The kidneys are the body's filtration system and are crucial for our health. The human body has two kidneys, each located on either side of the spine in the lower back. They are bean-shaped, about the size of a fist, and weigh approximately 114 grams. Normal kidney function involves purifying the blood and removing excess water and waste products from the body, maintaining mineral balance (sodium, calcium, potassium, phosphorus), assisting in blood pressure regulation, aiding in the production of blood cells, producing vitamin D to keep the bones strong. As long as one kidney functions normally at least at 20%, we can maintain our health.

When kidney tissue suffers irreversible damage due to disease, kidney function gradually declines. The rate of kidney function decline varies from person to person. In the early stages of kidney disease, there may be no noticeable symptoms, making it difficult to detect. However, as kidney function gradually deteriorates, the body becomes unable to naturally eliminate metabolic waste, leading to the onset of symptoms such as nausea, vomiting, hematuria (blood in urine), proteinuria (excess protein in urine), increased urination, decreased urination, swelling, fatigue, anemia, and shortness of breath, among others. When kidney tissue sustains long-term damage over months or years, and kidney function cannot recover its original capacity, it is referred to as chronic kidney disease (CKD). CKD progresses through five stages, with discomfort and symptoms gradually appearing as the disease advances.

The kidneys are highly vascularized organs, and abnormal blood lipids, such as oxidized "bad" cholesterol, can indeed cause localized damage to kidney tissues, leading to chronic kidney inflammation. Patients with abnormal blood lipids often also have risk factors such as obesity, smoking, high blood pressure, and insulin resistance, which can potentially harm vascular endothelial cells and trigger a cascade of organ damage. High blood lipids not only affect cardiovascular disease but are also associated with the development of chronic kidney disease. When chronic kidney disease progresses to the symptomatic stage, the condition is typically more severe. Therefore, it is recommended that patients with abnormal blood lipids undergo regular monitoring, including proteinuria, glomerular filtration rate, and blood pressure, at least every six months to a year.

In the past, the examination of kidney disease primarily relied on assessing the level of serum creatinine as a criterion. However, since the year 2000, the National Kidney Foundation in the United States has recommended using the Glomerular Filtration Rate (GFR) along with indicators of kidney tissue damage, such as proteinuria, as standards for diagnosing kidney disease. This has provided a new definition for kidney disease and has improved the accuracy of detecting early-stage kidney disease. According to this definition, chronic kidney disease can be classified into five stages based on GFR levels. It's important to remind individuals that, in addition to routine health check-ups, it is crucial to include urine tests to check for the presence of hematuria (blood in the urine) and proteinuria. Even more importantly, the results of serum creatinine tests should be converted into GFR values using a formula in order to detect kidney damage at an early stage.

Chronic kidney disease is classified into five stages based on the Glomerular Filtration Rate (GFR) indicator, which also takes into account age, gender, and serum creatinine (Cr) levels. Chronic kidney disease can generally be categorized into the following five stages: Stage 1: GFR is greater than 90 milliliters per minute, but there is continued presence of proteinuria (excess protein in the urine). Stage 2: GFR is between 60-89 milliliters per minute. Stage 3: GFR is between 30-59 milliliters per minute. Stage 4: GFR is between 15-29 milliliters per minute. Stage 5: GFR is less than 15 milliliters per minute. The deterioration of kidney function not only leads to patients developing uremia, requiring long-term dialysis treatment, but also significantly increases the risk of cardiovascular diseases and mortality.

The risk factors for the onset of chronic kidney disease include: ethnicity, gender, diabetes, metabolic syndrome, high glomerular filtration rate, high urinary albumin excretion, abnormal blood lipids, nephrotoxic substances, primary kidney diseases, urological diseases, cardiovascular diseases, and more. Additionally, smoking, obesity, advanced age, and family history are also important factors to be aware of. The vast majority of kidney disease patients are associated with the "three highs" - high blood pressure, high blood lipids, and high blood sugar. Individuals in these high-risk groups should be aware of kidney disease indicators (such as GFR) and seek early prevention and treatment to reduce the likelihood of developing kidney disease.

