Dr. Simon Prince is a founder of North Shore Nephrology, P.C. in Manhasset and a Clinical Assistant Professor of Medicine at NYU School of Medicine. He can be contacted at 516-365-5570, www.nsneph.com and www.uremicfrost.com.

By Simon Prince, M.D.

Most people know that they have two kidneys. However, very few individuals realize that the kidneys perform many vital functions and serve as the body’s natural filtration system. I hope this article will enable you to gain a better understanding of how our kidneys work.

The kidneys are bean-shaped organs that remove toxins, mineral salts and water from the blood to form urine.  They are located in the back of the body, on both sides of the spine, right below the rib cage.  If the kidneys did not remove wastes from blood, these wastes would build up and cause some serious damage.

Although a majority of people have two kidneys, some individuals are born with only one kidney. By the way, it doesn’t preclude them from living normal and healthy lives.

Let’s take a closer look at our kidneys and find out how they work.

The kidneys are instrumental in performing the following functions:

• Regulate the fluid balance in the body. You need a certain amount of water in your system – not too much, and not too little. So, kidneys help maintain the right balance. If there is too much water in the body, the kidneys produce more urine. Too little water results in less urine.
• Control blood pressure
• Monitor electrolytes (sodium, potassium, chloride, calcium and phosphorous being the main electrolytes)
• Balance the acids and bases in a person’s body.
• Contribute to the production of hormones, such as Erythropoietin and Vitamin D.  Erythropoietin stimulates the bone marrow to produce the red blood cell. Vitamin D promotes strong, healthy bones and helps to maintain normal chemical balance in the body.

Interestingly, the kidneys start to age immediately after birth. The process starts to accelerate when they reach about 30 years of age.  Each decade thereafter, the kidney function progressively declines. Is there reason to be concerned? Not really. And here is why. Fortunately, our kidney has a large reserve capacity and will continue to function for many decades, without a problem.

Many different conditions can affect your kidneys and the way they carry out their critical functions. Some conditions can lead to a rapid decline in kidney function, others lead to a more gradual decline. Ultimately, both can result in a build-up of toxic waste substances, which I pointed out above. Therefore, I recommend a few clinical laboratory tests to determine the cause and level of kidney dysfunction. Urine and blood samples are used for these tests. Once a diagnosis is made and the problem is clearly identified, the Nephrologist can suggest a specific treatment plan.

The doctor’s recommendations and treatment plan can help a patient to slow the progression of kidney disease as much as possible. In certain cases medications are necessary to treat patients with Hypertension and Diabetes. If the conditions continue to deteriorate, and the kidney function continues to worsen, the Nephrologist might suggest dialysis or kidney transplantation. Dialysis is a blood cleansing procedure that helps to remove excess fluids, minerals, and waste products. Kidney transplantation is a procedure to implant a healthy kidney into a patient whose kidneys are no longer able to function at an adequate level.

Here is what I want you to keep in mind. Most kidney problems are the result of another disease, such as Diabetes or Hypertension. These disorders continue to be on the rise and need to be monitored regularly. There are specific guidelines for glycemic control in Diabetes and well-defined goals for regulating High Blood Pressure.

For example, the doctor may administer the HbA1c blood test to monitor Diabetes and measure blood sugar levels, which should remain below 7%. The ideal Blood Pressure goal is 130/80mmHg or lower. From experience I know that failure to adhere to these guideline levels may eventually result in progressive Kidney disease. Even small elevations above target goals may cause a serious problem and should be addressed immediately.

Always remember: our kidneys are vital organs, and it is essential to maintain good kidney health throughout our lifetime.

If you have any questions or comments, feel free to contact us at (516) 365-5570 or emailinfo@northshorenephrology.com.