frozen vegetables, whole grains, and low-fat or fat-free dairy products. Eat healthy meals, and cut back on salt and added sugars. Aim for less than 2,300 milligrams of sodium each day. Try to have less than 10 percent of your daily calories come from added sugars.
Tips for making healthy food choices
Cook with a mix of spices instead of salt.
Choose veggie toppings such as spinach, broccoli, and peppers for your pizza.
Try baking or broiling meat, chicken, and fish instead of frying.
Serve foods without gravy or added fats.
Try to choose foods with little or no added sugar.
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With chronic kidney disease, the kidneys don’t usually fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, medicines and lifestyle changes may help slow its progress and keep you feeling your best for as long as possible.
Five stages of chronic kidney disease
To help improve the quality of care for people with kidney disease, the National Kidney Foundation (NKF) created a guideline to help doctors identify each level of kidney disease. The NKF divided kidney disease into five stages. When the doctor knows what stage of kidney disease a person has they can provide the best care, as each stage calls for different tests and treatments.
If you have stage 4 kidney disease, it is important for you to:
Learn what you can do to keep kidney disease from getting worse - and do it!
Do your part to manage the complications of kidney disease
Heart and blood vessel problems
Anemia (low red blood cell count)
High blood pressure
Kidney disease often goes undetected in the general population, but children and adolescents are at an even greater risk due to the nature of the causes of the diseases and the ambiguity of the symptoms.
In adults, 90% of cases are related to glomerular based renal disease caused by diabetes, hypertension and glomerulonephritis, which cues physicians to suspect kidney disease.
In children, 70% of CKD is associated with tubulointerstitial disease and lack the obvious symptoms such as hematuria (red blood cells in the urine), hypertension (high blood pressure) or edema (swelling). (1)
Adding to this difficulty, children might not be aware of some of the changes that are impacting their body and will not always let their parents know of potential issues.
Common symptoms for children are:
Swelling (even mild) of the hands and feet and/or puffiness around the eyes caused by excess fluid build-up, to the point where the child’s ability to move around normally is compromised
After initial swelling, socks or a belt can leave an indentation in the skin that will persist
Lack of or decrease in appetite.
In children with ESRD it is especially important to keep their appetite up because transplant eligibility is based partially on growth.
Kidney failure can be caused by many underlying issues and generally falls into two categories of disease, classified as acute or chronic. Acute diseases generally develop quickly, lasts for a limited amount of time and are more immediately severe than chronic conditions (think food poisoning). However, acute disease can also develop or cause lingering problems. Chronic diseases generally develop and worsen over time and do not go away.
In adults the most common causes of kidney failure are diabetes and hypertension. In children congenital defects causing urinary tract blockages (posterior urethral valves) or small or non-functioning kidneys (hypoplastic and dysplastic) or another disorder that causes scarring of the glomeruli that leads to nephrotic syndrome (Focal Segmental Glomerulosclerosis), are the most common causes. (1)
Until age 4, birth defects and hereditary diseases are by far the leading causes of kidney failure. Between ages 5 and 14, hereditary diseases continue to be the most common causes, but glomerular disease incidence rises. As children age past 15, glomerular diseases are the leading cause, and hereditary diseases become rarer.
Acute kidney disease can come from poisoning, but often comes from an injury. Injuries that result in blood loss may temporarily reduce kidney function; however once blood loss is limited, the kidneys usually recover.
Hemolytic uremic syndrome (HUS) - is rare disease that affects children mostly under 10 years of age and can result in kidney failure. HUS is caused by eating foods contaminated by Escherichia coli (E coli) bacteria, which leads to an infection in the digestive system. Poisons produced by the bacteria can damage the kidneys, causing acute kidney failure. Children with HUS may need blood transfusion or dialysis for a short time. Most however, return to normal after a few weeks, and only a small percentage of children (mostly those who have severe acute kidney disease) will develop
Children with kidney failure have a few options to choose from, depending on the severity of their disease. The primary goal is to have a successful transplant, however viable kidneys are not always available and some children are not strong candidates for transplants.
In some cases a nephrectomy is a solution that can make childhood disease easier to manage.
In most cases parents choose home dialysis options either home hemodialysis or peritoneal dialysis.
In adults, most transplanted kidneys come from donors who have just perished. However, about half of the kidney transplants in children come from a living donor, usually a parent or other close family member.
