When kidneys go wrong
Kidneys can develop abnormalities or stop working properly for many reasons. Issues can often be caused by other conditions putting a strain on them. The general term for kidney problems is kidney disease.
What is kidney disease?
Kidney disease is a term used by doctors to include any abnormality of the kidneys, even if there is only very slight, temporary damage – for example if someone gets a urinary infection.
If a person’s kidney damage is more likely to be permanent and possibly progressive it is known as chronic kidney disease (CKD) – where ‘chronic’ means ‘longer-lasting’, rather than ‘severe’. The condition is broken down into various stages, depending on the level of kidney damage and the percentage of kidney function left.
Sometimes people’s kidneys can suddenly develop problems. This is known medically as acute kidney injury (AKI). Where ‘acute’ means ‘sudden’, rather than referring to levels of severity and ‘injury’ means ‘any form of upset’, which doesn’t necessarily have to be a physical injury.
Kidney disease is extremely common. In fact, one in ten of us may have some reduction in kidney function. But far fewer than one in ten of those affected will develop kidney failure requiring dialysis or a kidney transplant.
People with kidney disease are more prone to have high blood pressure and potential problems with circulation so it’s always a good idea to have regular health checks so that people can be offered lifestyle advice and treatment to protect the kidneys from future damage and to reduce the risk of stroke and heart attack.
Where kidneys go wrong
When the kidneys are not working properly, harmful toxins and excess fluids can build up in the body and normal hormone production can be disrupted.
Normal kidney processes can go wrong in several areas including:
- the blood supply to the kidneys
- within the kidneys – especially the filters and tubules
- where urine flows from the tubules into the bladder.
How kidney disease can affect the body
Kidney disease can affect the body in a number of different ways:
Kidney damage and high blood pressure
The kidneys help to regulate blood pressure by controlling the amount of fluid in the circulation and by sending chemical messengers (called ‘hormones’) that control constriction of blood vessels. Many forms of kidney damage can cause high blood pressure. High blood pressure can also contribute to progressive kidney damage, so this can be a ‘vicious cycle’.
Erythropoietin is another hormone that is secreted by the kidney, and acts on the bone marrow to increase the production of red blood cells by the bone marrow. If kidney function diminishes, insufficient hormone is produced and the number of red blood cells being produced will fall, resulting in anaemia – a low blood count.
Bone and muscle weakness
Healthy kidneys ‘activate’ Vitamin D (which we get from some food and from sunlight). The active form of Vitamin D is needed to maintain normal bone structure and effective muscle function. Advanced kidney disease reduces the amount of activated vitamin D in the system. This can cause bone disease, increasing the risk of fractures and bone pain; and can sometimes cause muscle weakness.
Kidney disease is varied and complex, with many types of conditions, treatments and scales of illness (ranging from temporary, minor ailments to those that are life-threatening).
Help for you
Make an appointment to see your GP if you have any concerns about your kidneys or have any of the symptoms associated with possible kidney problems (including blood in your urine). You can find lots of helpful tips and advice about planning your visit, including what questions to ask, in our visiting your doctor section.
Reviewed April 2019
The need for more research
Researchers are continuing to investigate exactly why, where and how kidneys go wrong. They hope to find new and better ways to restore normal kidney function or prevent damage from happening in the first place.
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