Why kidneys matter — structure, function, prevention & treatment
Kidneys flush out harmful waste, maintain water and electrolyte balance, and regulate blood pressure. Malfunction can cause life-threatening illness. This page covers structure, common diseases, prevention strategies, diagnosis, dialysis, and transplantation in clear, patient-friendly language.
Structure of the Kidney
How kidneys work
The kidney produces urine by removing toxic waste products and excess water from the blood. Urine formed in each kidney passes through the ureter, flows into bladder before finally being excreted through the urethra.
Anatomical & measurable facts
Most adults (males and females) have two kidneys. Each kidney is bean-shaped — approximately 10 cm long, 6 cm wide and 4 cm thick, weighing ~150–170 g. The ureter is about 25 cm long. The adult bladder holds about 400–500 ml of urine.
Kidneys are located high and to the back side of the abdomen, on either side of the spine and are protected by the lower ribs. They lie deep inside the abdomen, so usually cannot be felt.
Primary functions
- Remove toxic wastes (urea, creatinine)
- Maintain fluid & electrolyte (sodium, potassium) balance
- Regulate blood pressure and acid-base balance
Major Kidney Disease
Common conditions include kidney failure (acute & chronic), urinary stones, infections, uncontrolled blood pressure related kidney disease, diabetes-related kidney disease and pediatric kidney diseases.
Kidney Failure
Kidneys are no longer able to remove waste effectively. The build up of waste products changes the body's chemistry causing symptoms. There are two types: Acute kidney failure and Chronic kidney disease.
Acute Kidney Failure
Acute means sudden failure often due to infections, toxins, severe dehydration or blood loss. Usually temporary — kidneys may recover if cause is treated.
Chronic Kidney Failure
Gradual progressive and irreversible loss of kidney function over months to years. May lead to complete kidney failure requiring dialysis or transplant.
Other conditions
- Urinary stone disease — pain, obstruction, infections
- Urinary tract infections (UTI)
- Diabetes-related kidney disease
- Hypertensive kidney damage
- Kidney disease in children
Prevention of Kidney Disease
Kidney diseases are silent killers. Early detection and treatment can often keep CKD from getting worse, and can prevent or delay the need for definitive therapy.
Precautions for Healthy Person
- Be fit and active: Regular aerobic exercise maintains normal blood pressure and controls blood sugar.
- Balanced diet
- Keep your weight in check
- Give up smoking and tobacco products
- Beware of OTCs — avoid prolonged painkiller use without medical advice.
- Drink lots of water
- Annual kidney check-up
Precautions for Kidney Patients
- Awareness and early diagnosis — watch for swelling, loss of appetite, nausea, frequent urination, blood or protein in urine
- Precautions in diabetic and hypertensive patients
- Early diagnosis of polycystic kidney disease
- Treat recurrent UTIs and manage BPH appropriately
- Cautious use of medicines and special care for solitary kidney
Diagnosis of Kidney Diseases
Many early stages of CKD are asymptomatic — laboratory tests are key. Early diagnosis allows appropriate treatment and can delay progression to ESKD.
Who should get checked?
- People with diabetes or hypertension
- Family history of kidney disease
- Frequent urinary infections or hematuria
- Long-term painkiller use
Screening & tests
- Blood tests: Creatinine, Urea, Electrolytes, Hemoglobin
- Urine tests: Routine & protein/albumin
- Imaging: Ultrasound of the kidneys
Treatment of Chronic Kidney Disease
Treatment options: medical management, dialysis, or transplant. Most patients start with medical management — medicine, dietary advice and monitoring — to slow progression.
Why medical management is important
Early conservative therapy can delay or prevent the need for dialysis/transplant. Many patients remain well on appropriate therapy; discontinuing therapy may lead to rapid worsening.
Goals of medical management
- Slow disease progression
- Treat underlying causes & complications
- Reduce cardiovascular risk
- Delay need for dialysis or transplant
Lifestyle & general measures
Stop smoking, maintain healthy weight, limit alcohol, follow a healthy eating plan with salt reduction, take medications as directed, and have regular follow-up with a nephrologist.
Dietary restrictions
- Salt: Restrict added & processed salt
- Fluid: Restrict fluids if urine output is low/swelling present
- Potassium: Limit potassium-rich foods when advised
- Protein: Avoid high-protein diets unless advised by specialist
Dialysis — Meaning & Indication
Dialysis removes waste products and excess water artificially when kidneys fail. It is life-saving for End Stage Kidney Disease (ESKD) or severe acute kidney injury until recovery or transplant.
How dialysis helps
- Purifies blood by removing creatinine & urea
- Removes excess fluid
- Corrects electrolytes and acid-base balance
Dialysis cannot replace all kidney functions such as hormone production (e.g., erythropoietin).
Types of dialysis
Hemodialysis (HD): Blood is passed through a dialyzer (artificial kidney) using a dialysis machine. Usually performed in a center ~3 times/week for ~4 hours each session.
Peritoneal Dialysis (PD): Dialysis fluid uses the peritoneal membrane to remove wastes; can be done at home (CAPD/CCPD/IPD).
Vascular access for hemodialysis
- Central venous catheters
- Native arteriovenous (AV) fistula (preferred long-term option)
- Synthetic grafts
Kidney Transplant
Kidney transplantation is a major advance and often the treatment of choice for ESKD — it may offer better quality of life and survival compared with dialysis.
When & why transplant?
When kidney function declines to the point that dialysis is required or in pre-emptive cases approaching ESKD. Not indicated for acute kidney injury expected to recover.
Advantages
- Better replacement of renal functions
- Freedom from dialysis
- Longer life expectancy compared to remaining on dialysis
- Lesser dietary & fluid restrictions eventually
Steps before living donor transplantation
- Voluntary willingness and consent
- Thorough history, physical exam, lab & radiological evaluation
- Authorization committee permissions (local rules)
Contact & Resources
Dr Bhavin Brahmbhatt — Consultant Nephrologist & Transplant Physician at Sovin Kidney Clinic
Sovin Kidney Clinic
G 14/15, Race Course, Near MLA Hostel
Phone: 9548658489