{"id":64966,"date":"2021-05-20T14:32:57","date_gmt":"2021-05-20T14:32:57","guid":{"rendered":"https:\/\/websitedesigns.com.au\/elankanew\/?p=64966"},"modified":"2023-06-28T16:46:53","modified_gmt":"2023-06-28T16:46:53","slug":"what-do-the-kidneys-do-for-you-by-dr-harold-gunatillake","status":"publish","type":"post","link":"https:\/\/websitedesigns.com.au\/elankanew\/what-do-the-kidneys-do-for-you-by-dr-harold-gunatillake\/","title":{"rendered":"What do the kidneys do for you?-By Dr Harold Gunatillake"},"content":{"rendered":"<h1 style=\"text-align: center;\"><span style=\"font-size: 28px; color: #008080;\">What do the kidneys do for you?-<span style=\"color: #99cc00;\">By Dr Harold Gunatillake<\/span><\/span><\/h1>\n<p><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-77916 aligncenter\" src=\"https:\/\/websitedesigns.com.au\/elankanew\/wp-content\/uploads\/2021\/11\/Harold-Gunethilake.jpg\" alt=\"Harold-Gunethilake\" width=\"160\" height=\"160\" \/><\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/l8jWZ7eO_kY\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">Transcript:<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u201cDoctor, lately, I feel tired and have less energy. I have a dry itchy skin and have sleepless nights. I pass sufficient more frequent urine, but I find that it is foamy. Please advise me.\u201d<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Kidneys are given a less priority when it comes to your health, as much contemplating on cholesterol levels to prevent a heart attack, though both organs go hand in glove situation.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Relatively recent research has shown that heart failure is a significant risk factor for kidney disease. When the heart is no longer pumping efficiently, blood seem to collect in the kidney veins, leading to congestion of blood in the kidneys.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">So, keeping your heart healthy is important for your kidney health function.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">The life-saving functions of the kidneys are many, but its main function is to filter the blood the unwanted waste products into the urine through the glomeruli and help regulate the water and salt levels to control your blood pressure.<\/span><\/p>\n<p style=\"text-align: justify;\"><!--more--><br \/>\n<span style=\"font-size: 20px; color: #000000;\">What are glomeruli in your kidneys. Let me explain briefly.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">There are approximately 1 million glomeruli or filters in each kidney. These are attached to the opening of a small fluid collecting tube called a tubule.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Blood coming from the minute arterioles is filtered in the glomeruli and the extra fluid and waste products enter the tubule and becomes urine. You get the proximal tubule and a distal tubule.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">The proximal tubule is essentially reabsorption of chemicals in accordance with the needs of homeostasis or equilibrium. They are glucose, amino acids, water, chlorides, potassium and bicarbs. These are all lost during glomerular filtration and reentering the blood from the renal tubules.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Glomerular filtration is the first step in making urine.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">It is the process that your kidneys use to filter excess fluid and waste products out of the blood into the urine collecting tubules of the kidney, so they may be eliminated from your body.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">You may be not drinking enough water to flush the kidneys, but you may be eating extra salt that is hidden in your food preparations.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Good examples of these salty delicacies are cheese, butter, sauces, salty nibbles, bread, potato dishes,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">When the heart does not pump sufficient blood due to failure, the kidneys become impaired, and the hormone system in the kidneys tend to regulate the blood pressure, enabling the kidneys to excrete waste products.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">What is this hormone system that controls the blood pressure?<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">The kidneys control the volume of fluid and help control of the chemical balance of the blood and regulates the body\u2019s level of sodium, potassium, and calcium.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Let us briefly talk about the nephrons, the unit of the kidney mainly responsible for the excretion of urine and its toxic waste products from the blood.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">At the end of the nephron, blood enters via the afferent arteriole, passes through a network of capillaries called the glomerulus and leaves via the efferent arteriole. As this occurs the blood is filtered out into an area known as the Bowman\u2019s Capsule. The bowman\u2019s capsule is a part of the nephron that forms a cup-like sack surrounding the glomerulus. Except for blood cells, the proteins are squeezed, water, glucose, amino-acids, sodium chloride potassium and bicarbonate, creatinine, urea are filtered into the urine.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">These enter the proximal convoluted tubules.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">About 65% of sodium and potassium, as well as 90% of bicarb are reabsorbed. Glucose and amino acids are absorbed.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">There are specialized cells called macula densa located in a portion of the distal convoluted tubules in the nephron. These cells monitor the salt concentrations in the blood that flows through the arterioles of the glomeruli of the kidneys and cause constriction or dilation of these arterioles, while the arterial cells called juxtaglomerular cells sense the blood pressure. In short, maculo densa cells are salt sensors.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Maculo densa cells release chemical signals for the juxtaglomerular apparatus to control vital kidney functions, including renal blood flow, glomerular filtration of urine and the release of renin.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Now let us talk about the juxtaglomerular apparatus.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">This is a structure in the kidney that regulates the function of each nephron, the functional units of the kidney. The juxtaglomerular apparatus is named because it is next to the glomerulus.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Renin is released from juxtaglomerular apparatus.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Summarizing:<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Maculo sensa cells checks and controls the salt in circulation and the granular cell of the juxtaglomerular apparatus regulates all the functions of the kidney and further releases a hormone called Renin.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Let us talk about the RAAS in the kidneys which modulates the blood pressure -God given life saving system in times of distress.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Renin activates the renin-angiotensin system, a key modulator of body fluid homeostasis.