Let's Recognize Our Kidneys
 

Kidneys are the two of the most important organs in our body. They exist in two sides of our lumbar vertebraes. They weigh from 124 to 170 grammes in males and from 115 to 155 grammes in females. Their lengths are from 11 to 12 centimetres, their thicknesses are from 3,5 to 4 centimetres and widthes are from 5 to 7,5 centimetres. They look like a couple of beans. The kidney in the right side is approximatelyone or two centimetres more below than the other one. These so little organs’ functions are as great as you can’t estimate. They are attached tightly to their places. They act by respiration.

Both kidneys have approximately 2400.000 filtration units, which are called nephrons. Their quantities decrease as time elapses. Heart pumps 5 or 6 litters blood in a minute and one per five of this is pumped in kidneys.In one minute one litter blood cross into nephrons which settle in kidneys. All of them show us that kidneys are how vitally important for our bodies.  After purifying, the crossing blood into kidneys profitable substances are delivered into blood again. For instance; blood elements, proteins.  By the way the toxic substances which must be removed from body are transformed to urine. 

By performing extremely physiological functions kidneys struggle for the steadiness of internal medium’s stability which is essential for the creature’s survival.  These are below:

1- This is the process of removing harmful wastes and toxic substances in the blood as  a result of metabolism and this is called urine producing. 

2- Kidneys arrange the balance of fluid-ion balance in body.

3- Arrange acid-base balance.

4- Allow to Waste  harmful toxic matters which becomes by chemical reactions in the body. 

5- As secrete some hormons they administer some essential revisions for body. These are below:

- As secreting “erythropoietin”, they arrange to produce blood. 

- As secreting “renin” and delivering it to blood, they arrange blood pressure

- As secreting  one per twenty five “dihidroxic calsiferol” they stabilize bone mineral establishment (Vitamin D active metabolit) These are the places of producing and eliminating of these hormones.

6-   Therefore kidneys provide that body can work regularly with unity of all organs  

When their these functions are failed, kidneys can not function properly, the harmful wastes can not be removable from blood where they come together and show unwelcome symptoms and the urinary volume decrease. Finally this process will ruin kidneys.  We call this situation “uremia”, in daily language we call it “Merging urine into blood”. Mostly Renal Diseases progress stealthily and painless. Disfunctioning kidneys can’t filter toxic substances which must be removed by urine, subsequently they show multiple symptoms in blood. In the moment of disfunctioning or stopping, kidneys show amendable situation (acute). If the disease progress stealthily this will cause an unrecoverable situation (chronic). 

These are the reasons of acute renal failure:

1-     Low blood pressure because of hard bleeding, vomitting, burning

2-    Consequences of some renal diseases. For instance nephrit, renal artherosclerosis.

3-     Blockages in urinary tract: Prostate enlarging, the blockage related stone. 

4-     Pregnancy: Miscarrying in unhygienic conditions, botulism during pregnancy, bleeding.

5-     Medications: Getting drug randomly, is the most frequent problem that we have ever met. So you must get drug under control of your physician.

6-    Irritation of muscle related earthquake and lossing fluid, lacking enough fluid, etc.

7-     Surgical Operations: Particularly acute renal failure can be seen after great surgical  operations.

If acute renal failure cases can be cured carefully and as required,  patients’ recovery chance will be higher.

Chronic Renal Failure’s Reasons:

1-     All the types of renal failures eventually will be chronic renal failure, unlless they can  be cured.

2-    Diabetes.

3-     Hypertension.

4-    Stone, blockage, tumour and similar urinary tract diseases are significant reasons. 

5-     Other reasons.

Here I would like to emphisize diabetes and hypertension. Because both diseases will be renal failure if they can not be treated. In our society even both disease are frequently visible.

Kidneys are the most important target organs of hypertension. Some people are diagnosed with hypertension and if the physicians can’t understand what the reason of this, we call it “essential hypertension”. If these patients can not be treated, 15% of them will be die.  

The renal complications of diabetes on have been known for  one hundred years. But so far the knowledges about clinical process are not sufficient. Whereby the recent studies’ results show us that diabetic nephropathy can progress in all diabetic patients. Clinical pursuing must be more carefully in these patients, have been supported by symptomical treatment so far. But at the moment they catch more radical treatment facilities and they are more conscious. I mean all diabetic patients must be cured in renal aspects and otherwise they must warn physicians.

