>> Welcome to the ABCs of Kidney Disease.
I'm Daphne Knicely, and today we're gonna talk about
normal kidney functioning and kidney disease.
This video's a part of the
Johns Hopkins Nephrology Patient Education Program.
And we'd like to thank our sponsors,
The Ed Kraus Endowment and The Shaw Foundation.
Let's start off with talking about
the normal system of the kidneys.
Your kidneys are about the size of your fist,
and they have tubes from each kidney going to your bladder.
These tubes are called your ureters.
And then from your bladder outside your body
is your urethra.
For men, this goes through your prostate.
So the kidneys do a lot of different things.
One, they manage the amount of water in your body.
So, what this means for example
is if I'm in the Mojave Desert with no access to water,
my kidneys recognize that I need to hold on
to as much water as possible.
I shouldn't make any urine.
Then, if I was in a radio contest and I drank
10 gallons of water, then my body recognizes,
hey, I don't need all this water.
I need to get rid of it
and maybe only hold on to a teaspoon.
The kidneys are also important
for balancing the chemicals in our body.
They're basically the chemist.
They help balance the sodium and the potassium
and the chloride, and all of those electrolytes
that are in our blood.
They're also the washing machine of the body.
So we naturally make toxins by doing work
and the kidneys get rid of it.
We naturally generate waste by what we eat.
The kidneys get rid of it.
And the breakdown of drug products,
the kidneys help get rid of that.
Sometimes people also forget that the kidneys are important
for making certain hormones.
They make some hormones that control our blood pressure.
So maybe if I had a low blood pressure,
my kidneys recognize it,
and they make the hormone to raise my blood pressure.
And the kidneys are important for making red blood cells.
They make a hormone called erythropoietin
that tells the bone marrow, make red blood cells.
And they're really important for strong bones
because the kidneys help hold on to calcium and phosphorus
at the right levels.
And they also convert vitamin D
into the working form for strong bones.
So what is kidney disease?
Well, kidney disease, kidney failure, kidney injury,
they all kind of mean the same thing.
It's when the kidneys are not working like they should.
They're not balancing the water in their body.
They're not being the chemist like they're supposed to be.
They're not getting rid of waste
like they're supposed to be.
It just means the kidneys aren't working perfectly.
So we break down kidney disease into different types.
One is acute kidney injury.
This form might be reversible.
This is like if I had completely normal kidney function
and then I got in a car wreck and I bled a lot.
Well, that's gonna cause damage to my kidneys.
My kidneys are very sensitive
to any type of hemodynamic changes.
Or maybe I was in the ICU and I had normal kidney function,
but I got a really bad infection
and I had low blood pressure.
That's gonna hurt my kidneys.
So this is like an immediate injury that happens.
And yes, my kidneys are gonna get injured.
Maybe it might take some time for them to get better,
but there's a possibility they'll get better.
I like to explain it as a cut.
Some people heal quicker than others.
Some people heal completely back to normal.
Some people might heal the scar.
Or in the case of kidney disease,
might have a little bit of kidney disease
after healing from that injury.
Another type is chronic kidney disease.
So this is more of a slow progression
of kidney disease over time
that can be caused by something else.
For example, diabetes or high blood pressure.
Over time that takes a toll on my kidneys.
Now the kidneys can progress to stopping completely.
And as a kidney doctor,
it's my job to recognize kidney disease
and hopefully slow that progression.
And I also with chronic kidney disease,
we stage it into five different stages.
And this helps me as a kidney doctor
to really know how to manage folks with kidney disease.
The final type is end-stage renal disease,
or end-stage kidney disease.
And what this basically means is
where it's total permanent loss of kidney function
and kidney failure, and people are requiring dialysis.
For more information on normal kidney functioning
and kidney disease, check out our resources.
Or if you're interested in learning about
the complications of kidney disease
or how to treat kidney failure, check out our videos.