Guest Author - Carolyn Chambers Clark, RN, EdD

Where are the kidneys located?

Your kidneys are small, about the size of your fist, and are located in the back, just below the rib cage.

What do the kidneys do?

These small organs perform many vital functions that help maintain your overall health, including filtering waste and excess fluids from our blood. Every day, your kidneys filter about 200 quarts of fluid. About 2 quarts leave the body in the form of urine, and the rest remains in your body. Besides filtering wastes, your kidneys also release hormones that help regulate your blood pressure, control the production of red blood cells and make vitamins that control growth

What are early warning signs your kidneys aren't healthy?

When your kidneys no longer can perform these functions, your body may give you early warning signs including high blood pressure, blood and/or protein in the urine, more frequent urination especially at night, difficult or painful urination, puffiness around the eyes or swelling of hands or feet especially in children, and a creatinine blood level greater than 1.2 for women and 1.4 for men.

What are the signs of a urinary tract infection

An infection in the kidney may be proceeded by a urinary tract infection lower in the urinary tract. If you suspect you have a urinary tract infection, you will probably have some of the following symptoms:

* an urgent need to urinate, often with only a few drops of urine to pass
* a burning feeling when urinating
* an aching feeling, pressure or pain in your lower abdomen
* cloudy or blood-tinged urine
* a strong odor in your urine

An acute infection of the kidney is usually due to a bacterium. Infections usually occur by ascending up from the bladder. Urine flow usually prevents infectious agents from traveling up from the bladder, but obstructions, tumors, and other conditions can make this journey possible. Escherichia coli is the most common bacterium found and accounts for nearly 75% of kidney infections. This bacterium is normally found in the intestine and can be inserted in the urethra in women by wiping from back to front after urinating or after having a bowel movement.

Glomerulonephritis is a disease that damages the kidney's filtering units or glomeruli. The cause of this condition is not always known, but some cases may be inherited while others may be triggered by an infection.

Other conditions that can affect your kidneys include kidney stones and inherited diseases such as polycystic kidney disease. In kidney disease, there is often loss of protein in the urine, called proteinuria.

What is a kidney stone?

A kidney stone is a crystallization of material (stone) formed in the kidney. Most stones are composed of calcium oxalate, but some are made of calcium phosphate,uric acid or other chemicals. Stones sometimes stay in the kidney and grow while other dislodge and try to pass down the narrow ureter and in this location may be more likely to cause disabling pain. It's hard to predict which stones will cause pain and which won't. Sometimes pain comes and goes. When pain is present, it most commonly occurs in the low back to the side, but it can also occur in your abdomen. If you believe you have kidney stones, drink lots of water until you can get treatment.

What are your risk of developing a kidney infection?

A kidney infection is more likely if you've had urinary catheterization. Infectious organisms have been found in patients who have indwelling catheters, who become infected while in the hospital, who are on chronic antibiotics or who are being treated by steroids (such as prednisone)
or immunosuppressive drugs (such as methotrexate, azathioprine, prednisone, cyclosporine or cyclophosphamide) used in severe rheumatoid arthritis or after organ transplantation.

What causes kidney stones?

It used to be thought that eating foods high in calcium would cause kidney stones. Now, according to New England Journal of Medicine, a high intake of calcium can reduce the urinary excretion of oxalate, which can lower the risk. A study in the Annals of Internal Medicine reported that eating dairy foods can decrease the risk of kidney stones. The same study found that sucrose (sugar) and sodium (salt) intake were associated stone development.

Another major risk factor for kidney stones is a low intake of fluids, especially water. produces a low urine volume which can lead to kidney stones, according to a report in Nephron.

The two leading risk factors for kidney failure are diabetes and high blood pressure. When these two conditions are controlled, the associated chronic kidney disease can often be prevented or slowed down. If they are not controlled, kidney failure can occur and requires regular dialysis or transplantation is necessary. A third cause of kidney failure is glomerulonephritis.

A study in the New England Journal of Medicine concluded that heavy use of acetaminophen(Tylenol) may cause kidney failure. Ibuprofen (Advil and Nuprin), and Naproxen (Aleve) also may damage the kidneys.

According to Prescription Alternatives, other drugs that can stress or damage the kidneys include ACE inhibitors, Acyclovir, Allopurinol, Aminoglycosides, Amphotericin, azathioprine, Beta-Blockers, Captopril, Cephalothin, chemotherapy drugs, Chlorothiazide, Chloropropamide, Clofibrate, cyclophosphamide, Cyclosporine, diuretics, Furosemide, Isoproterenol, Lithium, Macanylamine, Methotrexate, Methysergide, Morphine, Penicillins, Phenylbutazone, Phenytoin, Piperdine, prednisone, Probenecid, Procaine, Quinidine, Salicylate, Sulfonamides, and Tolazoline.

This article is excerpted from THE AMERICAN HOLISTIC NURSES' ASSOCIATION GUIDE TO COMMON CHRONIC CONDITIONS: SELF-CARE OPTIONS TO COMPLEMENT YOUR DOCTOR'S ADVICE.