[Kim Jaeho's Life Story]<257> What Happens When the Kidneys Fail

South Korea is known as one of the countries that manages waste disposal, including separation and recycling, most effectively. If a densely populated country like ours fails to properly handle waste, a waste crisis would occur, and it is obvious that our quality of life would plummet to a terrible level. But what if such a situation happened inside our precious bodies?

It is the kidneys that handle waste disposal in our bodies. When blood mixed with waste enters the glomerulus, a cluster of capillaries, the blood is filtered, and waste passes through the Bowman's capsule surrounding the glomerulus into the renal tubules. In the renal tubules, most useful substances like water and nutrients are reabsorbed, while waste is collected in the bladder and expelled from the body as urine.

The kidneys filter and recycle an astonishing 150 to 180 liters of water daily and expel about 1.5 liters of urine, enabling us to live healthy day by day. But what happens if these hardworking kidneys get damaged?

Kidney cells can be damaged or die due to various reasons such as exposure to toxic substances, lack of nutrients or oxygen, and stress, which harm the DNA that makes up the cells. Most damaged DNA is repaired to its original state by genes inside the cells, but severely damaged cells that are difficult to repair undergo programmed cell death (apoptosis), and new cells replace them to maintain function.

If all damaged kidney cells are repaired and dead cells are replaced by new ones, kidney function remains healthy. However, the extent of damage and repair depends on our thoughts and lifestyle habits. If one has habits that interfere with DNA repair and cell regeneration, the number of normal kidney cells gradually decreases over time.

Fortunately, the kidneys have a much larger capacity than needed for their function, so people usually do not feel discomfort even if 30 to 40% of kidney function is lost. Without testing, it is easy not to realize the damage, and many people live healthily with just one kidney.

However, if 40 to 70% of kidney function is lost, waste that cannot be expelled accumulates in the body, causing symptoms such as difficulty urinating, foamy urine, easy fatigue, swelling of hands and feet, hematuria (blood in urine), dry and itchy skin, anemia, vomiting, and loss of appetite. These symptoms worsen when kidney function falls below 30%.

When kidney function drops below 15% and the kidneys almost cease to function, this condition is called kidney failure or renal failure. If kidney failure persists for a long time, it can lead to seizures, coma, and ultimately death. In this state, aside from dialysis that artificially filters waste or kidney transplantation from a healthy donor, there is no option but to await death.

There are two types of kidney dialysis: hemodialysis, which removes blood from the body, filters out waste, and returns clean blood, and peritoneal dialysis, which involves inserting a permanent catheter into the body to remove water and waste through the peritoneum. Neither method restores kidney function; their purpose is to extend life or sustain survival until transplantation. Both have side effects that reduce quality of life.

There is no significant difference in effectiveness between the two dialysis methods. Common side effects include infections of the skin, blood, or peritoneum, fatigue, and itching. Hemodialysis-specific side effects include muscle cramps, low blood pressure, dizziness or nausea, and blood loss, while peritoneal dialysis may cause weight gain. According to a U.S. study, the average life expectancy of dialysis patients is 5 to 10 years, though some survive up to 30 years.

Kidney transplantation involves transferring a healthy kidney from a living or recently deceased donor to a patient with end-stage kidney failure. It offers a better quality of life than dialysis, with a 5-year survival rate exceeding 95%. However, due to a shortage of donor kidneys, transplantation is not easy, and lifelong immunosuppressant use has significant side effects.

Dialysis and transplantation save or extend the lives of many people with kidney failure, but many still die from kidney failure despite treatment. In 2022, 7,468 people died from kidney failure, far more than the 1,025 deaths from kidney cancer. The number of deaths from kidney failure also exceeded those from pancreatic, stomach, and blood cancers, with only lung, liver, and colorectal cancers causing more deaths than kidney failure.

As we have seen, kidney damage not only lowers quality of life but also threatens our survival. Therefore, it is crucial to prevent kidney failure by reducing DNA damage in kidney cells and adopting lifestyle habits that support DNA repair.

Common lifestyle habits to protect kidney health include: ① drinking enough water, ② eating a healthy diet with appropriate nutrients, ③ exercising adequately, ④ quitting smoking, ⑤ improving high blood sugar, high blood pressure, and obesity that severely damage kidney health, and ⑥ avoiding drug misuse.

In particular, drinking enough water is important to reduce the burden on the kidneys, which filter and recycle 150 to 180 liters of water daily, and to ensure that the 1.5 liters of urine expelled is not deficient. People with dark-colored urine should drink more water.

Furthermore, to protect kidney health, it is very important to adopt lifestyle habits that reduce DNA damage in kidney cells and help the body's top physician repair damaged DNA, including the kidney-friendly habits mentioned above. This way of life is called Newstart (see Life Story Part 6).

The first of Newstart's eight components, Life Diet, involves eating a variety of plant-based foods such as fruits, vegetables, and grains in their whole form without selective eating. It is also important to reduce intake of sugar, processed or refined bad carbohydrates, saturated and trans fats, salt, and alcohol, which cause many problems when consumed excessively.

Along with this, practicing the other Newstart components?exercise, water, sunlight, temperance, air, rest, trust, and love?is also important.

Independent Researcher

This content was produced with the assistance of AI translation services.