Who should get their kidneys checked?

There are 2 kidneys in your body, which are bean-shaped and reddish brown in color. Kidneys are located in the upper part of the abdomen on either side of the spine (backbone). Each of your kidneys is made up of millions of nephrons (small units present inside the kidney). These are the basic blood filters in the kidneys. Nephrons remove waste material from your body while retaining important nutrients and help in formation of urine.

Very basic blood and urine tests can detect chronic kidney disease (CKD) in the early stages. This helps to slow down the progression and prepare for more advanced stages of the disease progresses.

CKD is a condition in which kidney function declines gradually over months to years and even decades. As the disease progresses, wastes build up to high levels in your body and make you feel sick.

About 1 in 10 people have some degree of CKD. It can develop at any age with various conditions leading to CKD with increasing age.

15% of Indians may be having CKD, and most of them are unaware of it.

When kidney functioning is severely reduced (less than 15% of normal) it is called “Kidney Failure”. The medical terms are CKD stage 5, End Stage Kidney Failure (ESKF), End Stage Renal Disease (ESRD).

The important fact t” understand is that all these words refer essentially the same process of slow decline in kidney function over months to years.

Glomerular Filtrate Rate (GFR) is the best measure of kidney function. It tells how well the kidneys are doing their work of filtering the blood.Normal GFR varies by age, sex, and body size. GFR is approximately 120 to 130 mL per minute in young adults, and decreases by an average of 1 mL per minute per year after 30 years of age.A GFR less than 60 mL per minute represents a loss of at least 50% of normal kidney function; below this level, there is an increased prevalence of CKD complications.Since it is difficult to measure GFR directly, doctors use Estimated Glomerular Filtration Rate (eGFR) which gives a very good idea about the level of kidney function. eGFR is calculated by measuring the blood levels of a molecule called creatinine. This value is used to get your eGFR using mathematical equations.
Generally, higher the blood creatinine levels, lower the eGFR.

So, kidney function is assessed by two basic tests :
Blood creatinine level
Urine albumin to creatine ratio

The most common symptom of CKD is that there are “no symptoms.” This is very important to understand as only blood and urine testing will detect CKD in the earlier stages. Even when the kidneys are damagedupto 85-90%, the symptoms can be very mild. Because of all these factors, chronic kidney disease is diagnosed and treated very late with less than ideal outcomes.

The risk factors for kidney disease include:

• Diabetes
• High blood pressure
• Family history of kidney disease
• Obesity
• Smoking
• Heart disease
• Old age (more than 60 years)

People with these risk factors should get their kidney functions periodically. Those with diabetes must get these checked at least once a year. For others once in 2 years may be adequate.

So ask yourself if you have any of these risk factors and take appropriate steps.


Dr. Prashant C Dheerendra, Consultant Nephrology, Apollo Hospitals Bannerghatta Road, Bengaluru