In ancient times the kidneys were viewed as the seat of feelings, conscience and yearnings, and the source of morality and ethical activity. The kidneys were associated with the innermost parts of a person’s personality and well-being. While today’s article will deal with the kidneys on a more clinical level, they are nonetheless vital to our well-being.

The more we learn about our physical bodies, the more obvious it is that we are extremely complex creations. The kidney works in tandem with the rest of our organs to help us live a healthy life. Like any intricate machine, the kidney is very sensitive to its environment. Every time our heart beats, the kidney expects to get about 20% of the blood that is pumped. If it does not receive enough blood it will start to deteriorate. And since many acute illnesses can cause blood flow to fall, it is very common to have acute kidney injury whenever we get acutely ill.

What sort of health problems are we talking about?

First off, the kidney is the major player in the regulation of our blood pressure, as well as the make-up of the blood itself. The kidney regulates many substances, both helpful and harmful, that circulate throughout the body, keeping them all within very tight parameters. Too much water? Kidneys adjust to get rid of the surplus. Not enough water? Kidneys adjust their process quickly and efficiently. Same with salt. Same with potassium. Same with a list of other substances too long to mention. Many hormones vital to our very existence are produced or regulated by the kidney. Even hormones that tell bones when to make more blood cells are produced by the kidneys.

Chronic kidney disease affects about 15% of the human population. There are approximately 450,000 people in the U.S. who require renal replacement therapy to live, and 100,000 people who have been given a new chance at life with a kidney transplant. University Hospitals Samaritan’s Dr. Aaron Young, D.O., nephrology and critical care, stated: "I think I can confidently say that we all want to live a healthy life without having to worry about our kidneys failing. Typically, a referral is made to a nephrologist after the kidney has shown significant signs of decline or there are worrisome signs like protein or blood in the urine. I believe the most important part of my job is to try to prevent further damage to the kidneys and try to help people live as long as possible, as naturally as possible."

In America, the No. 1 cause of chronic kidney disease is diabetes mellitus. There are many complex reasons, and some reasons that are not completely understood, for the kidney to suffer from diabetes. The high glucose itself can hurt the kidney and cause thickening and damage to occur. It can also cause the kidney to filtrate too much and overwork itself causing destructive enzymes to proliferate. We know for sure that the better diabetes is controlled, the better chance we have to preserve the kidney function. If the diabetes is not controlled, protein will soon be seen spilling out into the urine.

Hypertension is the No. 2 cause in America of chronic kidney disease. In fact, 80-85% of people with chronic kidney disease will have hypertension. Chronic kidney disease can cause hypertension; likewise, hypertension can cause chronic kidney disease. Regardless of which came first, the hypertension or the kidney disease, it is vital to have blood pressure well-controlled and to take medications that help "off-load" the pressure on the kidney.

So how do we prevent chronic kidney disease? How do we improve our chances of avoiding the dreaded dialysis? Does drinking lots of water help keep our kidneys healthy? What food should we eat? What medications should we take?

The first place to get answers is with your primary care provider. You do have one, don’t you? If not find one at uhsamaritan.org. Have you put off your routine appointment due to the COVID 19 confusion? Put this article down right now and make your appointment.

On top of that, you must be knowledgeable about your medications and any chronic conditions you have. Ask questions. Make it your business to know. If you already know you have any renal/kidney disease, or if you and your primary care provider decide a consult would be in order, call Dr. Aaron Young’s office at 419-207-2351. That reminds me, Dr. Young is happy to announce he is getting help in his practice. Joining him is Lisa M Young, DNP (Doctorate of Nursing Practice), APRN (Advanced Practice Registered Nurse-Clinical Nurse Specialist).

— Steve Baldridge, RN, is staff educator and handles community outreach at UH Samaritan Medical Center.