Including dehydration of the body and excessive use of painkillers
Riyadh: Dr. Abeer Mubarak
Humans are born with two kidneys located in the back of the upper abdomen, on either side of the spine. Each kidney weighs about 160 grams and is between 10 and 16 centimeters long.
The primary function of the kidneys is to filter waste from the body and excrete it in the urine. In addition, the kidneys adjust the levels of electrolytes (sodium, potassium, calcium and other elements) to keep them at normal rates, which ensure the safety of the functioning and life of the body’s organs, especially the heart, brain and muscles. The kidneys also secrete a number of important hormones in controlling blood pressure within normal rates, as well as the hormone that stimulates the production of red blood cells, as well as the hormone needed to produce vitamin D, which is necessary to maintain bone health.
Harmful factors
The kidneys are sensitive organs in the body that are affected by harmful factors that may cause damage to them, the most important of which are diabetes and high blood pressure, in addition to a group of other harmful factors that cause kidney weakness.
However, among them there are four common causes, and what distinguishes them is that they are related to everyday behaviors. Which:
1- Pain relieving medications. There are many types of drugs that may cause kidney weakness, but analgesics remain one of the main causes of kidney weakness, especially non-steroidal anti-inflammatory drugs (NSAIDs), which are easy for some to take repeatedly and in high doses, without realizing the long-term side effects that can harm kidneys. This is not only for those who already have kidney weakness, but even for normal people.
Usually, a person does not notice his kidney weakness except by chance, such as when blood tests are performed for reasons unrelated to the kidneys, or after kidney weakness worsens to advanced stages. Therefore, it is worth reducing the regular use of pain-relieving medications, not exceeding the recommended dose, and taking them according to the medical recommendation for specific cases that require that. And the doctor, even if he prescribes it for long periods of time for chronic diseases, he usually makes it when necessary, and in the lowest possible dose, and follows up the results of kidney function analyzes.
Mayo Clinic doctors say: “If you take NSAIDs regularly, talk to your doctor so that he can monitor your condition and monitor possible side effects. Exceeding the recommended dose does not relieve pain and may increase the risk of serious side effects.”
Learn about the risks and benefits of common pain medications so that you can make safe choices as you search for a solution. Taking large doses of NSAIDs can cause kidney problems. The risk of these cases increases according to age and other health problems, such as diabetes, a history of stomach ulcers or gastroesophageal reflux, and kidney disease.
2- Salt and sodium. Physiologically, sodium is an essential element for maintaining the health and efficient functioning of the body’s cells. The body’s need for this element is limited. The body can be supplied with a sufficient amount of it by drinking water and eating natural food products. However, excessive sodium intake remains very common all over the world, although it is harmful to the body, especially as it causes high blood pressure, and thus damage to the kidneys, as well as increasing the chances of developing kidney stones. It also exacerbates the repercussions of other health problems, such as diabetes, heart disease, water retention in the body, stroke, and heart failure.
And when a person ingests high amounts of sodium, the body cannot get rid of it all through the kidneys in the urine, or through the sweat fluid on the surface of the skin. Consequently, the body is forced to keep high amounts of water in the body, in order to maintain a moderate balance of sodium metal in the body’s fluids, cells and organs, which in turn causes increased exhaustion of the heart and kidneys and an increase in blood pressure.
And the amount of sodium the body needs per day is less than about a teaspoon of salt. However, the problem with sodium intake remains that table salt is “one” of the nutrients that contain sodium, and not “the only source.” Salt makes up about 20 percent of the sodium we eat.
According to medical sources, the majority of sodium comes from certain foods that are not very salty in taste, such as: bread, processed cold meats, pizza, instant soups, fast food sandwiches, cheese, pasta dishes, and snacks such as potato slices and popcorn, because most of them contain chemical compounds. High in sodium, and not very salty.
“Most fresh fruits, vegetables, and meats are naturally low in sodium,” says Mayo Clinic doctors. Food and meals prepared in restaurants usually contain large amounts of sodium.
Dehydration and retention
3- Water and dryness of the body. Water makes up more than 60 percent of our body weight. The body becomes dehydrated from water, either when we do not eat enough amounts of it, or when we lose water due to diarrhea, vomiting, sweating, or excessive excretion of water in the urine, such as what happens in diabetics when the blood sugar level is high.
For the kidneys, water is a very vital element for them in three main aspects:
– Ensuring the “efficiency” of their continuous work in controlling the percentage of electrolyte minerals in the body and getting rid of toxins, waste and other chemical compounds harmful to the body.
– Water helps keep blood vessels open, so that blood flows freely to the kidneys, to supply them with food and oxygen, to ensure the continuity of “maintaining” the integrity of their components.
– Avoid the formation of painful and harmful kidney stones, as well as reduce the possibility of microbial infections in the urinary tract.
