Kidney Problems

Although many forms of kidney disease have no symptoms until late in the course of the disease, there may still be some warning signs. If you do have symptoms, they might include:

• Swelling in your feet, hands or face
• Pain in the small of the back, just below the ribs
• High blood pressure
• Burning or difficulty during urination
• Needing to urinate more often, especially at night
• Passage of blood in your urine
• Puffiness around your eyes
• Dry, itchy skin
• Increase in the size of your abdomen, such as with polycystic kidney disease
• Feeling tired and having less energy than usual
• Poor appetite
• Sleep problems, such as insomnia, restless leg syndrome and obstructive sleep apnea
• If you think you may have a kidney problem, see your doctor. Treatment is more effective if kidney problems are caught early.  Kidney problems that are left untreated may lead to permanent damage or even kidney failure.

The kidneys are two organs located on either side of your spine, just below your rib cage. They are part of your urinary tract. The kidneys perform several life-sustaining roles, which include:

• Cleanse your blood by removing waste and excess fluid, making up your urine
• Maintain a balance of water and concentration of minerals in your blood
• Help regulate blood pressure
• Stimulate red blood cell production
• Produce an active form of vitamin D, needed for bone health

If you have kidney problems, it means that your kidneys are not working as well as they should. When the kidneys become damaged, waste products and fluid can build up in the body, causing symptoms like swelling in your ankles, increased urination and weakness. There are many causes and types of kidney problems. While most are treatable, only some are curable. If left untreated, damage may become lasting and get worse over time. If the damage is very bad, your kidneys may eventually stop functioning completely. Kidney failure is serious, and you will need either dialysis or a kidney transplant in order to live.

What causes kidney problems?

The two main causes of kidney problems are diabetes and high blood pressure. According to the National Kidney Foundation , diabetes and high blood pressure are responsible for up to two-thirds of all cases of chronic kidney disease. Some infections, inherited diseases and injuries can also cause kidney problems.

What types of kidney problems are there?

There are various types of kidney problems, however some of the most common include:

• Chronic kidney disease: The term chronic kidney disease describes the gradual loss of kidney function over a period of months or years. This can be caused by various conditions. In the early stages of chronic kidney failure, you may have few non-specific symptoms. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can accumulate in your body causing symptoms such as swelling in the feet, vomiting and sleep problems.
• Acute kidney injury: Injuries, major blood loss, and some reactions to medicines can cause the kidneys to fail very quickly.  It develops rapidly over a few hours or a few days. In some cases, this kind of kidney failure may be reversible.  In other cases, the kidney failure may be permanent and can be fatal. Acute kidney injury requires intensive treatment. It is most common in people who are already hospitalised, particularly in critically ill people.
• Nephrotic syndrome: Nephrotic syndrome is a disorder that causes your body to excrete too much protein in your urine. Both children and adults can have nephrotic syndrome. This condition causes swelling (edema), particularly in your feet and ankles, and increases the risk of other health problems such as infections and blood clots.
• Polycystic kidney disease: This is the most common form of inherited kidney disease.  Polycystic kidney disease causes many fluid-filled cysts to form in the kidneys.  These cysts grow out of control and can overrun the kidneys. Over time, they can damage the kidneys and can lead to kidney failure.
• Kidney stones: Kidney stones are like small, hard deposits that form inside your kidneys.  Stones form when certain chemicals in the body clump together.  A stone can either stay in the kidney or travel through the urinary tract. This is called "passing." Passing kidney stones can be quite painful, but the stones usually cause no permanent damage.
• Kidney cancer: Kidney cancer is cancer that starts in the kidneys. It occurs when abnormal kidney cells grow and divide uncontrollably. The accumulating abnormal cells form a tumor that can extend beyond the kidney. Some cells can break off and spread (metastasise) to distant parts of the body. For more information, see Kidney Cancer.

