Page 6 - Seniors Today October 2020
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Cover Story                                                                                                      Keeping the kidneys healthy

                                                                                                                          Our kidneys are pretty good at looking
                                                                                                                          after themselves, and we do not need to
                                                                                                                          take special measures to look after them.
                                                                                                                          In fact the job of the kidneys (along with
                                                                                                                          the liver) is to look after our health when
                                                                                                                          we are not doing just that; they take care of
                                                                                                                          too much or too little water consumption,
                                                                                                                          manage the excretion of toxins and other
             our Body
                                            ’s
         Your Body’s                                                                                                      socially acceptable poisons that we are            Drink as much water as your thirst tells you to, but in-
         Y
                                                                                                                          prone to ingest, and effectively control
         F
              iltration Plant
         Filtration Plant                                                                                                 the elimination of drugs which may be              crease intake if you have had kidney stones in the past
                                                                                                                          prescribed or recreational.
                                                                                                                                                                             in the urine. When this mechanism fails,
                                                                                                                           Nevertheless, there are some conditions           either from being swamped by dietary or
                                                                                                                          that put the kidneys at risk of damage and         fluid indiscretions, or from inherent lack
                                                                                                                          we need to be aware of these. Diabetes             of normal inhibitory factors in the urine,
                                                                                                                          mellitus and hypertension over a period of         a kidney stone will form. Small stones
                                                                                                                          years can put the kidneys at risk of damage,       floating about in the kidneys rarely cause
         Often overlooked until something goes wrong with them, the kidneys are                                           and although this can be reduced by proper         any discomfort. It is usually when they
         vital organs which need preventive care, writes Dr Percy Jal Chibber                                             control with medications, the risk is not          become larger or start traversing the ureter
                                                                                                                          entirely eliminated. Chronic use of certain        on their way to the urinary bladder, that
         The kidneys are paired bean-shaped                 (homeostasis).                                                prescribed medications such as painkillers         the typical kidney pain results. Kidney
         organs situated on the back wall of the             Each kidney contains a million tiny                          (paracetamol and tramadol are reasonably           or ureteric colic is often severe spasmodic
         upper abdominal cavity. Urine filtered by          filtration units called nephrons, and this is                 safe) or antibiotics may affect kidney             pain on one side of the abdomen or back
         the kidney is conveyed by tubes called the         nature’s way of furnishing us with surplus                    function and you need to make your doctor          that radiates down to the groin. In between
         ureters that run from the kidneys down to          capacity. We do not become unwell or show                     aware of this if you have a kidney ailment.        spasms, the patient may be relatively
         the bladder, where it is stored before being       signs of kidney failure until we are down                     How much water is good for the kidney, is          comfortable. It may be accompanied by
         passed.                                            to the last 10-15% of our nephrons. An                        a question I am often asked. The obvious           nausea or vomiting, fever with chills
          The kidneys are literally vital organs, in        estimate of the kidney’s filtration capacity is               answer is, let thirst be your guide. However,      and difficulty in voiding. The urologist
         that, life is unsustainable in their absence.      the Glomerular Filtration Rate (GFR) which                    if you have formed kidney stones in the past       will confirm the diagnosis and detect the
         The main function of the kidneys is that           can be accurately measured, if required, or                   it may be advisable to maintain a good daily       number, size and situation of the stone/s
         of a filtration plant. It receives blood from      more commonly is roughly estimated by the                     urine output (2 litres) by consuming the           by doing a Non Contrast Scout CT Scan
         the body with each heartbeat and filters           serum creatinine level, and testing for urine                 requisite amount of water.                         of the abdomen, and will run some blood
         out unwanted stuff like excess of hydrogen,        composition and microscopy.                                                                                      and urine tests to check for infection and
         potassium, uric acid, water and other               In addition to being a vital filtration                      Kidney Stones                                      ascertain kidney function.
         breakdown products of metabolism or what           plant, the kidney also performs the role of                   The kidneys filter out solutes like calcium         If the stone is smaller than 6mm, then
         we imbibe, in the form of food or drugs and        an important endocrine gland producing                        oxalate, calcium phosphate, uric acid and          the patient is urged to try and expel the
         medications. It does this while retaining          hormones that are directly released into our                  urates and other such solutes. If the volume       stone spontaneously by taking painkillers,
         the desired levels of important ingredients        blood. These hormones are Renin to control                    of urine is high, then the urine solution is       copious water intake and medicines that
         like proteins, glucose, bicarbonate and            our blood pressure, Vit D and Calcitonin                      dilute and this deters crystals from forming       assist in relaxing the ureter and assisting
         other electrolytes and water. In so doing it       activating enzymes that control calcium                       in the urine. If crystals do form, they are        normal passage. If this fails, or if the stone
         maintains a steady balance of important            metabolism and Erythropoietin that                            prevented from aggregating to form a stone         is larger, or if pain and infection persist,
         body ingredients, despite external factors         maintains our haemoglobin levels.                             by protective substances usually secreted          then the stone will need removal. This is


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