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Dr Amira, Senior Consultant Nephrologist, LECC, Lagos, Nigeria

01 Nov 2019

Structure of the Kidneys

Location: You have two kidneys which are located toward your lower back, on either side of your spine. Posterior to your abdomen and below your rib cage.

Size: approximately the size of a human fist


  • Filter waste from your blood
  • Removes waste and toxins from your body
  • Sends toxins to your bladder which is then expelled from the body as urine
  • Controls the levels of water and essential minerals in the body including vitamin D, red blood cells and hormones that regulate blood pressure
  • Produces hormones that keep the bones strong and the blood healthy

Your kidneys are essentially like a sieve.

Kidney failure occurs when the kidneys lose the ability to function as listed above. Thus, your body and blood becomes overwhelmed with toxins and waste. If left untreated, this can be life threatening.

What can Interfere with my Kidneys?

  • Severe dehydration. That said, have you had water today?
  • Certain acute and chronic diseases such as diabetes and hypertension
  • Kidney trauma
  • Exposure to toxic pollutants
  • Certain medications


Image of a kidney


Although, sometimes, many patients present no symptoms of kidney failure until tests are done, the most common symptoms among patients who show them include:

  • Tenacious nausea or vomiting
  • Unexplained shortness of breath
  • Reduced urine and/or difficulty beginning urination
  • Blood in the urine
  • Painful urination
  • Swelling of the hands, legs, ankles and feet (from retention of fluids caused by kidney failure – inability to remove water waste)
  • Excessive fatigue
  • Drowsiness and confusion
  • Persistent forgetfulness
  • Seizures
  • Pain or pressure in the chest
  • High blood pressure


Causes / Risk Factors

People who are at risk of kidney failure usually experience one or more of the following diseases and/or conditions:

  • Sudden loss of blood flow to the kidneys which can be prompted by:
    • Heart disease(s) including hypertensive heart disease
    • Anti-inflammatory medications
    • Heart attack
    • Dehydration
    • Allergic reaction
    • Severe infection such as sepsis
    • Severe burn
    • Scarring of the liver
  • Inability to urinate: when your body cannot eliminate urine, toxins build up and overload the kidneys, which can prompt kidney failure
    • Cancers: prostate, colon, cervical and bladder cancers especially
    • Kidney stones
    • Nerve damage
    • Blood clots within the urinary tract / in or around your kidneys
    • An enlarged prostate
  • Vasculitis – the inflammation of blood vessels
  • Multiple infections of the kidneys
  • Drugs and alcohol
  • High cholesterol
  • Overload of toxins in the system from heavy metals
  • Lupus – an autoimmune disease that prompts the inflammation of several body organs
  • Uncontrolled diabetes
  • Chemotherapy drugs
  • Certain antibiotics
  • Multiple myeloma – a cancer of the plasma cells in the bone marrow
  • Hemolytic uremic syndrome – the breakdown of red blood cells following a bacterial infection
  • Glomerulonephritis – inflammation of small blood vessels of the kidneys
  • Thrombotic thrombocytopenic purpura – a disorder that causes blood clots in small vessels
  • Scleroderma – an autoimmune disease that affects the skin
  • Medications that treat some autoimmune diseases


Preventing Kidney Failure

Take the following steps to reduce your risk of kidney failure

  • FOLLOW YOUR DOCTOR’S DIRECTIONS when taking medications (including over-the-counter medications)
    • Taking doses that are too high can create high toxin levels
  • Limit your exposure to chemicals and toxics including household cleaners, tobacco, pesticides
  • Stay hydrated
  • Manage and control existing medical conditions
  • Healthy balanced diet and lifestyle – e.g. avoid smoking, keep up to date with vaccinations

Diagnosing Kidney Failure

The ways in which we diagnose kidney failure include:

  • Urinalysis – to test for any abnormalities such as abnormal protein or sugar levels in the urine
  • Urinary sediment examination – to measure the amount of red and white blood cells, check for high levels of bacteria, check for high numbers of cellular casts
  • Urine volume measurements – measures urine output. Low output may suggest kidney disease due to urinary blockage
  • Blood urea nitrogen (BUN) and Serum Creatinine (Cr) – a rise in these levels in the blood may indicate acute kidney failure as a result of buildup
  • MRIs and CT scans – to search for blockages in the kidneys
  • Kidney tissue sample from kidney biopsy to check for abnormalities in deposits, scarring and infectious organisms
  • 24-hour urine sample

Treatment for kidney failure

The type of treatment a patient requires depends on the type of kidney failure. They include:

  • Dialysis – filters and purifies the blood
  • Kidney transplant – if successful, the patient’s kidney can work perfectly and dialysis may no longer be required. However, the patient would require immunosuppressive drugs which has its own side effects, some of which are serious
  • Treating underlying conditions during early stages of kidney disease especially hypertension and diabetes