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Kidney Disease
 What is Kidney Disease?
 You have two kidneys. They are bean-shaped and about the size of a fist. They are located in the middle of your back, on the left and right of your spine, just below your rib cage.
 The kidneys' main job is to filter your blood, removing wastes and extra water to make urine. They also help control blood pressure and make hormones that your body needs to stay healthy.
 Kidney disease -- also known as chronic kidney disease (CKD) -- occurs when kidneys can no longer remove wastes and extra water from the blood as they should. Kidney disease is most often caused by diabetes or high blood pressure. Millions of Americans have kidney disease. Many more are at risk.
Each kidney contains about one million tiny filters made up of blood vessels. These filters are called glomeruli. Diabetes and high blood pressure damage these blood vessels, so the kidneys are not able to filter the blood as well as they used to. Usually this damage happens slowly, over many years. As more and more filters are damaged, the kidneys eventually stop working.
Early kidney disease has no symptoms, which means you can't feel if you have it. Blood and urine tests are the only way to know if you have early kidney disease. If you have diabetes or high blood pressure, you should be tested for kidney disease.
Kidney disease can progress to kidney failure, also known as end-stage renal disease, at which point dialysis or a kidney transplant is needed. Kidney disease is also linked to cardiovascular (heart) disease.
Proper treatment can help prevent further kidney damage and slow the progression of kidney disease. The earlier kidney disease is found, the sooner you can take medications and other steps to keep your kidneys healthier longer.
Quiz 1. Your kidneys filter your blood.
TRUE is the correct answer. Though they do other things, your kidneys' main job is to remove wastes and extra water from your blood.
2. Kidney disease is caused by not drinking enough water.
FALSE is the correct answer. The most common causes of kidney disease are diabetes and high blood pressure.
3. Back pain is a symptom of kidney disease.
FALSE is the correct answer. Although kidney stones and kidney infections can cause back pain, kidney disease typically has no symptoms, especially in its early stages. The only way to tell if you have kidney disease is to get tested.
4. It is important to find kidney disease early.
TRUE is the correct answer. The earlier kidney disease is found, the sooner you can start treatments to keep your kidneys healthier longer. That's why it is important to get tested if you are at risk.
Risk Factors and Prevention
Diabetes and high blood pressure are the two leading causes of kidney disease. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease -- without you feeling it.
 There are several other risk factors for kidney disease. Cardiovascular (heart) disease is a risk factor. So is family history: if you have a mother, father, sister, or brother who has had kidney disease, then you are at increased risk.
Ethnicity can also be a risk factor. African Americans, Hispanics, and Native Americans tend to have a greater risk for kidney disease. This is mostly due to higher rates of diabetes and high blood pressure in these communities, although there may be other reasons.
If you have ANY of these risk factors, talk to your health care provider about getting tested for kidney disease. You can't feel kidney disease, so it is very important to get tested if you are at risk.
 By taking steps to control your diabetes and high blood pressure, you can keep your kidneys healthy longer. Manage your diabetes and high blood pressure by eating healthy foods, staying active, taking your medicines as prescribed, and seeing your doctor regularly.
If you keep these risk factors under control -- especially your blood pressure -- you may be able to postpone and even prevent kidney failure.
Quiz 1. Which of the following are common risk factors for kidney disease?
A. diabetes
B. high blood pressure
C. heart disease
D. all of the above
D is the correct answer. Diabetes, high blood pressure, and heart (cardiovascular) disease are the three most common risk factors for kidney disease.
2. You are also at risk for kidney disease if
A. you drink alcohol.
B. someone in your immediate family has had kidney disease.
C. you don't drink enough water.
B is the correct answer. Kidney disease is linked to hereditary factors, which means it can run in families. If there is a history of kidney problems in your immediate family, you may be at risk for kidney disease.
3. The risk of kidney disease
A. is higher among African Americans, Hispanics, and Native Americans.
B. is higher among Caucasians and Asians.
C. is the same across all ethnic groups.
A is the correct answer. African Americans, Hispanics, and Native Americans have a higher risk of kidney disease. This is due in part to higher rates of diabetes and high blood pressure in these communities.
4. To keep your kidneys healthy, you need to
A. reduce your alcohol intake.
B. have surgery to repair your kidneys.
C. control your diabetes and high blood pressure.
C is the correct answer. Diabetes and high blood pressure damage your kidneys. This can cause kidney disease, and make it worse over time. You can keep your kidneys healthier longer by keeping your diabetes and blood pressure under control.
Symptoms and Diagnosis
Kidney disease is often called a "silent" disease, because most people have no symptoms before they are diagnosed. In fact, you might feel just fine until your kidneys have almost stopped working. Do NOT wait for symptoms!
 Lab tests are the only way to know if you have kidney disease. If you have diabetes, high blood pressure, or another risk factor, ask about your kidneys at your next medical appointment. Again, the only way to know if you have kidney disease is to get tested. And the sooner kidney disease is found, the sooner you can take steps to keep your kidneys healthier longer.
 A blood test and a urine test are used to find kidney disease. If you have diabetes, you should get both of these tests every year. If you have high blood pressure, you should also get tested regularly -- ask your health care provider how often.
The blood test helps your doctor measure how much blood your kidneys filter each minute. This shows how well your kidneys are working. The test is called "GFR" (which stands for glomerular filtration rate).
GFR is reported as a number. A GFR higher than 60 is in the normal range. A GFR of 60 or lower may mean you have kidney disease. You can't raise your GFR, but you can try to keep it from going lower. Ask your healthcare provider what you can do to keep your kidneys healthy.
The urine test looks for protein in your urine, which is a sign of kidney damage. This test has several different names. You could be told that you are being screened for "proteinuria" or "albuminuria" or "microalbuminuria." ("Albumin" is a type of protein, and "micro" means a small amount of it.) Or you could be told that your "urine albumin-to-creatinine ratio" (UACR) is being measured.
If you have albumin or protein in your urine, it could mean you have kidney disease. Your healthcare provider might do additional tests to be sure.
Quiz 1. People with kidney disease usually experience
A. frequent urination.
B. back pain.
C. no symptoms.
C is the correct answer. Most people have no symptoms whatsoever before they are diagnosed. You might not feel symptoms until you are almost at the point of kidney failure, so don't wait for symptoms to get tested!
2. Which type of test is usually used to detect kidney disease?
A. blood test
B. urine test
C. both
C is the correct answer. Both blood and urine tests are used to detect kidney disease. You routinely give blood and urine samples at the doctor's office, so it should be easy to have your kidneys tested.
3. GFR is a measure of
A. the size of your kidneys.
B. how much urine you produce.
C. how much blood your kidneys filter each minute.
C is the correct answer. GFR stands for glomerular filtration rate, which is a measure of how much blood your kidneys filter each minute. A GFR higher than 60 is in the normal range. A GFR of 60 or below may be a sign of kidney disease.
4. People with diabetes should get blood and urine tests to check for kidney disease
A. every year
B. every three years
C. every five years
A is the correct answer. Diabetes is one of the most common causes of kidney disease, so people with diabetes should have their blood and urine tested for kidney disease at least once each year.
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