Dr. Paul Tabor
1. The kidneys are magnificent organs. A chemical engineering process has not been designed that can accomplish what the kidneys do for our bodies. This web site review of kidney structure and function has excellent diagrams and discussion of kidney function for you to review. An interactive nephron module explains the regulation of fluids and fluid content in the blood. If blood flow begins to be restricted into a kidney (this is called renal artery stenosis) how would this affect the kidney's function? Can you conceive a model of what would happen to fluid volume in the body, the blood pressure, and the concentration of compounds in the blood that are produced continually in the body if blood flow is restricted into the kidneys? As this model (presented at the web site) shows, the kidney modifies the pressure of the circulatory system to counteract the restricted blood flow by raising the blood pressure. Does this indicate to you that a kidney disease could be responsible for the condition of ? There are groups in the US population that have a higher risk of hypertenison that the average. Does this mean that these groups are also at a greater risk for kidney disease? Two case studies of patients with renal artery stenosis possibly due to hypertension show how serious this kidney disease can be. What diagonstic tests can be used to identify the restriction in blood flow into the kidney?
2. We can not live long if our kidneys fail to balance salts, fluid volume and pH or fail to remove wastes from our bodies. Fortunately, there are blood tests that can be used to indicate when the kidneys are not functioning properly. One test involves urea concentrations (Blood Urea Nitrogen or BUN). A problem with the BUN test is that BUN can vary normally in a healthy individual. Wouldn't it be valuable to have a test that detected the rate of clearance of a blood component that was produced continuously at the same level no matter what? In the US, there are two diseases of the kidneys that usually result in the need for dialysis or kidney transplant. Can you discover something about each of these diseases? Diseases that result in kidney failure are grouped together and called End-Stage Renal Diseases (ESRD) because the possible treatments are the same. Do ESRD represent a major health concern in the US? How many people are treated for ESRD? Are there regions of the US that have higher or lower incidences of ESRD (at this site check the 1996 Annual Data Report and table II-4 near the end of the report). People who suffer from terminal kidney failure have a number of options for treatment. Two options are not cures and involve artificial dialysis. You have probably heard of hemodialysis. Do you know the pros and cons of hemodialysis as a treatment? The other form of dialysis is peritoneal dialysis. What are the pros and cons of this treatment? The third treatment is a kidney transplant. The kidney was the first organ to be transplanted successfully in humans. In the "prehistoric era" of kidney transplantation, organ rejection was much greater problem than today. So, who you expect were the most likely candidates for kidney transplants in the early days? What are the pros and cons of receiving a kidney transplant? Transplantation research has made great strides even in the last decade. One statistic that shows the advances in kidney transplant research is the one-year survival rate for transplant recepients. What improvements have taken place that have increased the success of kidney transplants? In 1995, nearly 12,000 kidney transplants were done. Where did these kidneys come from? As kidney tranplants become more successful, one of the greatest risks now is how patients adjust to being healthy again and the responsibilities of taking care of their new kidney!
Hopefully, you have now a growing interest in your kidneys and kidney diseases. There is a good site that has a searchable data base on kidney diseases. Also, there is a good site that provides information on all types of organ transplants.