and Not Even Know It?
Kidney disease is a growing threat in the United States, and the ninth leading cause of death.* Over the past decade, the number of people with kidney failure doubled. A total of 10 million to 20 million people have kidney disease, but most don't know it.**
Kidney Donation Helps Save Lives
In 2011, over 86,000 people awaited kidney transplants. But in 2011, only a fraction of that number – about 16,000 – received a new kidney.* There is a great need for donated kidneys.
Kidneys for transplant can come from either living or dead donors.
Living-donor transplants have been performed for more than 40 years, and studies that have tracked donors for more than 20 years have found no increased risk of death or kidney failure as a result of having donated a kidney.** The donor's remaining kidney grows slightly larger and works at greater capacity.
To donate your kidneys after your death, you can sign a donor card or indicate on your driver's license that you wish to be an organ donor. However, the most important step is discussing your wishes with your family. Hospitals seek the consent of next of kin before removing organs.
* Source: U.S. Department of Health and Human Services – Scientific Registry of Transplant Recipients
** Source: MayoClinic.com.
Kidney disease is a "silent" problem, like high blood pressure. Damage from kidney disease usually occurs gradually over many years, and in both kidneys. As the kidneys slowly stop doing their jobs, they work harder to compensate, so kidney disease produces no symptoms until almost all function is gone. It's typically discovered right before the kidneys fail. When the kidneys fail, dialysis or a kidney transplant are the only options for keeping the person alive.
What do kidneys do?
Located in your lower back just behind the rib cage, your kidneys—twin fist-sized organs—serve as the blood's waste disposal system. They filter toxins from your blood and help regulate blood pressure. They also work to balance certain important nutrients, including potassium and calcium, and regulate your body's water content.
Blood travels to your kidneys by way of an artery from the heart. Once the blood arrives, millions of tiny units, called nephrons, perform a thorough cleanup and excrete waste and excess fluids as urine into your bladder. The purified blood then passes through your veins back into your circulatory system.
When the kidneys can no longer function properly on their own, toxins and excess fluids build up in your blood.
Who's at risk?
Kidney disease affects adults of all ages and races. People with diabetes, high blood pressure or a family member with kidney problems are at higher risk than the general population. Among people with diabetes, those who are black, Mexican-American or American Indian have a higher risk of kidney disease than other diabetes patients.***
If you're at risk for kidney disease, you should have simple blood and urine tests to check for it. If kidney disease is caught early, you can take steps to keep your kidneys working. Often, that involves people with diabetes managing their blood glucose carefully, and people with high blood pressure keeping that well controlled.
Testing for kidney disease
A urine dipstick or 24-hour urine test will alert your physician to excess protein in the urine, a sign of potential trouble, since the kidneys normally separate protein from urine. A blood test can detect toxins and other excess fluids in your blood that your kidneys have failed to filter. Because these are the easiest tests—taking urine samples and blood and sending them to a lab—your healthcare provider will probably do them first if he or she suspects kidney disease.
If the results indicate that your kidneys are not working well, your doctor may recommend that you have further tests, using ultrasound, a computed tomography (CT) scan or magnetic resonance imaging (MRI) to help determine if you have an unusual growth or blockage.
If detected early, even before you experience noticeable symptoms, kidney disease can be treated with medication and lifestyle changes such as controlling high blood pressure and blood sugar, exercising and limiting the amount of protein you eat.
If you have diabetes, high blood pressure or a family history of kidney disease, ask your doctor about screening tests.
Treating end stage renal disease
If a person's kidney function reaches less than 10 percent of normal capacity, end-stage renal disease has set in., He or she will need to begin dialysis or undergo a kidney transplant. There may be a long wait for a transplant, because there are not enough donor kidneys available to meet the demand for them. (See sidebar.) But dialysis is also an option. There are two major forms:
Hemodialysis sends blood through a machine that filters away waste products, then returns the cleaned blood. This usually happens at a dialysis center two to three times a week, for three to five hours at a time.
Peritoneal dialysis uses the lining inside the abdomen as a filter. A cleansing fluid (dialysate) is put into the abdomen through a tube to collect waste products. After a few hours, it is drained and replaced with fresh dialysate. Patients usually perform this procedure themselves, at home.
* Source: American Kidney Fund, www.kidneyfund.org.
** Source: National Kidney Disease Education Program, www.nkdep.nih.gov.
*** Source: American Diabetes Association, www.diabetes.org.
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