The symptoms of renal diseases are unclear. Voldhard, is one of the first scientict who interested in renal diseases, was complaining “If only I wish this disease was painful”.  Frequently waking up to urinate during night, weakness, dyspnea, hypertension, swollen hand, foot and eyes, moreover when some the patients go to ear, nose and throat clinics with bleeding nose or go to gastroenterelogy clinics with bleeding stomach they may be diagnosed with who renal failure.

Renal diseases are below:

-  Glomerular diseases  (we know them as acute and chronic renal inflammation)

-  Tubular diseases

-  Kongenital diseases

-  Hereditary diseases

-  Vascular renal diseases

-  Botulism during pregnancy

-  Stone diseases

-  Urinary tract infections

- Shrinkage or blockage of urinary tract

- Renal diseases which related systemic diseases such as hypertension and diabetes.

- Renal diseases related drugs.  

Their clinic symptoms and detections are different in each diseases. Pain is not be frequently seen in renal diseases, except for circulating blockage in urinary tract and urinary tract infection.  We can see some anomalies like disfunctions in producing urine, frequently urinating, frequently need to urinate at night, painfully urinating, uncontrolled urination problems. Reduction in the quantity of urine, frequently going to urinate or never going to urinate may be symptoms of renal diseases. Furthermore general symptoms of renal disease are accumulation of excess fluid (edema) may be seen in eyes, feet etc. Higher blood pressure and symptoms related this. Some symptoms are like headache, vertigo, hum in the ear are connected with uremia can be seen. Digestive system’s symptoms such as loss of appetite, nausea, vomitting, diarrhea, by the way symptoms of bleeding such as bleeding nose, bleeding through the mouth, mixed bleeding with faeces can be seen in renal diseases.  Subsequently uremia comatose can be seen. This comatose was most severe in the past because dialysis did not exist. Currently dialysis provide appropriate management of uremia comatose.

The most important detection is chemical examination of urine for diagnosis. Not only it is cheap, but also very simple. Therefore you must have your urinalysis once six months.  You can avoid renal disease. If you are still suspicious, you must have a complete check-up once a year and then you will be more sure. If you have some symptoms or findings you must be always under control of your physician. I can say that easily; if you care about the renal diseases carefully, your life chance will be increase in whichever renal disease has been distressing you.

. Treatments of Chronic Renal Diseases:

-  Dialysis (Peritonal Dialysis and Hemodialysis)

-  Transplantation

We are utilizing all of these treatment methods in our country. In our investigations we point out that some patients have been treating for over twenty five years in hemodialysis and some patients have been living owing to transplantation for over twenty five years, too.  Our foundation gave awards the patient who had been living most long with hemodialysis (for 23 years, 7 months) with transplantation (for 20 years), with CAPD (continuous ambulatory peritonal dialysis- 7 years) in 1999

According to the currently registries of in the end of the 2005 by Ministry of Health 33487 patients have hemodialysis treatment, 926 patients have kidney transplants in our country. But Peritonal Dialysis’ registries aren’t ready yet. As late as 2004 4487 patients have peritonal dialysis.  We desire to see more transplantation cases.

Our recommendations for you to avoid from getting renal diseases are below:

• We believe that healthy life requires education.

• For a healty life, have your urinalysis done once six months and a complete check-up once a year.

• In order not to damage your kidneys,avoid indiscriminate use of medication

• Stop obesity and unbalanced nutrition! Welcome to conscious exercises and healthy life!

• Healthy nutrition is an indispensable part of a healthy life.

• For a healthy life, care  for the environmental and body cleanliness

• Have defenses against colds, infections,and contagious diseases; avoid being a kidney patient.

• Adapt global infection preventing rules, warn disagreable people and live healthy.

• We believe that living is a beautiful sense but saving one is a more worthy feeling.

• Every organ you donate will make a life sprout again. 

• Donate your organs; make happy, and be happy.

• Do you know your blood pressure and cholesterol levels?

• Do you know that hypertension causes cardiac, kidney and eye disorders?

• Do you know that the problems related high cholesterol levels?

• Do you know that exercise decrease the cholesterol levels?

• Do you know that obesity is a risk factor for hypertension?

• Do you know that you must avoid three white substances (salt, flour, sugar)?

• Do you know that exercise makes your bone metabolism strong?

I hope you will be healthy all the time if you obey our recomendation and answer our questions.

 Prof. Dr.Ayla SAN

President of Anatolia Kidney Foundation