Dr Zak: "Healthy kidneys as important as a healthy heart"

The majority are aware of how this pump works, and the signs and symptoms of heart disease. Yet other no less important parts of the body do not receive similar prominence in the media. Hence awareness of what the body part does, how to keep it healthy, and most importantly what to look out for, is often limited.

The kidneys may fall into this category. Typically, you are born with two kidneys, though some may only have one, and others three. Roughly the size of your fist, they are located one on either side of the spine, in the back of the abdomen, below the rib cage.

They are supplied by the renal arteries, which come directly off the aorta, the body’s main blood vessel.

Like the heart, they are truly marvellous organs, working day and night, consuming 25% of the body’s energy reserves.

As well as removing harmful waste products from the body, which are passed in urine, they maintain the correct amounts of salts in the blood, as well as the appropriate volume of fluid in the body.

In addition, they are involved in controlling blood pressure through a hormone they secrete called renin.

The kidneys produce the active form of vitamin D, the sunshine vitamin, needed for good bone and muscle health.

Furthermore, they increase the production of red blood cells, by producing the hormone erythropoietin (EPO), which stimulates the bone marrow. If EPO sounds familiar, it is the hormone involved in the blood doping scandal.

In the UK, there are in excess of three million living with chronic kidney disease (CKD), with an estimated million more undiagnosed.

Although it may initially be silent, symptoms of CKD include swollen ankles and feet, a puffy face, pain in the area of the kidneys, blood in your urine, as well as significant fatigue. Your blood pressure may also be abnormal.

CKD is diagnosed by a blood test and urine sample. The blood test measures your Glomerular Filtration Rate (GFR). A marker of kidney function, the top of the scale is greater than 90. A number below 60 will raise concern. The number can vary and may be affected by several factors including how much fluid you consumed before the blood test. More than one number below 60 is needed for a formal diagnosis.

In addition, protein may be found in your urine. This does not happen apart from to a minor level in the healthy state.

The most common acquired causes of CKD are uncontrolled blood pressure and poorly managed diabetes.

Excess salt in the diet, too much alcohol, and the use of recreational drugs are lifestyle choices that increase the risk of CKD.

It may come as a surprise that Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including the easily available ibuprofen, can damage the kidneys if used regularly or in excess.

CKD occurs with certain genetic conditions such as Alport’s Syndrome and Polycystic Kidney Disease (PCKD).

In addition, faulty valves in the urinary tract may cause a condition called vesico-ureteric reflux (VUR), where urine passes back up the ureters into the kidneys and damages them. This is sometimes picked up in young children with recurrent urinary tract infections.

If unaddressed and sadly sometimes despite treatment, certain cases of CKD will progress to End Stage Renal Failure (ESRF), requiring dialysis or kidney transplant if this is an option.

Though the donation of a kidney is one of the most selfless acts of generosity a living person can do, a suitable organ is not always available. At the present time there are around four thousand six hundred in the UK awaiting renal transplant. Numbers of kidney transplants have gone down during the pandemic and those hardest to match are often from Black and Ethnic Minority backgrounds, hence the push for all to consider becoming a donor.

Maintaining good kidney health is much the same as looking after your heart. Avoid consuming more than six grammes (roughly one teaspoon) of salt daily and make sure that you drink enough fluids.

Excess alcohol will directly damage the kidneys and smoking reduces the blood supply to them.

If you are diabetic or have high blood pressure, please remember to attend for your regular check-ups and blood tests.

Do not ignore a urine infection, especially if you feel unwell with it, or it has gone on for more than three days.

Thirty minutes of moderate exercise five times a week will benefit both your heart and your kidneys.

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