The kidneys are essential organs for regulating bodily fluids. When the glomerular filtration rate (GFR) decreases, the elimination of water may be affected. Additionally, the kidneys secrete hormones that play a role in regulating blood vessel tension, making them closely related to blood pressure. Prolonged high blood pressure can damage the small blood vessels in the kidneys, impairing their ability to filter toxins. Therefore, individuals with hypertension should not only monitor their blood pressure but also consider checking for changes in urine and kidney function to detect and slow down the deterioration of kidney function at an early stage. Regardless of the cause of high blood pressure, strict control of hypertension is crucial to prevent kidney disease from worsening. Dietary adjustments, such as reducing salt, oil, and meat intake, are essential for blood pressure management and kidney protection. Quitting smoking, reducing alcohol consumption, and engaging in regular physical activity are lifestyle changes that must be practiced. Additionally, appropriate medication for blood pressure control is necessary. Many people may not experience noticeable symptoms, which can lead them to underestimate the risks of high blood pressure. Unless blood pressure is extremely high, such as malignant hypertension exceeding 200/140, the uncomfortable symptoms like headaches and dizziness may not appear. However, high blood pressure is a silent killer that gradually hardens the blood vessels and erodes the functions of various organs. Therefore, it should not be taken lightly. Dietary and lifestyle adjustments, along with medication control, are effective methods for patients with compromised kidney function to maintain appropriate blood pressure and protect their kidneys.

Diabetes is a systemic metabolic disease, and poorly controlled blood sugar over the long term can affect various organs in the body, including the eyes, cardiovascular system, nervous system, and kidneys. Elevated blood glucose levels that cannot be properly metabolized lead to cellular dysfunction and structural changes in tissues. When the kidneys are affected, it can result in diabetic kidney disease. On average, it takes about ten years for diabetes to lead to kidney disease, and another ten years for kidney disease to progress to end-stage renal failure. In Taiwan, diabetic kidney disease accounts for 15%-25% of patients with uremia, and it is predicted that this percentage will increase significantly in the near future. Detecting early-stage microalbuminuria is essential to prevent rapid kidney disease progression. The treatment principle for diabetic kidney disease is early and aggressive management to prevent further deterioration. If you have diabetes, here are some important steps to take for kidney health: 1. Regularly monitor your glycated hemoglobin (HbA1c) levels, which provide an average of your blood sugar over 1-3 months. 2. Follow your healthcare provider's recommendations for insulin, medications, diet, exercise, and regular blood sugar monitoring. 3. Monitor your blood pressure regularly, and if you have hypertension, follow your doctor's advice to maintain blood pressure within a normal range. 4. Discuss with your doctor whether angiotensin-converting enzyme inhibitors (ACE inhibitors) are appropriate for you. 5. Regularly check your urine for signs of foamy or bubbly urine. If you notice any abnormalities, undergo further blood tests like creatinine and consult your doctor regarding dietary adjustments and control.

Early signs of kidney disease include: 1. Easy eye, facial, or extremity swelling 2. Fatigue 3. Headaches or high blood pressure 4. Changes in urine volume 5. Frequent urination at night 6. Foamy urine 7. Blood in urine 8. Urine turning rust-colored or brown 9. Pain in the lower ribcage just below the back 10. Elevated serum creatinine (greater than 1.2 mg/dL for females; greater than 1.4 mg/dL for males) 11. GFR (Glomerular Filtration Rate) less than 60 milliliters per minute In the early stages of chronic kidney disease, there may not be very noticeable symptoms. However, as kidney function continues to decline, patients may experience nausea, vomiting, poor appetite, swelling, high blood pressure, headaches, anemia, shortness of breath, and even bone disorders due to the inability to eliminate metabolic waste and fluids from the body.

When there are early signs of kidney problems, they can be detected through blood and urine tests. Early detection and treatment can be beneficial in preventing the progression of chronic kidney disease. Self-care measures for individuals with kidney issues include: 1. Regular follow-up appointments with a nephrologist for continuous monitoring. 2. Managing blood sugar and blood pressure levels. 3. Making moderate dietary adjustments. 4. Avoiding holding in urine. 5. Refraining from smoking and excessive alcohol consumption. 6. Avoiding the indiscriminate use of pain relievers and medications of unknown origin. 7. Reducing salt intake. 8. Engaging in regular physical exercise. 9. Maintaining a healthy weight. Regarding diet, it's important to: 1. Ensure an adequate calorie intake. 2. Follow a low-protein diet. 3. Maintain a low-phosphorus diet. 4. Adhere to a low-potassium diet. 5. Limit sodium intake. 6. Monitor fluid intake and drink in moderation.