What is the role of our kidneys?

St. Joseph’s/Candler primary care physician Dr. Thomas Falace explains kidney function, injury and protecting these two organs

You’ve most likely seen how a coffee filter keeps grounds out of your morning cup of joe. Your kidneys work similar, ridding waste products from your blood through your urine.

Everyone should have two kidneys, although people can function well with only one. The kidneys are purplish-brown organs located below the ribs towards the middle of the back. They have several important functions, says Dr. Thomas Falace, internal medicine physician with St. Joseph’s/Candler Primary Care on the Islands. These include:

• Filtering toxins and waste out of the body
• Maintaining electrolyte balance
• Maintaining acid base levels in the blood
• Managing calcium and vitamin D levels, which also supports bone health
• Releasing hormones to control blood pressure and red blood cell production

Our kidneys can easily be damaged or suffer disease. Injury to the kidneys is defined as acute kidney injury or chronic kidney disease.

Acute kidney injury can occur if you’re severely dehydrated or lose a lot of blood limiting fluid to the kidneys, Dr. Falace says. Certain medications, like NSAIDs or some over-the-counter drugs, can cause kidney damage. Obstructions, most commonly kidney stones, also fall under acute kidney injury, Dr. Falace adds. These injuries are typically treated in a hospital setting and should get better.

Then there’s chronic kidney disease (CKD). The Centers for Disease Control & Prevention estimates more than 37 million people have CKD. People with diabetes or high blood pressure are at higher risk of kidney disease. It’s estimated that 30 percent of adults with diabetes also have CKD. Just as eye opening, as many as 9 in 10 adults with CKD do not know they have the condition.

How’s that? Signs and symptoms are not always recognizable.

“Sometimes people will lose a kidney, whether to surgery or something else, and they still function well with even just one kidney,” Dr. Falace says. “The point of that is to say you can have a significant decrease in kidney function before you may see some signs that something is wrong.”

Signs and symptoms

Kidney disease typically has no symptoms at first. As it progresses, you may notice:

• Swelling, especially in your legs, feet and ankles
• Sleep problems and fatigue
• An accumulation of an unwanted substance in the blood
• A change in your electrolyte balance
• Trouble focusing
• Nausea and vomiting

Patients with diabetes and high blood pressure should especially pay attention to these symptoms and have their primary care doctor monitor kidney health closely. Kidney function can be checked through blood work, urine test and imaging.

Blood tests allow physicians to categorize the level of kidney function or dysfunction, Dr. Falace says. Urine tests show the levels of protein in the urine, and if any test results come back alarming, a non-invasive ultrasound can show physicians what may be causing the problem, Dr. Falace says.  

If caught early on, medications and other steps can be taken to prevent long-term damage. If kidney dysfunction reaches a certain level, dialysis may be needed.

Protecting our kidneys

Most doctors check kidney function during annual blood work for all adults. Those with diabetes or high blood pressure may have their levels checked more often.

Related Article: Are you seeing a healthcare provider annually?

Even though they are only the size of a small fist and not often thought of when it comes to bodily organs, it’s important that we do what we can to maintain the health of our kidneys. Dr. Falace recommends:

• Avoiding certain medications that are harmful to your kidneys (You can always talk to your doctor before taking any OTC or steroid medication.)
• Controlling your blood pressure whether it’s through diet, exercise or medication
• Managing your blood glucose levels, also through diet, exercise or medication
• Staying hydrated by drinking lots of water
• Taking medications as prescribed by your doctor, especially if you already have kidney disease

Related Article: Are you taking your medications as prescribed?

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