World Kidney Day

If you’ve ever eaten the good old rajma-chawal, you’ve noticed the shape of ‘rajma’. It is no coincidence that our very own ‘rajma’ is called kidney beans. It’s World Kidney Day today, and it is appropriate to celebrate our kidneys and all the work they do. But first, what are kidneys, where are they, and what do they really do? 

Kidneys are bean-shaped (remember rajma!), fist-sized vital organs placed in the abdominal cavity just below your ribs, against the back muscles. Our kidneys (along with our brain, heart, lungs, liver) are considered a vital organ because the job they do is vital to health and survival:

1. Our kidneys eliminate wastes and extra fluid from our bodies. Yes, I’m talking about peeing.
2. Our kidneys also maintain a healthy balance of pH, water, salts, and minerals in our blood. This balance keeps our nerves, muscles, and other tissues working normally. 
3. Our kidneys also make important hormones that help control blood pressure, make red blood cells, and keep bones strong and healthy.

Most of us are born with two kidneys, but only one kidney is needed to lead a healthy life. This is because kidney cells, called nephrons, are super-efficient blood-filtering units. Each kidney is made up of about 1.5 million nephrons, and one kidney is more than enough to get the job done. What most people don’t know is that we need a minimum of 300,000 nephrons to filter blood, remove wastes, and to make urine. All of the blood in our body passes through our kidneys many times during a single day, and — fun fact — healthy kidneys filter about a half a cup of blood every single minute! Only if you’re a kidney, it’s a good thing when all your hard work goes down the drain. Talk about ironic work efficiency.

This is precisely why people who have a single healthy kidney (either by birth or because of an illness in one kidney) can live healthy lives. And, thanks to medical technology, folks without healthy kidneys can survive with dialysis, a process where the job of filtration of blood (which you now know is one of the many jobs done by the kidney) is taken over by a machine. Dialysis makes up for a portion of the job of the failing kidneys and gets rid of extra fluids and waste products. A kidney transplant can even more completely take over the function of the failing kidneys. For some people, with type 2 diabetes or chronic kidney disease, this can be lifesaving.

Understandably, staying hydrated helps keep your kidneys working well, but we certainly don’t want to drink too much water. I speak to many patients who tell me with pride that they drink 5 liters of water each day. If this is you, it’s important to understand that doing so can cause a condition called ‘hyponatremia’ — a condition in which the concentration of sodium in the blood becomes low because the kidneys are unable to get rid of the excess fluid fast enough. Hyponatremia, aka “water intoxication” or “water poisoning”, disturbs the delicate balance of electrolytes in the body due to excessive water intake. This can affect brain function and may cause symptoms such as confusion, nausea, and vomiting. Although relatively uncommon, severe cases of hyponatremia have been known to cause seizures, coma, and even death. So how much water is the right amount? According to health authorities, the recommended amount of water is around 9 cups (2.2 liters) per day for women and about 13 cups (3 liters) for men. Drink the appropriate amount of water, and keep your body out of hot water.

Now that you understand the important role that our kidneys play in keeping us alive and healthy, it’s easy to understand how kidney disease can be a serious health problem. Kidney disease is considered a non-communicable disease (NCD). A noncommunicable disease is a disease that, unlike coronavirus, is not transmitted from one person to another. Kidney disease is, unfortunately, quite common, and affects around 850 million people worldwide. According to The International Society of Nephrology (ISN):

• One in 10 adults has chronic kidney disease (CKD). In fact, CKD is projected to become the 5th most common cause of years of life lost globally by 2040. 
• The costs of dialysis and kidney transplantation account for a significant portion of the annual healthcare budget in high-income countries.
• In low-income and/or middle-income countries, people with kidney failure have insufficient access to life-saving dialysis and kidney transplantation.

There are 3 types of preventions for kidney disease and you can play an important role in advocating for your own health by understanding each of these:

Primary Prevention

Primary prevention is the earliest form of intervention prior to the manifestation of symptoms in order to prevent the development of kidney disease. This includes identification and modification of risk factors, especially type 2 diabetes and hypertension, unhealthy diets, salt (and water!) consumption, etc., and screening tests for targeted monitoring of those at high risk. Some kidney diseases (such as polycystic kidney disease, certain metabolic diseases, and immune glomerulonephritis) have genetic basis and can be passed on from one generation to the next. Speak with a genetic counselor if you have a family history of kidney disease, hypertension (high blood pressure), type 2 diabetes, heart disease, etc. to understand your risks and what you can do about it.

Secondary Prevention

Secondary prevention refers to the strategies that lead to early diagnosis and timely treatment of kidney disease to prevent the development of severe disease. This is oftentimes achieved by monitoring and controlling levels of blood pressure and blood sugar. Dietary and lifestyle modification and prophylactic — aka preventive — medication under the guidance of a physician are effective strategies of secondary prevention.

Tertiary Prevention

Tertiary prevention is the term used for the effective management of a diagnosed kidney disease with the aim of controlling/delaying disease progression and preventing the development of more severe complications related to kidney disease (such as end-stage kidney disease). In patients with advanced CKD, management of co-morbidities – the medical jargon word for coexisting illnesses- such as uremia (harmfully high levels of urea in the blood) and heart disease is of utmost importance.

If all this is just too much, here are 10 simple things we can all do to keep our kidneys healthy so that they can, in turn, keep us healthy:

On World Kidney Day today, MapmyGenome aims to create awareness and to educate. Knowledge is power, prevention is better than cure, and I don’t want to list out more motivational quotes. Bottom line, though, kidney disease can be prevented, and progression to end-stage kidney disease can be delayed with appropriate practices of prevention, access to basic diagnostics, and early treatment of common kidney diseases. Get started today!