Mainly associated with the excretory function, they actually account for many more areas and functions in the body. When they get sick they don’t hurt, but it’s a more dangerous situation! Undetected, a serious disease can develop in the body, which, if left untreated, can lead to dialysis or a transplant, explains Prof. Bożena Birkenfeld from the Department of Nuclear Medicine of the Pomeranian Medical University in Szczecin.
- The main task is the production of urine, with which various toxic chemicals are excreted, produced in the process of metabolism
- – Probably not everyone knows that the kidneys are also involved in: metabolism, regulating blood pressure and producing hormones and vitamins, producing red blood cells and detoxifying the body – explains prof. Birkenfeld
- For the proper functioning of the kidneys, it is important not to burden them with: excess salt, a high-protein diet, consumption of alcohol or painkillers
- Sick kidneys do not show symptoms for a long time. Symptoms – when they appear – are not very specific, such as hypertension
- More information can be found on the Onet homepage
Professor, what is the function of the kidneys in the human body? It is mainly associated with the filtering and excretory function. Is it all true?
Exactly – not really. But let’s start from the beginning. The kidneys are a bean-shaped paired organ located in the lumbar region, which is to serve us throughout our lives. It is a very complex organ that performs various functions in our body. Its main task is the production of urine, with which various toxic chemicals are excreted, produced in the process of metabolism in the human body. Probably not everyone knows that the kidneys are also involved in: metabolism, blood pressure regulation and produce hormones and vitamins.. The kidneys are also necessary for the maintenance of proper water and electrolyte balance, the production of red blood cells and the cleansing of the body of toxins.
How does this multifunctional even organ work?
Everything that we eat and drink is absorbed in large part from the digestive tract, metabolized, we will say colloquially: “processed” by the liver, and products harmful to the body are excreted by the kidneys. Therefore kidneys are such purification plants that work without any interruption throughout our lives and producers of substances necessary for the proper functioning of our body. For the proper functioning of the kidneys, it is important not to burden them with: excess salt, a high-protein diet, alcohol consumption, painkillers or other substances – then they may be damaged and fail to function properly.
What can kidneys suffer from?
The kidneys can suffer from various diseases including parenchymal and excretory functions. We have an influence on the emergence of some diseases, on some – we do not. Congenital diseases include various kidney defects, for example polycystic kidney disease, which results in less active parenchyma and poorer organ function. Acquired diseases include: kidney tumors, nephritis (acute and chronic), nephrolithiasis. Often the symptoms of kidney disease are pain in the lumbar region, urination disorders, urine color change, haematuria, edema, hypertension.
The kidneys are said not to hurt. So it is easy to overlook the disease?
Unfortunately it’s the truth. And untreated kidney diseases can have very serious consequences, i.e. their failure. The rescue is then dialysis – cleansing the blood of toxins with the use of a special device. Unfortunately, it is very burdensome for the patient, as it requires regular, several-day sessions of long-term treatment in specialized centers where the so-called renal replacement therapy or kidney transplantation is carried out – if it is still possible … The effects are therefore very serious and it is worth doing everything possible to avoid the advanced stage of the disease.
The kidneys get sick quietly, without any distressing symptoms for a long time. Take care of their condition – buy the package Kidney diseases – prophylactic laboratory tests and show the results to your doctor.
So how do you know early on when something is wrong with your kidneys? Is it even possible?
In addition to the symptoms listed above, which we can observe ourselves and which should arouse our concern, various diagnostic tests can be performed. The research makes it possible to clarify whether there is really a problem, if so – where it is located and how advanced. Tests should usually be performed at the request of a physician. The simplest and available test is urine testing and the determination of various parameters from the blood taken from the patient, including urea, creatinine, albuminuria and e-GFR. The determination of these parameters is also important in diabetic patients because they are at risk of renal complications and the development of chronic kidney disease, including renal failure. Additionally, various imaging tests are performed. The doctor decides what tests are necessary. Ultrasound examination, i.e. the so-called kidney ultrasound, is a very good, widely available, non-invasive method, applicable in children and adults. Another possibility is computed tomography and its various types, including vascular examinations with contrast. Magnetic resonance imaging also plays a very important role in the diagnosis of kidney disease. However, despite the usefulness of the above techniques, radioisotope tests play a huge role in the assessment of kidney function, about which it is worth mentioning a bit more.
Radioisotope research, i.e. using ionizing radiation?
Yes. Radioisotope testing involves giving a patient intravenously a chemical labeled with a radioisotope – most commonly technetium – and observing how the compound behaves in the body: how it is taken up by the kidneys and excreted by the kidneys into the bladder. These tests are most often dynamic kidney scintigraphy or static kidney scintigraphy.
What are these procedures? What possibilities do they give?
As in any nuclear medicine test, these procedures should also give the patient a radiopharmaceutical, i.e. a chemical compound labeled with 99mTc radioisotope that accumulates and / or is excreted by the kidneys. The distribution of the administered radiopharmaceutical in the kidneys and the rate of its excretion are recorded using devices called gamma cameras.
How exactly can changes in the metabolism of the radiopharmaceutical administered to the patient be observed?
The dynamic examination of the kidneys is a series of images recorded for about 25-30 minutes in the patient’s supine position. The obtained images allow the quantitative and qualitative assessment of kidney function, urine output rate, glomerular filtration rate and other parameters of their function. This test is applicable in patients with suspected renal arterial hypertension, but additionally, a test must be performed after administration of captopril – a drug that is also used to treat arterial hypertension. Another advantage of dynamic kidney examination is the possibility of assessing disorders in the outflow of urine from the calicopelic system, which often occur in the course of nephrolithiasis in adults or congenital abnormalities in children. These tests are very useful and safe even in very young children: they can be repeated, performed at intervals to better follow the effects of, for example, surgery treatment. The result of the test is numerical data that allow the function of each of the kidneys to be compared over time.
What about static testing?
A static kidney test is very common, even in young children who have had a kidney or urinary tract infection – for example, acute pyelonephritis. It enables the very early detection of so-called functional post-inflammatory scars, which may regress with proper treatment. There is no other non-invasive method that makes this possible. It is also a very good examination in the case of suspected congenital kidney defects, such as: horseshoe kidney, polycystic kidney disease, kidney agenesis or hypoplasia, ectopic position of the kidney.
Is this a study that requires special preparation?
Kidney radioisotope tests are safe for patients, and do not involve the risk of allergy to contrast or other complications. They are performed on adults and children – even infants. However, you need to prepare for an intravenous puncture to administer a radiopharmaceutical. To perform a radioisotope examination of the kidneys, you must have a referral from a specialist clinic, for example from a nephrologist, urologist, pediatric surgeon or other specialist. Tests are performed in nuclear medicine plants located all over Poland, mainly in larger cities.
What should you know before making them?
Research is non-invasive. Fasting is not necessary before dynamic and static kidney examination. This is good news, especially for young children and their parents. In fact, it is recommended that the child be full and drink the appropriate volume of fluid, because it calms the child and even allows him to fall asleep during the examination. Which is very desirable because it prevents movement during the procedure. It is worth knowing about these tests because they can really help in the early detection of abnormalities in the functioning of the kidneys, save health and even life.
Professor, thank you for the interview.