As there are very few, if any, symptoms in the early stages of kidney disease, certain tests and procedures are needed to determine how well your kidneys are working. These may include:

• Blood tests: Checking for the buildup of metabolic waste products in your blood is the easiest way for your doctor to evaluate your kidney function. The most common tests measure creatinine and urea in your blood. When creatinine and urea levels are high, it suggests decreased kidney function.
• Urine tests: Analysing a sample of your urine may reveal abnormalities that point to kidney conditions. They can also help identify the cause of the problem. Harvard Health holds that the most important urine test of all is to check for protein, or proteinuria, in the urine. A simple dipstick check can also screen for evidence of bleeding and infection.
• Imaging tests: Your doctor may use ultrasound to assess your kidneys' structure, size and degree to which they reflect sound waves. Specialised tests, including computed tomography (CT) scans and magnetic resonance imaging (MRI), can be used when more detailed images are required.
• Kidney biopsy: A kidney biopsy may be recommended by your doctor to help determine what’s causing your kidney problems. In this procedure, a long, thin needle is inserted through your skin and into your kidneys, to remove a sample of kidney tissue. This sample is them sent to a laboratory for detailed testing.

Depending on the underlying cause, some types of kidney problems can be treated. Others though, may have no cure. Treatment generally includes measures to help manage your symptoms, ease health complications, and to reduce or slow further damage to the kidneys.  While treatment options vary, they may include:

• Low protein diet: As your body processes protein from foods, it creates waste products that your kidneys must filter from your blood. Your doctor may recommend a low protein diet to reduce the amount of work your kidneys must do.
• Medications
  • High blood pressure medications: People with chronic kidney disease may experience worsening high blood pressure. Your doctor may prescribe medications to lower your blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors. This will likely be recommended alongside a low-salt diet.
  • Cholesterol-lowering medications: If your kidney problems are caused by high levels of bad cholesterol, your doctor may recommend medications, called statins, to lower your cholesterol and risk of heart disease.
  • Medications to relieve anemia: Kidney problems are sometimes linked with anemia. To relieve fatigue and weakness associated with anemia, your doctor may recommend erythropoietin supplements to induce production of more red blood cells.
  • Medications to relieve swelling. Decreased kidney function may cause you to retain fluids. This can lead to swelling in the arms and legs, as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body.
• Dialysis: If you have end-stage kidney disease meaning your kidneys can’t keep up with waste and fluid clearance on their own, you may require dialysis. According to the American Kidney Fund , hemodialysis is the most common type of treatment for kidney failure. It is a treatment that cycles your blood through a special filter on a dialysis machine to remove excess fluids from your body. Peritoneal dialysis uses the lining of your abdomen and a special solution to drain waste and extra fluid from your blood.
• Kidney transplant: If you have no life-threatening medical conditions other than kidney failure, a kidney transplant may be an option for you. Kidney transplant involves surgically placing a healthy kidney from a deceased or living donor into your body. 

While it’s not always possible to prevent all types of kidney problems, there are certainly lifestyle changes you can make for better kidney health. To protect your kidneys, you should:

• Get a kidney health check regularly: Ensure you get tested regularly for kidney disease, especially if you have one or more risk factors, such as high blood pressure, diabetes or a family history of kidney disease.
• Have a healthy diet: Eat a diet full of fresh fruit and vegetables, whole grains, lean meats, legumes and low-fat dairy.
• Maintain a healthy body weight: Being overweight increases your risk of developing diabetes and high blood pressure which are major risk factors for kidney disease.
• Don’t smoke: According to Kidney Health Australia , smokers are 3 times more likely to have reduced kidney function, and at 4 to 5 times greater risk of heart attack and stroke.
• Be physically active: Aim for at least 30 minutes of moderate-intensity exercise, such as cycling, most days of the week.
• Limit alcohol intake: Drink alcohol in moderation, if at all. The recommended guideline is 2 standard drinks per day for men, and 1 standard drink for women.
• Control Diabetes: If you have diabetes, work with your health care provider to keep your blood sugar levels under the best possible control. A program of diet, regular exercise, glucose monitoring, and medications to control blood sugars and protect kidney function can help.
• Control High Blood Pressure: If you have high blood pressure, work with your doctor to get your blood pressure within target ranges. A program of diet, regular exercise, and medications can help.