The two kidneys that flank the lower spine are exemplary organs. They are multitasking machines charged with controlling the body's fluid balance, filtering the blood of waste and producing a host of regulating hormones. They are not only at the center of the urinary system, but they also have a hand in making red blood cells and vitamin D. When they fail, the breakdown can have body-wide ramifications.
There are a number of underlying diseases can cause progressive kidney disease, chief among them is diabetes and high blood pressure. The effects of hypertension such as stroke, heart attack and heart failure may be more familiar. But high blood pressure assaults arteries everywhere, including in the kidneys, where it damages small blood vessels and filtering structures to the point of no return. Damage can occur under the radar, sometimes taking decades to make its presence known.
Kidney damage can be particularly problematic because ironically, among the many jobs the kidneys perform, is blood pressure control. If blood pressure sensors in the kidney malfunction, a vicious cycle of uncontrolled pressure ensues. Kidneys can slowly collapse, eventually progressing from mild chronic kidney disease to kidney failure or end-stage renal disease (ESRD), where they just stop doing any good at all.
It may take years before routine blood and urine tests give clues that the kidneys are beginning to fail. Eventually, as the damage worsens, people with kidney disease must have waste manually removed from their blood via dialysis or have a kidney transplant to sustain life.
Anyone with higher then normal blood pressure is at risk of developing kidney failure, particularly African Americans, who tend develop kidney disease even when blood pressure is only slightly elevated.