CHENNAI: The kidneys are critical to good health and normal functioning of metabolic processes of the body. They filter out toxins from the blood and food we consume, in the form of urine. The filtering is done by millions of nephrons located in the kidney.
They also remove excess fluid from the body and maintain electrolyte balance (sodium, potassium, calcium, and magnesium levels) in the blood. They regulate the production of red blood cells and secrete hormones that regulate blood pressure.
While vitamin D can be absorbed by the body from the food we consume, kidneys produce the active form of vitamin D. This helps to strengthen the bones. Like every other organ, the kidney is vulnerable to various ailments, conditions or diseases. The signs and symptoms may not be apparent in all situations, however, we have to be careful with the following symptoms:
Too few or too frequent urination: While frequent urination throughout the day and night can be a sign of urinary tract infection (UTI) or enlarged prostate in men, reduced urination throughout the day may be due to dehydration or not getting enough water. However, both these conditions can also be a sign of kidney damage. The kidneys are not as efficient as before, in removing wastes or excess fluid. Less urination can also be a sign of an obstruction or kidney stone.
Red or brown urine: This is a sign that there is blood in the urine. This happens when the kidney’s microfilters get damaged.
Foamy urine: A healthy kidney excretes proteins only in limited quantity. A damaged kidney loses its ability to conserve protein, so more protein makes its way into the urine. This condition is called proteinuria. The protein in the urine makes it foamy.
Pain and muscle cramps in the back: The kidneys are located at the back, just below the rib-cage. Pain in the back may be due to injury or improper posture. It can also be a sign of UTI or kidney stones. A breakdown of kidney function can also affect calcium and phosphorus levels in the body causing muscle cramps.
Swelling in the arms: Healthy kidneys help remove excess fluid in the body. Damaged kidneys lose this ability and cause fluid accumulation in two ways. First, sodium balance is not maintained, and the excess sodium causes fluid to be retained. Secondly, proteinuria can cause albumin to be lost through urine. Albumin is a protein that helps to keep fluid inside blood vessels. When albumin is lost, fluid collects in the body tissues causing swelling. The hands, feet and ankles of the person may get swollen to an extent that it’s difficult to wear shoes or walk comfortably.
Swollen face, puffy eyes: Fluid accumulation as described above can also cause swelling in the face, leading to puffy eyes and swollen look.
Shortness of breath: In addition to the limbs and face, fluid starts accumulating in the lungs too. This deprives the body of adequate oxygen supply and causes shortness of breath. Even simple tasks can make the person tired now.
Fatigue: The kidneys produce erythropoietin, a hormone that helps to regulate the production of red blood cells. When the kidney function is disrupted, there are not enough RBCs produced. The body doesn’t get enough oxygen due to anaemia. As a result, the person feels weak or tired all the time. In some cases, the person may experience dizziness or even faint. Fatigue can also occur in end stage kidney disease due to accumulation of urea and other toxic metabolites.
Cognitive changes: Normal brain function is affected in kidney disease due to accumulation of urea and other toxic metabolites. As a result, concentrating and remembering simple things are more difficult now. The person may be confused often.
Feeling cold: Anaemia can also make the person feel cold even in warm conditions.
High blood pressure: Healthy kidneys eliminate excess fluid and maintain the electrolyte balance, both of which are required to keep blood pressure normal. Also, kidney regulates blood pressure by producing a hormone called Renin. When this function is disrupted, high BP is inevitable.
Sleep issues: A disrupted kidney function can cause restless legs and sleep apnoea, both of which can cause disturbed sleep.
Dry and itchy skin: Since kidneys remove wastes and toxins, loss of kidney function causes toxins to accumulate in the blood leading to various conditions including dry skin and itching which can get severe.
Bad breath: Loss of kidney function causes uremia the accumulation of urea in the blood. In the mouth, saliva breaks down urea into ammonia which gives a bad odour to the breath.
Poor appetite and weight-loss: Uremia can also make protein sources such as dairy and meat to taste bad. The person loses appetite and hence weight over time.
Nausea: Uremia can also cause the person to feel nauseated all the time and vomit now and then.
Dental issues: Kidney disease can cause a variety of dental issues such as decay and loss of teeth and dry mouth.
Chronic Kidney Disease (CKD) is a condition in which damage to the kidney has been developing over the years. If it is not detected or treated on time, it can lead to kidney failure and even death. However, if one recognises the symptoms, and seeks medical help, the condition can be cured or brought to control, over time.
If you or any of your dear ones are showing any of the above signs more than once, it’s time to get a kidney function test done at a reputed hospital. Once the test results are out, consult a nephrologist at the hospi tal . He/she will evaluate the results and design the best course of treatment for quick recovery and rehabilitation.
The writer is a senior consultant nephrologist & transplant physician, Department of Nephrology, Gleneagles Global Health City, Chennai