Dialysis: Take Care of Your Kidneys

by Food and Drug Administration (FDA)

(Page 3 of 3)

Dialysis in the Future

The first successful artificial kidney was developed in the 1940s by a Dutch physician, Willem J. Kolff. Because of World War II and the Nazi occupation of his country, he improvised many materials. For example, he used sausage-link casing for the semipermeable membrane. Since then, the process of dialysis has been fine-tuned over the years, and semipermeable membranes and dialysate have improved.

Still, dialysis is not a cure. If a person's kidneys are temporarily damaged, dialysis can give them a rest and a chance to recover. But for chronic, end-stage renal disease, a kidney transplant is the only long-term solution that frees a patient from dialysis.

Living relatives can donate a kidney if their remaining organ is healthy. Even with a kidney from a close relative, however, a transplant recipient must take drugs to suppress the immune system from rejecting the organ. There are about three times as many people waiting for transplants as there are kidneys available.

Some dialysis patients are not well enough for the rigors of a transplant operation and the drugs that follow, according to Robinson of the American Association of Kidney Patients. In fact, 20 percent of dialysis patients are over 65. More than half suffer from other illnesses, such as diabetes and high blood pressure. Some patients receive transplants only to have them rejected by their immune system later. Some patients refuse transplants. For them, says Robinson, dialysis may be something of a social gathering and a way to be monitored and cared for by a group of health-care providers that become like friends.

Dialysis survival in the United States after one year is 77 percent, according to the National Center for Health Statistics. After five years it is 28 percent, and after 10 years it is about 10 percent. Transplant survival rates are higher: 77 percent of patients survive 10 years after a living-relative donor. Many experts point out there is room for improvement in the survival rate and quality of life for American dialysis patients.

"I think everything will be different in the future," predicts Eknoyan of the National Kidney Foundation. "People are working on fine-tuning dialysis and improving the technology. For instance, they are trying to develop ways to put essential substances back into the blood while taking the impurities out."

Perhaps kidney transplants, always in shortage, will become easier to get if animals such as pigs are used as donors, Eknoyan adds. But the best treatment, of course, is to protect healthy kidneys in the first place. Diabetes and high blood pressure account for more than half of all cases of end-stage renal disease. Both of these conditions usually can be managed with proper medical care (see article below, "Take Care of Your Kidneys").

Says Eknoyan, "Prevention is going to be a big part of the answer."

Take Care of Your Kidneys

Healthy kidneys are the body's cleaning crew. Located under the rib cage in the lower back, these twin bean-shaped organs, each the size of a fist, filter out extra water, minerals, and toxins dumped into the blood by the body's other organs.

Kidneys process 18 gallons of blood each hour with a sophisticated method of excretion, absorption and re-absorption. By the end of each day, they can produce as much as 7 gallons of urine.

The kidneys are reddish-brown, their concave sides facing each other. They are cushioned in fat, with only the tops of them protected by the rib cage. Perched on top of each kidney is an adrenal gland, which produces many hormones vital to life. The right kidney is a little lower than the left because it must squeeze under the liver, a large organ that occupies a large section of the upper right abdominal cavity.

In the concave section of the kidney is a depression containing blood vessels, nerves and the ureter, a small tube that carries urine away from the organ and down to the bladder. The blood-filtering units of the kidney are microscopic tubes called nephrons.

The leading causes of end-stage renal (kidney) disease are diabetes and high blood pressure. These two conditions take a toll on blood vessels, and the kidneys are rich with blood vessels. Managing these diseases can go a long way toward preventing kidney failure and the need for dialysis.

If your kidneys are normal, they don't need special care. A healthy, balanced diet and enough water to quench thirst are adequate to keep kidneys working fine. Fad diets, such as those very high in protein, however, can hurt your kidneys. Drinking very little water, or an overabundance of water (more than 8 quarts a day), may also damage these organs.

Other than illnesses, the real kidney killers are drugs — they must pass through the kidney to be filtered out of the bloodstream. Some antibiotics, anesthesia medications, and antipsychotic drugs may damage kidneys. Even over-the-counter painkillers, if taken in large doses, may lead to kidney failure.

Common household chemicals can also hurt your kidneys. Chemical solvents, wood alcohol, toluene, carbon tetrachloride (a cleaning fluid), and ethylene glycol (antifreeze) can damage kidneys if ingested or inhaled. Be very careful handling any chemical and use it according to directions.

About the Author

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