Chronic Kidney Disease

The kidneys are a pair of bean-shaped organs that lie on either side of your spine in the lower middle of your back. Each kidney weighs about 1/4 pound and contains approximately one million filtering units called nephrons. Each nephron is made of a glomerulus and a tubule. The glomerulus is like a miniature filtering or sieving device while the tubule is a tiny tubelike structure attached to the glomerulus.

The kidneys are connected to the urinary bladder by tubes called ureters. Urine is stored in the urinary bladder until you are ready to empty your bladder. The bladder is connected to the outside of the body by another tubelike structure called the urethra.

The main function of the kidneys is to remove waste products and excess water from the blood. The kidneys process about 200 liters of blood every day and produce about 2 liters of urine. The waste products are generated from normal metabolic processes including the breakdown of active tissues, ingested foods, and other substances. Your kidneys allow you to continue to consume a variety of foods, drugs, vitamins and supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels. The kidney also plays a major role in regulating levels of various minerals such as calcium, sodium, and potassium in the blood.

As the first step in filtration, blood is delivered into the glomeruli by microscopic leaky blood vessels called capillaries. Here, blood is filtered of waste products and fluid while red blood cells, proteins, and large molecules are retained in the capillaries. In addition to wastes, some useful substances are also filtered out. The filtrate collects in a sac called Bowman capsule and drains into the tubule.

The tubules are the next step in the filtration process. The tubules are lined with highly functional cells which process the filtrate reabsorbing water and chemicals useful to the body while secreting some additional waste products into the tubule.

The kidneys also produce certain hormones that have important functions in the body, including the following:

Activate form of vitamin D (calcitriol or 1,25 dihydroxy-vitamin D) - Regulates absorption of calcium and phosphorus from foods, promoting formation of strong bone

Erythropoietin (EPO) - Stimulates the bone marrow to produce red blood cells

Renin - Regulates blood volume and blood pressure

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