KIDNEY

A. Definiton
Every person has a pair of kidneys in his body. Just like other
organs, this organ, also known as renal, must be kept healthy so that it can
work optimally and free from problems. To make it easier, you must first
understand anatomy, how it works, the type of kidney function check, and
healthy tips for keeping this organ healthy.
The kidneys are excretory organs in vertebrates that are shaped like
peanuts. In adult humans, the kidney is about 11 centimeters in length. The
kidneys receive blood from a pair of renal arteries, and blood comes out
through the renal vein. Each kidney is related to the ureter, the tube that
carries urine out to the bladder.
B. The Location
The kidneys (renal) are located along the back muscle wall
(posterior muscles) of the abdominal cavity. The shape of this organ is
similar to a bean that is about the size of a fist, about 12 cm long wide.
Just like other organs, the kidneys play an important role in the
human body. The main function of the kidneys is to filter out wastes
(waste) in the body, both those from food, drugs, and toxic substances.
The kidneys filter 200 liters of blood every day. Of the filtered
blood, there are 2 liters of waste that must be excreted in urine. For this
reason, this organ is equipped with a pair of ureters, a bladder, and urethra
that will carry urine out of the body.
In addition to removing waste substances in the body, this vital organ can
also absorb back the substances needed by the body, such as amino acids,
sugar, sodium, potassium, and other nutrients. The kidney function is
apparently influenced by the adrenal glands located at the top of each
kidney.
The adrenal glands produce the hormone aldosterone. This hormone
functions to absorb potassium from urine into blood vessels so that the
body can be utilized again. Do not stop there, renal is also tasked to
produce hormones that are beneficial to the body, including:
- Erythropoietin (EPO), a hormone that stimulates bone marrow to
produce red blood cells.
- Renin, serves to regulate blood pressure.
- Calcitriol, an active form of vitamin D that helps maintain bone health.

C. Anatomy
In general, human kidney anatomy consists of three parts, namely
the renal cortex, renal medulla and renal pelvis. For more complete, see
the explanation of the renal parts below.
 1. Renal cortex
The outer portion of the kidney is called the cortex. This section is
surrounded by renal capsules and layers of fat that function to protect
the structure in the organs from damage.
2. Renal Medulla
The medulla is smooth kidney tissue. This part consists of the loop of
Henle and the renal pyramid, which is a small structure that contains
nephrons and tubules. It is this tubule that functions to transport fluid
into and remove urine from the renal.
3. Pelvic renal
The renal pelvis is the deepest part of the funnel-shaped kidney. The
function of this part is as a pathway for fluid to move from the renal to
the bladder.
The renal pelvis consists of two parts. The first part of the renal pelvis
consists of calyces, which are cup-shaped spaces that function to
collect fluid prior to the bladder. Furthermore, the liquid will enter the
hilum, which is a small hole that will drain the liquid into the bladder.

In addition to these parts, the kidneys also consist of nephrons. This

nephron is located along the cortex to the renal medulla. The function
of the nephron itself is to filter blood, absorb nutrients, and drain waste
substances into urine.

The nephron consists of several parts, namely:

1. The malphigi body, also called the renal corpus. The malphigi
body consists of two parts, the glomerulus or a collection of
capillaries that absorb protein from the blood; and Bowman
capsules.
2. Renal tubules, a collection of tubes that travel from the Bowman's
capsule to the collecting tube (tubular collection). This collection
of tubes consists of the proximal tubule, the loop of Henle, and the
distal tubule.

D. How the kidneys work

1. Urine formation is initially preceded by a blood filtration process. This
process is carried out by the glomerulus of blood flowing from the aorta
through the renal arteries to the malphigi body. Then, the filtered waste
(primary urine) containing water, glucose, salt, and urea is stored in a
Bowman capsule.
2. Furthermore, primary urine will be flowed into the collecting ducts. When
this is flowed urine will experience the stages of reabsorption (absorption).
Various substances that can still be used, such as glucose, amino acids, and
 salt will be absorbed again by the proximal tubule and the loop of Henle.
Well, this absorption will produce secondary urine that has high urea levels.
3. After that, the final process of forming urine is augmentation or secretion.
Secondary urine will flow into the distal tubule through the blood capillaries
to release various substances that are no longer useful to the body. This
augmented urine is actually urine and stored in the bladder.
When the bladder is full of urine, the nerves around the bladder send
signals to the brain. When the signal is received by the brain, there will be a
feeling of wanting to urinate.

E. Various kidney diseases

If you do not maintain optimal health of the renal parts, you must be
careful with the increasing risk of various diseases. Because, most kidney
problems do not cause any symptoms until the disease enters an advanced stage.

