The Kidneys


Why are the kidneys so important?

1Most people know that a major function of the kidneys is to remove waste products and excess fluid from the body. These waste products and excess fluid are removed through the urine. The production of urine involves highly complex steps of excretion and re-absorption. This process is necessary to maintain a stable balance of body chemicals.

The critical regulation of the body’s salt, potassium and acid content is performed by the kidneys. The kidneys also produce hormones that affect the function of other organs. For example, a hormone produced by the kidneys stimulates red blood cell production. Other hormones produced by the kidneys help regulate blood pressure and control calcium metabolism.

The kidneys are powerful chemical factories that perform the following functions:

  • remove waste products from the body
  • remove drugs from the body
  • balance the body’s fluids
  • release hormones that regulate blood pressure
  • produce an active form of vitamin D that promotes strong, healthy bones
  • control the production of red blood cells

Chronic Kidney Disease (CKD)

2Chronic kidney disease is defined as having some type of kidney abnormality, or “marker”, such as protein in the urine and having decreased kidney function for three months or longer.There are many causes of chronic kidney disease. The kidneys may be affected by diseases such as diabetes and high blood pressure. Some kidney conditions are inherited (run in families).

Others are congenital; that is, individuals may be born with an abnormality that can affect their kidneys. Diabetes is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. This results in a high blood sugar level, which can cause problems in many parts of your body. Diabetes is the leading cause of kidney disease.High blood pressure (also known as hypertension) is another common cause of kidney disease and other complications such as heart attacks and strokes. High blood pressure occurs when the force of blood against your artery walls increases. When high blood pressure is controlled, the risk of complications such as chronic kidney disease is decreased.

Acute Kidney Injury (AKI)

3In recent years the nephrology community has been joined by other medical colleagues in recognising the urgent need to increase awareness about Acute Kidney Injury amongst physicians and hospital staff, but also the need for a public awareness campaign which could demystify this dangerous condition and make it recognisable to the public in a similar way that heart-attack or stroke campaigns have done.

In the developed world AKI is often seen in hospital settings: US data suggests that an estimated 5% to 20% of critically ill patients (patients in the intensive care unit) experience an episode of AKI during the course of their illness, and development of AKI has a major negative impact on outcomes of any illness. To this end, greater awareness of AKI amongst the general physician and health care profession is needed. There are also important opportunities for prevention, especially by careful attention to prescription medicines management in elderly people.

AKI is inadequately addressed in clinical education and training programmes, and largely neglected in public awareness and research programmes. The consequences are missed opportunities to mitigate risk, delayed diagnosis, poor management and increased lengths of hospital stay that contribute to spiralling health care costs.

AKI is particularly relevant in the developing world where children and young adults are at special risk for AKI because it occurs frequently as the result of gastroenteritis, poisonings, malaria or other infectious diseases. Victims of crush injuries in natural disasters such as earthquakes often die of AKI. Many cases of AKI can be prevented simply by educating the community, and local and regional health care practitioners about prevention and early warning signs requiring immediate intervention.