Those who do not have a relative able to donate a live kidney need to enter the United Network for Organ Sharing (UNOS) managed Organ Procurement and Transplantation Waiting List. (1) Candidates' ages and length of time on the waiting list are factors in the donor point system. Children aged 18 and under get extra points compared with adults, because they are likely to receive the greatest benefit from a donated kidney. (2)
Living Donor Kidney - A kidney from a living donor often has advantages over a kidney from a recently deceased individual. (3)
A kidney from a parent is guaranteed to match on at least three of six proteins, which means it is less likely to be rejected.
With a living donation, there is additional time to pre plan and schedule the operation.
Shortens the number on the waiting list.
Psychological benefits of knowing that the donation came from a caring family member.
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Even if you get treatment in stage 4 and are careful about your health, your kidneys may still fail. Kidney failure happens when:
85-90% of kidney function is gone
GFR falls below 15
Kidneys don't work well enough to keep you alive
There is no cure for kidney failure, but with treatment it is possible to live a long, fulfilling life. Having kidney failure is not a death sentence. People with kidney failure live active lives and continue to do the things they love.
Treatments for Kidney Failure
The two treatments for kidney failure are kidney transplantation and dialysis. Two different types of dialysis can be done - hemodialysis and peritoneal dialysis.
Kidney Transplantation. This is an operation that places a healthy kidney into your body. The kidney can come from someone who has died or from a living donor. A new kidney will usually function immediately. You will need special medicines to prevent your body from rejecting the new kidney. If rejection happens, dialysis is needed and you can consider a second transplant. A kidney transplant is a treatment, not a cure. Kidney transplant recipients still have chronic kidney disease, and you may still need some of the other medicines you took before the transplant.
Hemodialysis (HD). Hemodialysis is a treatment that removes wastes and extra fluid from your blood. It can be done at home ("home hemodialysis") or in a dialysis center. During hemodialysis, your blood is pumped through soft tubes to a dialysis machine where it goes through a special filter called a dialyzer (also called an artificial kidney). As your blood is filtered, it is returned to your blood stream. Only a small amount of blood is out of your body at any time. In-center treatment time is 3-5 hours, 3 times a week. People who do home hemodialysis have more flexibility about how often it can be done. If done daily, treatment time would be 1½ to 2 hours. You will need an access into the bloodstream for placing needles needed for hemodialysis.
The goal of treatment for chronic kidney disease is to prevent or slow further damage to your kidneys. Another condition such as diabetes or high blood pressure usually causes kidney disease, so it is important to identify and manage the condition that is causing your kidney disease. It is also important to prevent diseases and avoid situations that can cause kidney damage or make it worse.
Treatment to control kidney disease
Control the disease that's causing the kidney damage
One of the most important parts of treatment is to control the disease that is causing kidney damage. You and your doctor will create a plan to aggressively treat and manage your condition to help slow any more damage to your kidneys.
If you have diabetes, it is important to control your blood sugar levels with diet, exercise, and medicines. A persistently high blood sugar level can damage the blood vessels in the kidneys. For more information about kidney disease caused by diabetes, see the topic Diabetic Nephropathy.
If you have high blood pressure, it is also important to keep your blood pressure in your target range, for example less than 130/80. To learn ways to help control your blood pressure, see the topic High Blood Pressure.
If other conditions or diseases are causing kidney damage, such as a blockage (obstruction) in the urinary tract or long-term use of medicines that can damage the kidneys, you and your doctor will work out a treatment plan.
You may need to change what you eat to manage your chronic kidney disease (CKD). Work with a registered dietitian to develop a meal plan that includes foods that you enjoy eating while maintaining your kidney health.
The steps below will help you eat right as you manage your kidney disease. The first three steps (1-3) are important for all people with kidney disease. The last two steps (4-5) may become important as your kidney function goes down.
The first steps to eating right
Step 1: Choose and prepare foods with less salt and sodium
Why? To help control your blood pressure. Your diet should contain less than 2,300 milligrams of sodium each day.
Buy fresh food often. Sodium (a part of salt) is added to many prepared or packaged foods you buy at the supermarket or at restaurants.
Cook foods from scratch instead of eating prepared foods, “fast” foods, frozen dinners, and canned foods that are higher in sodium. When you prepare your own food, you control what goes into it.
