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About Kidney Disease

About the kidneys
Kidney disease
Symptoms of chronic renal failure
End-stage renal disease

About the kidneys

Most people are born with two kidneys. They are bean-shaped organs located in the middle of the back, on either side of the spine. Each kidney weighs about five ounces and is about the size of a fist. Every day the kidneys filter 160 quarts of fluid from the bloodstream, removing about 1-1/2 quarts of waste in the form of urine. Normal kidneys perform several important tasks that keep the body in good health:

  • Clean your blood and remove waste products through the formation of urine
  • Balance fluids in the body by controlling water and salt concentrations
  • Maintain the balance of the body's chemicals (potassium, calcium, magnesium and phosphorus)
  • Control blood pressure
  • Supply elements used to make red blood cells, which carry oxygen in the blood
  • Help sustain strong bones

One kidney, functioning at 20% capacity, can do all of the above!

Kidney disease

Another term for kidney disease is renal disease. There are many disease processes that can damage the kidneys, including diabetes, high blood pressure, ureteral obstruction (blockage in the ducts that carry urine from the kidneys to the bladder), and glomerulonephritis (inflammation of the kidney). Some diseases—including polycystic disease, which leads to the development of cysts (balloon-like growths on the kidneys)—are genetic, while other diseases like high blood pressure or renal vascular disease (blockage of the blood vessels supplying the kidney) are acquired over a lifetime. Most kidney diseases affect both kidneys at once; however, some conditions like kidney cancer can affect only one kidney at a time.

Rarely, patients develop acute kidney failure. In this situation, the kidney function fails within days. This is often due to another medical condition including heart failure, severe infection, or rarely, a reaction to medication. In some cases the kidneys will function again. Often, the kidney failure will improve after only a few weeks. Unfortunately, in some cases it can take as long as a year.

In general, kidney failure happens slowly over a long period of time (chronic renal failure). Loss of kidney function in this case is permanent, and can't be regained with treatment. As the kidneys stop working, waste products and water become trapped in your body, making you feel ill.

Symptoms of chronic renal failure include:

  • Swelling in the hands, feet, and face
  • Shortness of breath
  • Fluid retention, or a change in the number of times you urinate
  • Difficulty thinking, having headaches, or feeling dizzy
  • Abnormal urine or blood test results
  • An ammonia-like odor to your breath
  • A metallic taste in your mouth
  • Lower back pain
  • High blood pressure
  • Feeling fatigued or tired

End-stage renal disease

Once patients have significant symptoms of renal failure, they have developed End Stage Renal Disease (ESRD). Patients with ESRD will need treatment to perform the functions usually performed by the kidney. There are a variety of choices to treat patients with kidney diseases, including hemodialysis (waste and fluid is removed by a machine), peritoneal dialysis (waste and fluid is removed using a special fluid placed in the abdomen several times a day), or a kidney transplant. If you have ESRD, you will not be able to live longer than a few months without dialysis or a kidney transplant. The Dartmouth-Hitchcock Transplant Center and your nephrologists (kidney specialists) will work together with you to determine which type of treatment is best for you.

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