Wednesday, 10 August 2011

Healthy kidneys

Knowing how to keep kidneys healthy is a mystery to most people. Many don’t know what they do. And when failure occurs, it’s often over months or years and doesn’t cause symptoms, so they’re unaware there’s a problem until it’s too late.
The main function of healthy kidneys is to clean your blood by removing excess water (and salt) from the liquid that you drink, and wastes from food.
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How do you know your kidneys are unhealthy?

If a doctor tells you that you’ve less than 100 per cent kidney function, you should be very concerned. Kidneys rarely get better, and almost always deteriorate - fortunately this is usually a slow process.
If you are ever told this by your doctor, make sure you have a regular blood test (called a creatinine) for the rest of your life.
Symptoms of kidney failure don’t usually occur until you have less than 20 per cent function. By this time, dialysis is usually inevitable. However, there are steps you can take to prevent this from happening:
  • Don’t smoke; it’s the only thing you can do directly to affect the health of your kidneys. Smoking furs the artery to the kidney, which can cause kidney failure. Smoking also affects the blood vessels to the heart and brain in the same way, causing heart attacks and strokes. Unfortunately when damage has occurred, stopping smoking has little effect, so it’s important not to start in the first place.
  • Keep to a healthy weight. Obesity leads to type 2 diabetes which is the most common cause of kidney failure.
  • Make sure your blood pressure is normal. High blood pressure can damage the kidneys. Make sure you have it checked regularly, and that it is consistently below 130/80 mmHg. If you’re in an ‘at risk’ group, you should make sure it’s checked regularly, and start treatment if it goes up.
  • Family history. If you know that someone else in your family has kidney failure, or has ever had dialysis or a transplant, get your kidneys checked with blood and urine tests, and an ultrasound. There are several inherited forms of kidney failure, the commonest being polycystic kidney disease.
For people who only have one kidney, it’s best to avoid contact sports such as karate, that might damage the kidney. Fortunately the kidneys are well protected by the ribcage at the back, so are rarely affected by trauma.
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Kidney infections and stones

If you’re regularly diagnosed with urinary tract infections (including cystitis) it’s important to start taking antibiotics as soon as they’re prescribed, and make sure you have a urine sample taken straight after the infection, to confirm it has gone.
If you have kidney stones, and pass a stone in your urine, this doesn’t mean an end to the problem. Ask your doctor to see if there is anything you can do to prevent it happening again. Make sure the doctor checks (with another x-ray) that there are no further stones, potentially damaging the kidney.
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Prostate problems

Prostate problems are very common in men over 50, and are usually due to enlargement of the prostate gland, causing problems passing urine. A slowly growing prostate gland can silently damage the kidneys over a period of years. So, it‘s worth having regular blood tests of kidney function to monitor the situation.
Some people think that alcohol damages the kidney, which is a popular myth, as it mainly affects the liver. Many people also think drinking a lot of water is good for the kidney, as it ‘flushes it out’. Again, there’s no medical evidence for this idea.
Care should be taken with the use of non-steroidal inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. They can be dangerous if taken in high dosage over a number of years, and can cause kidney failure.
Although most causes of damage to the kidneys is irreversible once diagnosed, ESRF requiring dialysis or transplants is extremely rare.

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