Some symptoms that a person might experience if his kidney is having problems
include:
Hard to sleep
Anxious
Difficult to concentrate
Dry and itchy skin
Change the frequency of urination
Pain when urinating
Bloody urine
Foamy urine
Swelling around the eyes and feet
Decreased appetite
Muscle cramp
As we get older, almost all organs of the body will experience decreased
function. The same is true for your kidneys. As a result, the ability of this organ
to filter blood is not optimal. For this reason, the elderly generally experience one
or more of the symptoms of kidney disease above.
Unlike the decline in kidney function caused by disease, this can lead to
more serious health problems. If the renal function is reduced by 10 to 15
percent, this indicates that someone has kidney failure. As a result, sufferers need
dialysis or even a kidney transplant so that the kidneys can continue to work
optimally.

Various problems with this organ filtering bodily fluids, which may occur
include:
1. Acute kidney failure
Kidney failure is a condition when the renal is no longer able to filter
out residual substances from the blood. This can be caused by urinary tract
stones, medication, severe dehydration, or trauma to the renal.
 Symptoms can include a decrease in the amount of urine, swelling in
the legs, shortness of breath, chest pain, anxiety, convulsions, to coma. If not
treated immediately, this can threaten the lives of sufferers.
2. Kidney stones
Kidney stones are crystals that form in the renal. You may more
commonly know him as urinating. Although referred to as kidney stones,
crystallized rocks do not only nest in the renal. Rocks can move along the
urinary tract, be it in the ureter, bladder, or urethra.
If kidney stones have moved to the urinary tract, the crystals can
injure the walls of the urinary tract. This can cause blood spots in the urine.
3. Glomerulonephritis
Glomerulonephritis is inflammation of the glomerulus or small blood
vessels that filter blood. Because the glomerulus is inflamed, the renal cannot
filter blood normally and you can experience kidney failure.
Similar to other kidney diseases, symptoms of glomerulonephritis
can include bloody urine, high blood pressure, rarely urinating, abdominal
pain, foamy urine, and swelling in the face, hands, feet, and stomach due to
the accumulation of fluid in the body.
4. Acute nephritis
Acute nephritis is inflammation (swelling) of the renal nephron. This
condition causes abnormal cells from the blood to enter the urine and causes
inflammation. These cells are usually in the form of eosinophils or a type of
white blood cell.
When inflammation has caused nephritis, sufferers will experience
fever, vomiting, hypertension, back pain, and urinary disorders (burning
sensation, frequency changes, foamy urine, or bloody urine).
5. Urinary tract infections
Urinary tract infections occur when bacteria infect your urethra, from
the kidneys to the urethra. Symptoms are fever, pain during urination, and
increased frequency of urination. Usually the doctor will suggest drinking
enough water and giving antibiotics to treat the infection.
6. Acidosis
Acidosis is a condition when the body is filled with acidic blood.
Normally, the body's pH is not too acidic or not too alkaline, which is around
7.4.
Under conditions of acidosis, the body's pH tends to be less than
7.35. This can be caused by the high levels of carbon dioxide in the body,
diarrhea, a decrease in the amount of insulin, or because the kidneys fail to
filter alkaline substances in the body.
 7. Uremia
Uremia is a buildup of urea in the blood that causes irritation to the
nervous system. At first, people with uremia do not feel any symptoms.
However, over time the sufferer will experience leg cramps, loss of appetite,
headaches, severe fatigue, vomiting, and difficulty concentrating.
8. Polycystic Kidney (PKD)
If a family member has polycystic kidney disease, it means you are at
risk of developing the same disease. Yes, this disease is a hereditary disease
caused by several cysts in the renal.
People with this condition tend not to feel any symptoms. New cyst
symptoms will be felt if the cyst has begun to grow by three centimeters or
larger. Symptoms include bloody urine, stomach pressure, urinary tract
infections, and so on.
9. Chronic kidney failure
Chronic kidney failure is a decrease in kidney function below the
normal limit for more than 3 months. If you suffer from this disease, it means
that the renal function is no longer able to filter out impurities, control the
amount of water in the body, also the levels of salt and calcium in the blood.
This disease is generally caused by hypertension and diabetes which are not
treated immediately. Symptoms are marked by shortness of breath, vomiting,
bone pain, swelling around the eyes and feet, fainting, numb hands and feet,
and weight loss

