Your pancreas can affect your kidneys

Kidney weakness (chronic): causes & risk factors

Common causes of chronic kidney failure are diabetes (diabetes mellitus) and high blood pressure, which each account for around 35% of all cases. 15% of kidney failure patients suffer from inflammatory diseases of the kidney corpuscles, the so-called glomerulonephritis. Hereditary diseases such as cystic kidneys (8%) as well as drugs that damage the kidneys or chronic pelvic inflammation (5% each) are further causes. The various diseases lead to a decline in kidney function at different rates.

Blood sugar and blood pressure significantly influence the development and progression of chronic kidney weakness. Even slightly elevated blood pressure can make kidney weakness and diabetes progress more quickly. The systolic pressure in healthy people is in the range of 110-130 mmHg, the diastolic pressure between 70-80 mmHg. A pressure of 140/90 and above is considered to be elevated blood pressure.

However, the reasons for chronic kidney failure are not always known. There seems to be a genetic predisposition for this, as people with relatives with kidney disease are also more likely to develop kidney failure. We also know today that being overweight and smoking can also increase the risk of chronic kidney weakness.

Diabetes

A common cause of chronic kidney failure is diabetes. If the blood sugar level remains high for a long time, there is a risk of chronic kidney disease. Increased blood sugar damages the walls of the blood vessels in the long term. This hinders the blood flow and thus the transport of nutrients to the organs. The later damage caused by diabetes to the kidneys is also called diabetic nephropathy.

By damaging the small blood vessels in the kidneys, their wall becomes more permeable. Small protein particles, so-called albumins, slip through the vessel walls and are excreted with the urine. The detection of albumin in the urine is the first warning sign that diabetes is damaging the kidneys. The narrowing of the small blood vessels in the kidneys also means that the kidney tissue is no longer adequately supplied with oxygen and nutrients and the kidney cells die.

Glomerulonephritis

The kidney corpuscles are the "microfilters" of the kidneys and are also known as glomeruli. They consist of tiny coiled blood vessels and filter salts, metabolic products, pollutants and, above all, fluids from the blood. Each kidney has around half a million to a million glomeruli. The contact pollutants in the blood can cause the kidney corpuscles to become inflamed. The inflammation always affects both kidneys and to a greater or lesser extent all kidney corpuscles.

Cystic kidneys

This congenital kidney malformation usually leads to kidney weakness from the age of 40. Numerous fluid-filled cavities (cysts) restrict the function of the kidney tissue. These cysts are small in childhood, fill more and more with fluid over the course of life and then displace normal kidney tissue. This then leads to kidney weakness, which often leads to dialysis in the sixth decade of life.

high blood pressure

High blood pressure can be both a cause and a consequence of chronic kidney failure. On the one hand, high blood pressure damages the kidney corpuscles (glomeruli), so that they gradually fail. On the other hand, when kidney function declines, more blood pressure-increasing hormones are formed. In addition, too much salt and water remain in the body, which also increases blood pressure.

A disturbed kidney function and high blood pressure cause and reinforce each other. In many cases, therefore, high blood pressure patients are also kidney patients and vice versa.

Medication

As an important excretory organ in the body, the kidneys also filter many drugs or their breakdown products. However, some of these substances can damage kidney tissue. Such kidney damage caused by drugs is generally rare and occurs either only with very high doses (for example paracetamol, see also below) or in patients with certain risks. So z. B. Diclofenac is more likely to affect the kidneys of elderly people with arteriosclerosis who take antihypertensive drugs and diuretic substances. Medicines that can occasionally cause kidney damage include:

  • Painkillers: e.g. B. paracetamol, ibuprofen, diclofenac
  • Antibiotics: e.g. B. aminoglycosides (amikacin, gentamycin, neomycin or streptomycin)
  • Cancer drugs (chemotherapeutic agents)
  • Contrast media containing iodine

Over-the-counter pain relievers can damage the kidneys if taken continuously. The active ingredient paracetamol can have a kidney-damaging effect from a total dose of 1,000 grams - an amount that is reached after three years if 500 milligram tablets are taken twice a day. Damage to the kidneys has also recently been increasingly discussed with the long-term use of pantoprazole and other gastric acid blockers (so-called PPIs).

In the case of improper use or incorrect dosage, high blood pressure medication and water tablets (diuretics) can also trigger acute kidney failure.

Blood vessel disorders

Chronic blood vessel disorders can impair kidney function. Vascular diseases can lead to reduced blood flow and thus trigger a reduced blood flow to the kidneys. Deposits of lime and fats (so-called plaques) on the vessel wall, such as B. in arteriosclerosis, the vessels can gradually close completely so that the kidney tissue behind is no longer supplied with blood and dies. This can also affect blood vessels that are outside the kidneys. For example, if there is a constriction between the abdominal artery (aorta) and the kidney, it is called renal artery stenosis.

Blood vessels can also become inflamed; this is called vasculitis (from the Latin vas for blood vessel). Such vascular inflammations sometimes only take place in the kidneys, more often the kidneys and other organs are affected. They often progress very quickly, i.e. kidney function can be completely lost within weeks. Fortunately, the doctors have very good drugs to cure vascular inflammation, at least if diagnosed in good time.