To clarify, when water is available in the blood fluid, the ability of the kidneys to filter the blood from harmful chemical compounds increases, and to remove them from the body with the urine fluid. And vice versa, as the dehydration of the body causes the kidneys to prioritize preserving the amount of water in the body, and not focus on removing toxins, waste and harmful compounds from the body. Which causes the accumulation of waste and acids in the body. It can also get blocked in the tiny tubules of the kidneys with muscle proteins (myoglobin). And all of these things can harm the kidneys.
There is no specific amount of water that should be taken daily by all people. Rather, the best way for a person to know that he is drinking sufficient amounts of water is the color of urine. It is normal for the color of urine to be transparent or very light yellow. Dark yellow urine is a sign that the body needs water.
And when mentioning “eating” water, it is not only meant to “drink” pure water, but many vegetables, fruits, foods (such as soup) and drinks (milk, coffee, tea, etc.) are indeed rich in water.
4- Urinary retention. The urinary tract is designed so that urine flows from the kidneys, through the ureters to the bladder, and then out through the urethra. And when urinary retention occurs, as a result of not emptying urine from the bladder, the bladder swells, and urine may return to the kidneys. At this point, the kidneys can fill with urine to the point that they swell and put pressure on nearby organs. This pressure can lead to kidney damage, chronic kidney disease and kidney failure.
In addition to damage to the kidneys, prolonged retention of urine may cause the bladder to expand greatly. Thus, the bladder muscles are damaged. Damage to the bladder muscles means sagging of the bladder, as it becomes unable to pressurize to expel the urine that collects in it, i.e. does not work properly in pressing to expel urine. Failure to completely empty the urine from the bladder gives bacteria an opportunity to multiply and infect the urinary tract with infections, which may spread to the kidneys. It may also cause incontinence. It may also cause frequent urge to urinate, without getting much of it.
Urinary retention may be “voluntary” as a result of not responding to the body’s call when the urgency of urination arises, i.e. not going to the bathroom to urinate and delaying that for long periods. It may also be “forced” as a result of an enlarged prostate or the presence of stones in the urinary tract and other pathological causes.
– Kidney weakness… many pathological factors
The US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports that diabetes and high blood pressure are among the most important pathological causes of kidney impairment. He adds, “Other causes of kidney disease include:
A genetic disorder that causes the growth of many cysts in the kidneys, polycystic kidney disease (PKD).
Microbial infection in the urinary system.
– Taking a drug that has a toxic effect on the kidneys.
Autoimmune disorders, in which the body’s immune system attacks its own cells and organs, such as lupus (SLE).
– Infections of the blood vessels inside the kidneys, or the glomeruli (the sites of blood filtration within the tiny renal units), especially with certain types of IgA antibodies.
Heavy metal poisoning, such as lead poisoning.
Rare genetic conditions.
Hemolytic uremic syndrome in children.
Renal artery stenosis.
Diabetes… How does it cause kidney weakness?
> Kidney failure is one of the most prominent potential complications of diabetes, and the US Centers for Disease Control and Prevention (CDC) reports that among those with end-stage ESRD (which requires either starting dialysis or undergoing a kidney transplant), diabetes was It is the cause of kidney failure in 44 percent of them.
She adds that diabetics can prevent this from happening, through the success of therapeutic follow-up in reducing risk factors, the most important of which are high blood sugar, hyperglycemia and high blood pressure. As well as through better treatment of cases of deterioration of kidney function in its early stages, which includes patients taking a certain type of medication to reduce high pressure, which slows down the deterioration in kidney function, in addition to contributing to reducing high blood pressure. And also by conducting an analysis of the amount of albumin protein in the urine, Urine Albumin, which is one of the early indicators of damage to the work of the kidneys as a result of diabetes.
To be clear, each kidney is made up of hundreds of thousands of tiny units called nephrons. They are units whose mission is: to filter the blood, remove harmful chemicals from the body, and control the fluid balance in the body. And in diabetics who do not have controlled glucose levels in the blood, Diabetic Nephropathy occurs. This is due to the slow change in the composition of the nephron unit. Specifically, its components thicken, and small scars of fibrous tissue appear, causing albumin to leak from the blood into the urine. It should be noted that this damage to the structures of the kidneys may begin to occur years before the start of complaining of any symptoms, and also perhaps before the patient discovers that he has diabetes.
In order to ensure the safety of kidney functions in patients with diabetes, or to follow up on any weakness that may occur in them, it is worth conducting a number of examinations, including:
– Analysis of the percentage of glucose accumulation in the blood hemoglobin HbA1C. This gives the average blood sugar levels over the past three months.
– Blood analysis to determine the percentage of urea nitrogen and creatinine.
Urinalysis to look for a protein called Microalbuminuria Test. A high amount of this protein is often a sign of kidney damage.
Follow up on blood pressure readings, because high blood pressure harms the kidneys, and the presence of weak kidneys makes it difficult to control high blood pressure.
Internal medicine consultant