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.

1. Your kidneys filter your blood.

2. Kidney disease is caused by not drinking enough water.

3. Back pain is a symptom of kidney disease.

4. It is important to find kidney disease early.

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.

1. Which of the following are common risk factors for kidney disease?

2. You are also at risk for kidney disease if

3. The risk of kidney disease

4. To keep your kidneys healthy, you need to

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.

1. People with kidney disease usually experience

2. Which type of test is usually used to detect kidney disease?

3. GFR is a measure of

4. People with diabetes should get blood and urine tests to check for kidney disease

There are several types of treatments related to kidney disease. Some are used in earlier stages of kidney disease to keep your kidneys healthier longer. These medications and lifestyle changes help you maintain kidney function and postpone kidney failure. Other treatments, such as dialysis and transplantation, are used in later stages of kidney disease. These methods help replace kidney function if your own kidneys have stopped working.

Researchers are working at every stage of kidney disease to improve diagnosis and treatment. Some are trying to find a better way to identify who is at greatest risk for rapidly progressing kidney disease. Some are trying to find more effective medications to treat kidney disease and its risk factors. And some are working to improve dialysis and the results of kidney transplantation.

Treatments for early kidney disease include both lifestyle changes and medications. Lifestyle changes, such as eating less and exercising regularly to maintain a healthy weight, can help prevent the diseases that cause kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys.

Restricting your use of salt can be an important lifestyle change, as this helps control blood pressure. For people with greatly reduced kidney function, another change often recommended by experts is to follow a moderate-protein diet. Because protein makes your kidneys work harder, eating less protein may help delay progression to kidney failure. Anyone considering dietary changes because of kidney disease should work with a dietitian to ensure that they are getting proper nutrition.

Medications can also help keep kidneys healthier longer. Two types of blood-pressure medications -- angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) -- have been shown to slow down kidney disease and delay kidney failure. These medications have been shown to work in people who have either diabetes or high blood pressure, and many other kinds of kidney disease, to protect kidney function.

Many people need two or more types of medicines to keep their blood pressure below recommended levels (130/80 mmHg) to keep the kidneys healthy. A diuretic (water pill) also can be important. Your healthcare provider will determine which medication or combination of medications is right for you.

Some older adults with kidney disease may be taking medications for other diseases as well. As kidney disease progresses, it is likely that the doctor will need to adjust the dosages of all medications being taken.

If kidney disease progresses to kidney failure (sometimes called end-stage renal disease, or ESRD), the goal of treatment changes. Since the kidneys have now stopped working, the goal is to find treatments that can replace kidney function. There are two main options for this: dialysis and transplantation.

Dialysis is a treatment to filter wastes and water from your blood. There are two major forms of dialysis: hemodialysis and peritoneal dialysis. In hemodialysis, blood is run through an external filter and the clean blood is returned to the body. Hemodialysis is usually done at a dialysis center three times a week. Each session usually lasts between three and four hours.

Peritoneal dialysis is another way to remove wastes from your blood. This kind of dialysis uses the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. It works by putting a special fluid into your abdomen that absorbs waste products in your blood as it passes through this lining. This fluid is then drained away. A key benefit of peritoneal dialysis is that it can be done at home, while you sleep.

Hemodialysis and peritoneal dialysis are treatments that help replace the function of the kidneys. These treatments help you feel better and live longer, but they don't cure kidney failure.

Although patients with kidney failure are now living longer than ever, over the years kidney disease can cause problems such as heart disease, bone disease, arthritis, nerve damage, infertility, and malnutrition. So to stay as healthy as possible for as long as possible while on dialysis, follow your doctor's recommendations, take your medications, and continue to follow the lifestyle and dietary habits you adopted to slow the progression of kidney disease.

Dialysis can be a special challenge for older adults, especially those who have other diseases or conditions. For example, hemodialysis requires that a person be able to leave home, travel to the dialysis facility, and sit for 4 hours during treatment. Peritoneal dialysis can be done at home, but requires someone to help. Often, older adults require assistance with some or all of these activities, and they and their families need to consider these issues as they choose treatment options and living facilities.