F. Types of examination of kidney function

One way to find out the good or bad function of your kidneys is to
undergo a screening test. Especially if you are at high risk of kidney disease,
such as diabetes, hypertension, heart disease, or a family history of similar
diseases. If so, you should routinely do kidney function checks at least once a
year.
There are two types of tests that must be undertaken, namely blood
tests and urine tests. Let's peel one by one.
1. Blood test
Blood tests are needed to find out how optimal your renal
function is in filtering blood. This examination is referred to as
glomerular filtration rate (GFR).
In this test, your blood will be tested by looking at creatinine
levels. Creatinine is a waste product that is produced by muscle tissue
and will be excreted through the process of excretion.
 When someone is affected by kidney disease, this organ will be
difficult to remove creatinine from the blood. So, the greater the
creatinine, the lower your renal function.
Even so, this blood test does not only depend on the amount of
creatinine alone. This creatinine result will be combined with your age,
race, height, weight, and gender to determine the final GFR score.
There are five GFR phases that describe the health of a person's
kidney function, namely:
Phase 1: GFR> 90, organ function tends to be normal
Phase 2: GFR 60-89, mild organ dysfunction
Phase 3a: GFR 59-45, moderate organ dysfunction
Phase 3b: GFR 30-44, moderate to severe organ dysfunction
Phase 4: GFR 15-29, severe organ dysfunction
Phase 5: GFR <15, kidney failure
If the results of examination with GFR shows a number less than
60, then your doctor will recommend you to do other medical
examinations, such as ultrasound, CT scan, or kidney biopsy. This is
done to see the possibility of kidney stones, tumors, or other causes of
kidney disease.
2. Urine test
Examination of this renal function is done by looking at the
patient's urine condition. The aim is to see how much albumin (a type of
protein) that dissolves with urine.
A healthy kidney will not allow albumin to enter the urine.
Because the albumin should be in the blood, not residual substances that
must be removed through urine. The presence of albumin in the urine is
called albuminuria.
Reporting from the National Kidney Foundation, there are two
ways you can do to check the levels of albumin in urine, namely:
o Urine dipstick test, which is testing by dipping the strip into a urine
sample. The strip will change color if there are abnormalities such as
excess amount of protein, blood, pus, bacteria, and sugar.
o Comparison of albumin and creatinine in urine (UACR), which is a
renal function examination procedure by comparing the amount of
albumin with creatinine in urine for 24 hours. If the UACR yield
exceeds 30 milligrams per gram, this can be a sign of interference
with the renal.

G. Various ways to maintain kidney health

Kidney is an important organ that must be maintained health. The reason
is, this organ can affect other organs. If you have problems with your renal or are
affected by disease, then other organs will also have problems, especially the
heart.
So that kidney function remains normal, there are various healthy ways
you can do, namely:
1. Avoid salty foods
Most eating salty foods can disturb the balance of minerals in the
blood. This can make the kidney work harder and interfere with its function
of working normally. Over time, you risk kidney disease.
For that, exchange processed foods that contain high salt with
healthier foods. For example fresh fruits and vegetables, lean meat, and nuts.
You can reduce the use of salt in cooking by adding spices, such as pepper,
pepper, or onions to keep the food delicious.
2. Regular exercise
Hypertension is a risk factor for chronic kidney disease. That is why,
you are encouraged to control blood pressure so that your renal function is
maintained.
Instead of taking shortcuts by taking hypertension medication, you
should do a healthier way with exercise. Doing this physical activity
regularly, at least 20 minutes a day can help control blood pressure. As a
result, every part of your renal will remain healthy, work optimally, and
avoid the risk of disease.
3. Meet the needs of body fluids
If you want to avoid any disease, make sure your body's fluid needs
are met properly. The reason is, drinking enough water can help the main
function of the renal to get rid of toxins or poisons in the body remain
optimal.
How much of your fluid needs each day depends on your gender,
age, and type of activity. Ask your doctor about your daily fluid needs.
4. Pay attention to the drugs consumed
Are you taking certain medications? Come on, check the medicinal
content again. The reason is, several types of drugs can affect the health of
your kidneys.
NSAIDs are one of the over-the-counter drugs which in fact can
interfere with renal health, especially if used excessively or in the long run.
Consult your doctor to get recommendations for other drugs that are safer for
your renal health.
5. Stay away from risk factors and stop smoking
To keep the renal function healthy, make sure you avoid various risk
factors. Some risk factors that can increase your chances of developing
kidney disease are diabetes, obesity, hypertension, and a family history of
similar diseases.
If you feel you have one of the risk factors, this means you need to
do regular checks. It aims to control the risk factors so that they do not
develop into diseases and become more severe.
In addition to maintaining your diet, you must also eliminate
smoking. Various substances in cigarettes, can interfere with blood pressure
and slow blood flow to organs, including your renal.