Common Health Consequences Associated With End Stage Renal Disease


The kidney is an important anatomical structure that performs many tasks that help to sustain life. This fist-sized organ is located in the lower abdominal cavity just in front of the bottom set of ribs and is well-known for its role in filtering water and waste from the bloodstream. The critical nature of filtration is demonstrated by the fact that most people have two kidneys that are capable of enlarging to compensate for a decrease in functionality of either kidney. What many people fail to realize is that the kidneys also perform many other important tasks including blood pressure regulation and hormone secretion.

The signs and symptoms associated with the diverse responsibilities of the kidneys have become more concerned in recent years because of the spike in new end stage renal disease cases secondary to diabetes and high blood pressure. As demand for renal care continues, it is very important for medical personnel to educate the public on the health consequences of renal disease and the steps that can be taken to help reduce the risk of damaging the kidneys. An understanding of what the kidneys do along with the steps that can be taken to reverse the prevalence of renal failure is the first step in reversing the trend towards widespread chronic kidney disease.

Filtration of the bloodstream is easily the most important job that the kidneys perform. They accomplish this monumental task using a series of blood vessels, collecting tubes, and membranes that are permeable to small particles such as water and waste. As blood travels through the kidneys it passes by membranes that allow water and waste to pass through and accumulate it the collecting tubes while preventing important particles such as blood and proteins from leaving the blood vessels. The filtrate that is collected is then transported along a series of concentration gradients and transport channels that give the body the opportunity to absorb any elements that it can still use. The remaining filtrate is sent to the bladder where it is stored as urine until it can be excreted.

When the kidneys become damaged, they often lose the ability to remove potential harmful particles from the body. This allows water and waste to accumulate in the body and causes uncomfortable symptoms that often require dialysis treatment. An abnormally high level of water and waste in the body is referred to as uremia and is often associated with swelling of the face, hands, and feet; dry and itchy skin; unusual changes in urine production; an ammonia smell to the breath; a persistent metallic taste in the mouth; muscle cramps; fatigue; diarrhea; constipation; and many other problems. Those who are at risk of developing renal failure are encouraged to seek professional medical advice if they begin to experience any of these symptoms.

The secretion of erythropoietin (EPO) is another important role that the kidney has. EPO is a hormone that functions to communicate the need for additional red blood cells to the marrow found at the center of the bones. The kidneys usually know when to secret erythropoietin based on the level of oxygen in the blood. If the childrens have been damaged, they may not be capable of determining the appropriate level of EPO secret and often fail to inform the bone marrow about the need for more red blood cells. These results in a deficiency in oxygen carrying capacity and blood volume that is commonly referred to as anemia. In many cases, the left ventricle of the heart will enlarge in an attempt to compensate for oxygen deprivation in cells through the body. This condition is known as left ventricular hypertrophy and it causes heart failure in many renal failure patients.

Another important hormone secreted by the kidneys is called calcitriol. This hormone helps facilitate the absorption of calcium from digested food as it travels along the gastrointestinal tract. Another name for this hormone is active Vitamin D. A deficiency in calcitriol causes the parathyroid glands to secret abnormal levels of parathyroid hormone (PTH) that functions to pull calcium from the bones and place it in the blood. Although this process restores proper levels of calcium in the bloodstream it also weakens the bones and causes many problems including calcium deposition in the blood vessels and heart. This can cause signs and symptoms such as muscle cramps, a predisposition to bone fractures, visual changes, and mental changes.

The diverse array of responsibilities that the kidneys have demonstrated the need for a lifestyle that supports renal health. The growing prevalence of chronic diseases in the United States demands that more effective public awareness campaigns be implemented. Those who work in the industry as technicians and nurseries are often able to have the greatest impact on people because they spend the most time with patients and are acutely aware of the damage that is caused by kidney disease. The basic concepts outlined above are important for the provision of high quality care and the delivery of effective public awareness campaigns.