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Blood flows through the renal arteries. Renal perfusion pressure directly regulates sodium excretion, through the maculo densa cells, and activates the renin-angiotensin system or the RAS, or the renin-angiotensin-aldosterone system or RAAS, a hormone system that regulates blood pressure and water balance.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">So, the kidneys play a central role in the regulation of arterial extra-renal blood pressure, that is the blood pressure when recorded with your monitor.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Kidneys influence the blood pressure by:<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Causing the arteries and veins to constrict.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Increasing the circulating blood volume.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Now let us talk about the RAAS i.e. The Renin-Angiotensin-Aldosterone-System.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">This is a hormone system within the body that is essential for the regulation of blood pressure and fluid balance.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">There are three hormones in this system-renin, angiotensin 11 and aldosterone.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">In the first stage of the RAAS is the release of the enzyme renin.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">This is released from the granular cells of the renal juxtaglomerular apparatus as described earlier.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Renin response occurs when there is reduced delivery of sodium in the distal convoluted tubule detected by macula densa cells.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Also, reduced perfusion pressure in the kidneys.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Angiotensinogen is a precursor protein produced in the liver and is converted into angiotensin 1 by renin.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Angiotensin 1 is then converted into angiotensin 11 by angiotensin converting enzyme ACE.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">This conversion occurs in the lungs, where ACE is produced by the endothelial cells of the lung inner lining.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Angiotensin 11 causes narrowing or constriction of arteries. This increases the peripheral resistance and cause high blood pressure.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">In addition to the low salt content in the perfused blood, reduced blood flow through the kidneys stimulates RAAS. In other words, when there is a drop in blood pressure RAAS gets activated to increase water and electrolyte reabsorption in the kidney: which compensates for the drop in blood volume, thus stepping up the blood pressure.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">So, the renin-angiotensin-aldosterone system is a well-known regulator of blood pressure.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">IN an accident with loss of blood volume due to dehydration or hemorrhage the RAAS gets activated. This is a survival kit the body has in emergencies.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">This activation also improves cardiac output through increased retention of salt, water, and peripheral arterial vasoconstriction.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">Relatively recent research has shown that heart failure is a significant risk factor for kidney disease. So, keeping your heart healthy, also means that you are keeping the functions of the kidneys in trim condition, too.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">If doctors suspect kidney disease, they do a routine kidney function tests such as check the creatinine level, a waste product usually excreted by the kidneys. If the kidneys are impaired, the creatinine seems to accumulate in your blood.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">So, the functions of the kidneys are:<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Regulation of extracellular fluid volume as already discussed.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Regulating and filtering minerals from blood<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Filter waste material from food, medications, and toxic substances.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Production of hormones that help produce red blood cells, promote bone health, and regulate blood pressure.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">People with kidney disease should lower the blood pressure to normal range.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Blood sugar must be controlled.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Reduce your salt intake.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Avoid NSAIDs.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Protein consumption in your food should be moderate.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Exercise regularly, Control body weight.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Hope this video talk was useful. You appreciate the part played by your kidneys in life, and it is important to look after them, for good health and longevity.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Stay safe and goodbye for now.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">Disclaimer:<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">The information contained in this article is for general information purposes only, and whilst the author will endeavour to keep the information up to date and correct, eLanka makes no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the eLanka website or the information, products, services, or related graphics contained in this article for any purpose. Any reliance you place on such information is therefore strictly at your own risk. In otherwords, eLanka In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of this website \/ article. Also please note that through this website \/ web page articles you are able to link to other websites which are not under the control of eLanka and therefore we have no control over the nature, content and availability of those sites. The inclusion of any links does not necessarily imply a recommendation or endorse the views expressed within them<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>What do the kidneys do for you?-By Dr Harold Gunatillake \ufeff Transcript: \u201cDoctor, lately, I feel tired and have less energy. I have a dry itchy skin and have sleepless nights. I pass sufficient more frequent urine, but I find that it is foamy. Please advise me.\u201d Kidneys are given a less priority when it [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":116942,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"aside","meta":{"footnotes":""},"categories":[20,1103],"tags":[872],"class_list":{"0":"post-64966","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-articles","8":"category-dr-harold-gunatillake","9":"tag-dr-harold-gunatillake","10":"post_format-post-format-aside"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.7.1 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What do the kidneys do for you?-By Dr Harold Gunatillake<\/title>\n<meta name=\"description\" content=\"\u201cDoctor, lately, I feel tired and have less energy. I have a dry itchy skin and have sleepless nights. 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