The bean-shaped kidneys lie on either side of the lumbar spine, behind the abdominal cavity. You are responsible for the body of vital organs that filter pollutants from the blood and form the urine. They also produce hormones which control our acid-base balance. It is therefore important to protect them.
The functions of the kidney
The primary role of the kidney is the filtration of small molecular weight substances from the blood, the elimination of the health of the body is necessary. The filter function of the kidney is met by the renal corpuscles (glomeruli). These are little balls of hair-thin blood vessels. The walls of these blood vessels (capillaries) are of the basement membrane – a fine membrane, which surrounds the capillaries – coated, which represents the actual filter barrier. It is like a fine network through which small molecules such as
- excess water,
- Metabolic degradation radicals, eg, creatinine, uric acid and urea,
- Residues of drugs and
leave the bloodstream and pass into the urine. Larger molecules, such as blood cells or proteins that can not normally happen this fine grid. They remain present in blood.
With its formation, the kidney hormone controlling various processes in the body. The blood pressure is influenced by the renin-angiotensin-aldosterone system. The enzyme renin, acting through several steps to ensure that the hormone angiotensin II is formed. This pulls including the vessel walls together, so that the pressure in the vessels – and thus the blood pressure – increases. It also causes the release of the hormone aldosterone from the adrenal cortex, which also increases the blood pressure. Also, the hormone erythropoietin is produced by the kidney. It controls the production of red blood cells that are responsible for transporting oxygen. The calcium metabolism is also subject to regulation by the kidney. Through intermediate steps to the active form of vitamin D. Calcitriol – for the stability of the bone.
Acids and bases
The body needs to function a certain ratio of acids and bases. This helps the kidney by acid and basic components accounted eliminated, so that it can not come to an imbalance.
The result is a kidney disease
In addition to a hereditary history (family history), high blood pressure and other factors may develop a disease of the kidneys as a result of diabetes mellitus (diabetic nephropathy). Diabetes-related changes in the kidneys begin very slowly and are not associated with pain or other noticeable symptoms.
Inadequate blood glucose control harms the kidneys through the “saccharification” with deposition of protein in the glomeruli. Thereby swells the basement membrane; the mesh enlarge, and the filter is permeable to protein, which is normally retained in the blood. The albumin – a protein molecule – is filtered and enters into the urine. Initially, since only small amounts of albumin in the urine can be detected, then one speaks of a “microalbuminuria”.
Gradually decrease the ability of the kidney filter. In the long run it is also a strong growth of the basement membrane. This leads finally to be closed by the time that the fine blood vessels in the glomeruli by cell growth. The filter function of the kidney is always a limit then more, until it is eventually lost altogether. This process is very lengthy, it takes about 10 to 20 years.
Risk factors for the kidney
Kidney disease as a consequence of diabetes mellitus are common. In Germany, make up one third of all diabetic patients who are constantly dependent on dialysis. These alarming numbers continue to rise. Half of all newly added dialysis patients are diabetic. In order to perform all the functions of the kidney in the long term, it needs to stay healthy. Anyone can do a lot. The first step is to make clear to themselves what risks there are for the kidney:
Too high blood sugar levels can cause damage to small blood vessels in the kidney lead to a microangiopathy. It is shown that the onset of diabetic kidney disease can only come with a good metabolic control to a halt.
High blood pressure
Hypertension (high blood pressure) loaded the small blood vessels and can cause serious damage to the kidney – with the same consequences as a high blood sugar. Here, however, results in a cycle: Because the kidneys are involved through their own production of hormones in the regulation of blood pressure, a damaged kidney, this regulation may no longer be maintained. Thus, cause and effect are mutually dependent.
Another factor is nicotine. Who smokes as diabetes, increases the likelihood of developing diabetic nephropathy, on the double! Studies show that the development of the disease is accelerated, although not yet the mechanisms behind known exactly
You can prevent
Just in time to prevent is always the best method. The following measures are recommended:
Blood glucose levels continuously adjust well
There are many ways to adjust the blood sugar well. The large Diabetes Control and Complications Trial (DCCT) has shown that a more flexible attitude leads to improved HbA1c levels and fewer complications. Flexible treatment options that offer themselves are intensified insulin therapy and insulin pump therapy. Here it is worthwhile to inform themselves fully informed of all treatment services. The more you know, the better your opportunities to do something themselves.
Blood pressure to levels around 130/85 mmHg lower
Even when blood pressure is called: find out! Diabetics have before the start of diabetic kidney disease had a normal blood pressure with the disease at first almost imperceptibly, but steadily rising.
Movement, and endurance while lowering blood pressure! Endurance sports is not only good for your figure. Blood pressure falls outside the normal range, are necessary tablets. The decision about which pills are the right ones, must be enclosed with your doctor – for there is a wide range of active ingredients.
The Federal Centre for Health Education provides the Internet at www.bzga.de many aids, such as the brochure “Yes, I’m smoking.” But the decisive factor is the will: “Yes, I quit!” Very good is your kidney.
Every 3 to 6 months, but at least once a year, let the urine checked for albumin
Kidney damage cause no pain at first. Therefore, regular screening of urine for albumin are required. Today there are very fine measurement methods that can detect even small amounts. The limit is 20 mg / l urine. A urinary tract infection or other febrile infection should be excluded. The investigation should be once or twice a year carried out (in cases of suspected or proven disease more frequently). There is also a reliable test strips, which can be bought at the pharmacy, the evidence in the fasting urine microalbumin. Because of the slow change in albumin excretion, it is not useful, more often than quarterly measure.
In advanced kidney disease, it is proved that a reduced protein diet has a positive effect. It is recommended that the daily protein intake to less than 0.8 g as / kg body weight decrease per day. This goal is best achieved with a predominantly vegetarian diet of meat and dairy products are not prohibited, but should not be eaten regularly. It makes sense, the daily protein intake from time to time to review the basis of food tables. You have to some degree in their own hands, how are your kidneys. If you want to know more about the kidneys get to the website of the Society of Nephrology much information. You will find www.nierengesellschaft.de under the heading “patient”.