Instead of dialysis, some people with kidney failure -- including older adults -- may be able to receive a kidney transplant. This involves having a healthy kidney from another person surgically placed into your body. The new, donated kidney does the work that your two failed kidneys used to do. The donated kidney can come from an anonymous donor who has recently died, or from a living person -- usually a relative. But you might also be able to receive a kidney from an unrelated donor, including your spouse or a friend.

Kidney transplantation is a treatment for kidney failure -- not a cure. You will need to see your healthcare provider regularly. And you will need to take medications for as long as you have your transplant to suppress your immune system so it doesn't reject the transplanted kidney.

Not all treatments are right for all people. Be sure to talk to your doctor and other health professionals -- including nurses, dietitians, and diabetes educators -- to figure out the best treatment plan for you. The right choice for you depends upon your medical condition, lifestyle, and personal likes and dislikes.

1. There are no effective treatments for kidney disease.

2. Once you are diagnosed with kidney disease, you don't have to worry about blood pressure or diabetes -- the damage has already been done.

3. There are different types of dialysis.

4. You can only get a donated kidney from a family member.

There are many researchers who are working on kidney disease. They are looking for ways to improve diagnosis, make treatments more effective, and make dialysis and transplantation work better.

Several areas of research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) hold great potential. Emphasis is being placed on research related to prevention and early intervention in kidney disease.

Another focus is on the interaction between diabetes, kidney disease, and cardiovascular disease. Advances in treatments for diabetes and high blood pressure may help reduce the damage these conditions do to the kidneys in the first place. Research into how to predict who will develop kidney disease may improve prevention.

NIDDK is sponsoring a major study -- the Chronic Renal Insufficiency Cohort (CRIC) study -- to learn more about how kidney disease progresses. CRIC is following 3,000 adults for seven years. All study participants have mild to moderate kidney disease, and about half have diabetes.

It is believed that some CRIC study participants' kidney function will decline more rapidly than others', and that some will develop cardiovascular disease while others won't. The goal of the study is to identify the factors linked to rapid decline of kidney function and the development of cardiovascular disease.

The data and specimens collected from study participants will be available to other researchers who are studying kidney disease and cardiovascular disease. The CRIC study will allow future investigation into the role of genetic, environmental, behavioral, nutritional, and other factors in kidney disease.

In the area of transplantation, researchers are working to develop new drugs that help the body accept donated organs. The goal is to help transplanted kidneys survive longer and work better.

NIDDK scientists are also developing new techniques to improve the body's tolerance for foreign tissue even before the donated kidney is transplanted. This could help reduce or eliminate the need for drugs that suppress the immune system, which could reduce transplantation costs and complications. In the future, scientists may even develop an artificial kidney for implantation.

1. The CRIC study is looking into why some people's kidneys fail faster than others' do.

2. Researchers clearly understand the relation between kidney and cardiovascular disease.

3. Half of the participants in the CRIC study have kidney disease.

4. Researchers are trying to make it easier for the body to accept donated organs.

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 or perform other functions as they should. Millions of Americans have kidney disease. Many more are at risk.

Kidney disease is most often caused by diabetes or high blood pressure.

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.

Diabetes and high blood pressure are the two leading risk factors for 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.

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.

You can keep your kidneys healthy longer by taking steps to control your diabetes and high blood pressure. 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.

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 for kidney disease is called a GFR. (GFR stands for glomerular filtration rate.) This test helps your doctor measure how much blood your kidneys filter each minute. This shows how well your kidneys are working.

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 for kidney disease 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.

Treatments for early kidney disease include both lifestyle changes and medications. Lifestyle changes, such as eating less and exercising regularly to maintain a healthy weight, can help prevent the diseases that cause kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys.

