For most of us, kidney health is so far down our worry list we can go years without thinking about this very important organ. If we do worry about our health, we focus on the heart or blood pressure. More people are concentrating on blood glucose levels, paying attention to increasing information about diabetes. However, kidneys play a vital role in staying alive and healthy.
Kidneys have been called the master chemists of the body because their work is so complex. They affect the health of the heart and blood pressure, and provide a host of other benefits we take for granted. Chronic Kidney Disease (CKD) is a condition that develops over time. The kidneys lose more and more ability to function. Sometimes they stop working completely. Then, kidney replacement therapy (dialysis or a kidney transplant) is necessary or the person will die.
The problem is that early chronic kidney disease is a silent (secret) condition. Symptoms are so subtle that most people have no warning until at least half of kidney function is lost. However, this does not have to be the case. Finding kidney disease early is important. Effective treatment can preserve kidney function and delay or avoid the need for dialysis or kidney replacement (transplantation).
Kidneys are reddish-brown organs about the size of an adult fist. Shaped like kidney beans, they are found on either side of the spine under the lower ribs. We are born with two kidneys, but it is possible to live a healthy normal life with only one.
The kidneys are constantly at work. Each minute of every day, one litre of blood (20 per cent of the adult blood supply) is pumped through them.
Healthy kidneys are vital to our everyday health. They:
Blood pressure and heart health: Much has been written about the dangers of high blood pressure, also called hypertension. It leads to heart attack, stroke, and encourages build-up of fatty plaque, causing atherosclerosis, a condition that can cause blood clots. Healthy kidneys regulate blood pressure levels in the body, helping prevent these related conditions. However, high blood pressure can develop from other sources. When it does, it damages blood vessels in the kidneys. This reduces their ability to regulate blood pressure, making readings even higher. Blood supply to the kidneys is also reduced. The kidneys become unable to remove fluids and waste products from the blood. Left untreated, this can result in kidney failure.
Diabetes: Kidney disease due to diabetes is the number one cause of kidney failure in Canada. Diabetes injures the blood vessels of the kidneys. This prevents the kidneys from cleaning the blood properly. The body then retains more water and salt than it should, which can cause weight gain and ankle swelling. Protein may also develop in the urine. Waste materials build up in the blood.
Since the kidneys play a central role in controlling blood pressure, people with kidney disease related to diabetes often have high blood pressure too. Lowering blood pressure may slow the progression of kidney disease.
Diabetes can also damage nerves in the body. Some people begin to have difficulty emptying the bladder. The pressure of a full bladder can make urine back up and the increasing strain can injure the kidneys. Also, infection can occur if urine lingers in the bladder, as bacteria grow rapidly in urine with a high sugar level.
Those with diabetes should have their blood, urine and blood pressure checked at least annually by their doctor. This ensures early detection and treatment of high blood pressure and kidney disease.
Chronic kidney disease (the presence of kidney damage or a lowered level of kidney function) is on the rise. In Canada, it is estimated that almost two million people have this life-threatening disease. The rate is growing at epidemic proportions. As the symptoms can be silent, many do not know they have it.
People most at risk of developing CKD are those with:
If you are part of this at risk group, please see your doctor. Ask for eGFR and urinalysis tests if they have not been done in the past. These simple tests screen for the presence of chronic kidney disease.
The B.C. branch of The Kidney Foundation of Canada (KFOC) recently launched a targeted screening program. It identifies those at risk of developing kidney disease by providing on-the-spot testing. It is anticipated this program will be available across Canada later in 2011.
Visit www.kidney.ca for more information on how to keep your kidneys healthy.
Organ transplantation has become the treatment of choice. It is the best option for eligible kidney patients needing life-saving renal replacement therapy. However, the number of people registered to donate organs does not come close to matching that of those hoping for transplant. Midway through 2010, 2030 Canadian kidney patients were on the active wait list for a transplant, 873 of whom were from the four western provinces. There is also a chronic shortfall of hearts, lungs and livers. The sad truth is that some hopefuls will die waiting.
The good news? In recent years the number of kidney transplants donated from living donors has steadily increased. To reduce the life-threatening wait, friends and family members of kidney patients are now assessed as potential living donors for their loved ones. Since the human body doesn’t need two kidneys, living kidney donation is an excellent alternative and helps reduce the wait list. In some provinces, kidney transplants from living donors have exceeded the number of transplants from those who have died. Success rates for kidney transplants are very good for both donor and recipient. Most transplant recipients enjoy an extended quality of life and are able to return to former activities at work or school.
In July 2006, the BC Branch of The Kidney Foundation of Canada (KFOC) partnered with BC Transplant to launch the Living Organ Donor Expense Reimbursement Program (LODERP). This three-year pilot program was designed to support living kidney and liver donors by reimbursing eligible expenses related to assessment, surgery and recovery. The goal is to increase the number of living donor transplants by removing the burden of related expenses. LODERP also shares information about this project freely to encourage similar programs in other health regions.
To date, Alberta, Manitoba and Ontario have launched reimbursement programs based on the BC model. It is hoped that soon any living kidney or liver donor donating to a Canadian recipient can be reimbursed for expenses related to their generous gift of life.
The Kidney Foundation of Canada is committed to raising awareness of the need for organ donation. Not only does transplant allow kidney patients to live a fuller healthier life, it saves the healthcare system thousands of dollars a year. In the first year, the cost of organ donation surgery plus anti-rejection medication is less than half that of hemodialysis. From the second year on, anti-rejection meds are the only regularly scheduled cost. Visit www.kidney.ca for more information about organ donation.