Use spices, herbs, and sodium-free seasonings in place of salt.
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Good self-management will help you to live a long, fulfilling life and continue to do the things you love. It can also help to slow or even stop kidney disease from getting worse - and it may even stop or delay kidney failure. Good self-management starts with:
Controlling other health problems you may have
Treating complications of kidney disease
Managing or preventing heart disease
Control Other Health Problems
You may have other disorders, such as diabetes and high blood pressure, which can damage your kidneys. One of the goals of your treatment is to make sure these are well-controlled. Ask your healthcare professional what you can do to keep these conditions under control - and do it! Some of the things your healthcare professional may ask you to do:
Take medications called angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) as part of your therapy. Studies have shown that these medications help to protect your kidney function. You may also need other blood pressure medications to control your blood pressure.
Lose weight if you are overweight
Cut down on salt in your diet to control blood pressure
If you have diabetes, monitor your blood sugar, follow your diet and take your medications as prescribed
Do What You Can to Manage the Complications of Kidney Disease
Kidney disease can cause other health problems throughout your body including:
Heart and blood vessel problems
Anemia (low red blood cell count)
Mineral and bone problems
High blood pressure
Poor nutritional health
Many Americans know nothing about kidney disease—until it's too late.
"Unlike many diseases, kidney disease often has no symptoms until it is very advanced," says Andrew Narva, M.D., Director of the National Kidney Disease Education Program (NKDEP) a part of the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
"For this reason and others, it is important for people to not only become aware of their risk, but also to learn about the steps they can take to keep their kidneys healthier longer. An important step is to get tested."
That testing is even more important for populations that are at higher risk for kidney disease, such as African Americans, adds Dr. Narva.
How can you tell if you are at risk for kidney disease? Ask yourself these questions:
Do you have diabetes (problems with your blood sugar)?
Do you have high blood pressure?
Do you have heart disease?
Did your mother, father, sister, or brother have kidney disease? (Kidney disease runs in families.)
If you answered "yes" to any of these questions, you are at risk for kidney disease. Now is the time to get tested.
Your health care provider will order two simple tests to check your kidneys—a blood test to check your glomerular filtration rate (GFR) and a urine test to check for protein.
GFR—A blood test measures how much blood your kidneys filter each minute, which is known as your GFR (glomerular filtration rate). This shows how well your kidneys are working. A GFR of 60 or higher is in the normal range. A GFR below 60 may mean you have kidney disease. You can't raise your GFR, but you can try to keep it from going lower.
Urine Protein—A urine test checks for protein in your urine, which can be a sign of kidney disease. Protein can leak into the urine when the filters in the kidneys are damaged. This test has several different names, including a check for "proteinuria," "albuminuria," or "microalbuminuria." It can also be called a "urine albumin-to-creatinine ratio."
A lymph node is a small, round or bean-shaped cluster of cells covered by a capsule of connective tissue. The cells are a combination of lymphocytes — which produce protein particles that capture invaders, such as viruses — and macrophages, which break down the captured material. Lymphocytes and macrophages filter your lymphatic fluid as it travels through your body and protect you by destroying invaders.
Lymph nodes are located in groups, and each group drains a specific area of your body. You may be more likely to notice swelling in certain areas, such as in the lymph nodes in your neck, under your chin, in your armpits and in your groin. The site of the swollen lymph nodes may help identify the underlying cause.
The most common cause of swollen lymph nodes is an infection, particularly a viral infection, such as the common cold. Other possible causes of swollen lymph nodes include:
Infected (abscessed) tooth
Skin or wound infections, such as cellulitis
Human immunodeficiency virus (HIV) — the virus that causes AIDS
What is a kidney stone?
A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine (hematuria) and often severe pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi.
The condition of having kidney stones is termed nephrolithiasis. Having stones at any location in the urinary tract is referred to as urolithiasis, and the term ureterolithiasis is used to refer to stones located in the ureters.
Kidney stones (renal lithiasis, nephrolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.
Kidney stones have many causes and can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.
Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications — surgery may be needed.
Your doctor may recommend preventive treatment to reduce your risk of recurrent kidney stones if you're at increased risk of developing them again.
Kidney stones are the result of an accumulation of dissolved minerals on the inner lining of the kidneys.
They are usually comprised of calcium oxalate but may be composed of several other compounds deposits.
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