Restricting your use of salt can be an important dietary change, since this helps control blood pressure. For people with greatly reduced kidney function, another change often recommended by experts is to follow a moderate-protein diet. Because protein makes your kidneys work harder, eating less protein may help delay progression to kidney failure. Anyone considering dietary changes because of kidney disease should work with a dietitian to ensure that they are getting proper nutrition.

Two types of blood-pressure medications --angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) -- have been shown to slow down kidney disease and delay kidney failure. These medications have been shown to protect kidney function in people who have either diabetes or high blood pressure, as well as those with various types of kidney disease.

Many people need two or more types of medicines to keep their blood pressure below recommended levels (130/80 mmHg) to keep the kidneys healthy. A diuretic (water pill) also can be important. Your healthcare provider will determine which medication or combination of medications is right for you.

Some older adults with kidney disease may be taking medications for other diseases as well. As kidney disease progresses, it is likely that the doctor will need to adjust the dosages of all medications being taken.

When your kidneys fail, they lose their ability to filter blood and remove waste and excess fluid from your body. Kidney failure (sometimes called end-stage renal disease, or ESRD) causes harmful waste and excess fluid to build up in your body. Your blood pressure may rise, and your hands and feet may swell. Since the kidneys have now stopped working, the goal is to find treatments that can replace kidney function. There are two main options for this: dialysis and transplantation.

Dialysis is a treatment to filter wastes and water from your blood. There are two major forms of dialysis: hemodialysis and peritoneal dialysis. In hemodialysis, blood is run through an external filter and the clean blood is returned to the body. Hemodialysis is usually done at a dialysis center three times a week. Each session usually lasts between three and four hours.

Peritoneal dialysis is another way to remove wastes from your blood. This kind of dialysis uses the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. It works by putting a special fluid into your abdomen that absorbs waste products in your blood as it passes through this lining. This fluid is then drained away. A key benefit of peritoneal dialysis is that it can be done at home, while you sleep.

No. Hemodialysis and peritoneal dialysis are treatments that help replace the work your kidneys did. These treatments help you feel better and live longer, but they don't cure kidney failure.

Although patients with kidney failure are now living longer than ever, over the years kidney disease can cause problems such as heart disease, bone disease, arthritis, nerve damage, infertility, and malnutrition. So to stay as healthy as possible for as long as possible while on dialysis, follow your doctor's recommendations, take your medications, and continue to follow the lifestyle and dietary habits you adopted to slow the progression of kidney disease.

Dialysis can be a special challenge for older adults, especially those who have other diseases or conditions. For example, hemodialysis requires that a person be able to leave home, travel to the dialysis facility, and sit for 4 hours during treatment. Peritoneal dialysis can be done at home, but requires someone to help. Often, older adults require assistance with some or all of these activities, and they and their families need to consider these issues as they choose treatment options and living facilities.

Instead of dialysis, some people with kidney failure -- including older adults -- may be able to receive a kidney transplant. This involves having a healthy kidney from another person surgically placed into your body. The new, donated kidney does the work that your two failed kidneys used to do. The donated kidney can come from an anonymous donor who has recently died, or from a living person -- usually a relative. But you might also be able to receive a kidney from an unrelated donor, including your spouse or a friend.

Kidney transplantation is a treatment for kidney failure -- not a cure. You will need to see your healthcare provider regularly. And you will need to take medications for as long as you have your transplant to suppress your immune system so it doesn't reject the transplanted kidney.

There are many researchers who are working on kidney disease. They are looking for ways to improve diagnosis, make treatments more effective, and make dialysis and transplantation work better.

Several areas of research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) hold great potential. Emphasis is being placed on research related to prevention and early intervention in kidney disease.

Another focus is on the interaction between diabetes, kidney disease, and cardiovascular disease. Advances in treatments for diabetes and high blood pressure may help reduce the damage these conditions do to the kidneys in the first place. Research into how to predict who will develop kidney disease may improve prevention.