What do the kidneys do?
You have two kidneys. They are bean-shaped and about the size of a fist.
They are located in the middle of your back, on the left and right of your spine, just below your rib cage. The kidneys' main job is to filter your blood, removing wastes and extra water to make urine. They also help control blood pressure and make hormones that your body needs to stay healthy. When the kidneys are damaged, wastes can build up in the body.

What is kidney disease?
Kidney disease -- also known as chronic kidney disease (CKD) -- occurs when kidneys can no longer remove wastes and extra water from the blood or perform other functions as they should. According to a study of Bangladesh Kidney Foundation, 13% of Bangladesh population suffers from kidney disease, beyond which many are undiagnosed.
 
What causes kidney disease?
Kidney disease is most often caused by diabetes or high blood pressure. Each kidney contains about one million tiny filters made up of blood vessels. These filters are called glomeruli. Diabetes and high blood pressure damage these blood vessels, so the kidneys are not able to filter the blood as well as they used to. Usually this damage happens slowly, over many years. As more and more filters are damaged, the kidneys eventually stop working.

What are the risk factors for kidney disease?
Diabetes and high blood pressure are the two leading risk factors for kidney disease. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease -- without you feeling it. There are several other risk factors for kidney disease. Cardiovascular (heart) disease is a risk factor. So is family history: if you have a mother, father, sister, or brother who has had kidney disease, then you are at increased risk.

What are the symptoms of kidney disease?
Kidney disease is often called a "silent" disease, because most people have no symptoms in early kidney disease. In fact, you might feel just fine until your kidneys have almost stopped working. Do NOT wait for symptoms! Blood and urine tests are the only way to check for kidney damage or measure kidney function.

How can you keep your kidneys healthy?
You can keep your kidneys healthy longer by taking steps to control your diabetes and high blood pressure. Manage your diabetes and high blood pressure by eating heart healthy foods like fresh fruits and vegetables, whole grains, and low-fat dairy foods; cutting back on salt; being more physically active; losing weight if you are overweight; taking your medicines regularly; keeping your cholesterol levels in the target range; taking steps to quit smoking and seeing your Nephrologist (kidney doctor) regularly.

How do doctors diagnose kidney disease?
A blood test and a urine test are used to find kidney disease. If you have diabetes, high blood pressure, heart disease, or a family history of kidney failure, you should also get tested regularly -- ask your Nephrologist (kidney disease specialist) how frequently.

What does the blood test for kidney disease reveal?
The blood test checks your GFR. GFR stands for glomerular filtration rate. GFR is a measure of how much blood your kidneys filter each minute. This shows how well your kidneys are working.
GFR is reported as a number.
A GFR of 60 or higher is in the normal range.
A GFR below 60 may mean you have kidney disease. However, because GFR decreases as people age, other information may be needed to determine if you actually have kidney disease.
A GFR of 15 or lower may mean kidney failure.

What does the urine test for kidney disease reveal?
The urine test for kidney disease looks for albumin, a type of protein, in your urine. A healthy kidney does not let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
If you have albumin or protein in your urine, it could mean you have kidney disease.
A urine albumin result below 30 is normal.
A urine albumin result above 30 is abnormal and may mean kidney disease.

How is kidney disease
treated?
Treatments for early kidney disease include both diet and lifestyle changes and medications. Diet and lifestyle changes, such as eating heart healthy foods and exercising regularly to maintain a healthy weight, can help prevent the diseases that cause kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys.

What lifestyle changes can help with kidney disease?
Following a healthy lifestyle is good for people with kidney disease, especially if you have diabetes, high blood pressure, or both. Talk with your dietitian, diabetes educator, or other health care professional
about which actions are most important for you to take. As you will see, many of these actions are related.

Keep your blood pressure at the target set by your doctor. For most people, the blood pressure target is less than 140/90 mm Hg. Eating less sodium may help you control your blood pressure. Aim for less than 2300 milligrams (mg) of sodium each day.

If you have diabetes, control your blood glucose level. Good blood glucose control may help prevent or delay diabetes complications, including kidney disease.
Keep your blood cholesterol in your target range. Diet, being active, maintaining a healthy weight, and medicines can all help control your blood cholesterol level.
Take medicines the way your doctor tells you to.
If you smoke, take steps to quit. Cigarette smoking can make kidney damage worse.
Become more active. Physical activity is good for your blood pressure, as well as your blood glucose and blood cholesterol levels.
Lose weight if you are overweight. Being overweight makes your kidneys work harder. Losing weight helps your kidneys last longer.

What is kidney failure?
When your kidneys fail, they are no longer able to filter blood and remove waste from your body well enough to maintain health. Kidney failure causes harmful waste and excess fluid to build up in your body. Your blood pressure may rise, and your hands and feet may swell.

What is dialysis and how is it used to treat kidney failure?
Dialysis is a treatment to filter wastes and water from your blood. There are two major forms of dialysis: hemodialysis and peritoneal dialysis.

In hemodialysis, blood is run through a filter outside of your body and the clean blood is returned to the body. Hemodialysis is usually done at a dialysis center in a hospital; each session usually lasts between three and four hours.

Peritoneal dialysis is another way to remove wastes from your blood. This kind of dialysis uses the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. It works by putting a special fluid into your abdomen that absorbs waste products in your blood as it passes through small blood vessels in this lining. This fluid is then drained away.

Is dialysis a cure for kidney
failure?
No. Hemodialysis and peritoneal dialysis do not cure kidney failure. They are treatments that help replace the function of your kidneys and may help you feel better and live longer.

To stay as healthy as possible while on dialysis, follow your dietitian’s recommendations, take your medications, and continue to follow the lifestyle habits you adopted to slow the progression of kidney disease.

What kind of diet is recommended for a person on dialysis?
For people who are on dialysis or approaching total kidney failure, adequate nutrition is important for to maintaining energy, strength, healthy sleep patterns, bone health, heart health, and good mental health.

The diet should be based on the type of treatment the person is receiving. People on hemodialysis must watch how much fluid they drink and avoid eating foods with too much sodium, potassium, and phosphorus.
In contrast, people on peritoneal dialysis—a type of dialysis that uses the lining of the abdomen, or belly, to filter the blood inside the body—may be able to eat more potassium-rich foods because peritoneal dialysis removes potassium from the body more efficiently than hemodialysis.

Both hemodialysis and peritoneal dialysis can remove proteins from the body, so anyone on either form of dialysis should eat
protein-rich foods such as meat, fish, and eggs.

People who are on dialysis or have a kidney transplant should talk with their hospital’s dietitian to develop a meal plan that will enhance the effectiveness of their treatment.

What is involved in a kidney transplant?
Instead of dialysis, some people with kidney failure -- including older adults -- may be able to receive a kidney transplant. This involves having a healthy kidney from another person surgically placed into your body.

The new, donated kidney does the work that your two failed kidneys used to do. The donated kidney can come from a close relative (parents, children, spouse, first degree paternal/maternal uncle/auntie).

Kidney transplantation is a treatment for kidney failure -- not a cure. You will need to see your Nephrologist regularly. And you will need to take medications for as long as you have your transplant to suppress your immune system so it doesn't reject the transplanted kidney.