YOUR KIDNEYS AND HOW THEY WORK:  What Do My Kidneys Do ?  What Is “ Renal Function” ?  Why Do Kidneys Fail ?  What Are the Signs of Kidney Disease?  How Will My Doctor Detect Kidney Disease?  What Can I Do About Kidney Disease?  What Happens If My Kidneys Fail Completely?   What Will the Future Bring?

Your two kidneys are vital organs, performing many functions to keep your blood clean and chemically balanced. Understanding how your kidneys work can help you to keep them healthy.

What Do My Kidneys Do ?

Your kidneys are bean-shaped organs, each about the size of your fist. They are located near the middle of your back, just below the rib cage. The kidneys are sophisticated trash collectors. Every day , your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The waste and extra water become urine, which flows to your bladder through tubes called ureters. Your bladder stores urine until you go to the bathroom.

The wastes in your blood come from the normal breakdown of active muscle and from the food you eat. Your body uses the food for energy and self-repair. After your body has taken what it needs from the food, waste is sent to the blood. If your kidneys did not remove these wastes, the wastes would build up in the blood and damage your body.

The actual filtering occurs in tiny units inside your kidneys called nephrons. Every kidney has about a million nephrons. In the nephron, tiny blood vessels called capillaries intertwine with tiny urine carrying tubes called tubules. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system.

At first, the tubules receive a combination of waste materials and chemicals that our body can still use. Your kidneys measure out chemicals like sodium, phosphorus, and potassium and release them back to the blood to return to the body. In this way, your kidneys regulate the body’s level of these substances. The right balance is necessary for life, but excess levels can be harmful.

In the nephron (left), tiny blood vessels intertwine with urine-collecting tubes. Each kidney contains about 1 million nephrons.

In addition to removing wastes, your kidneys release three important hormones:

• Erythropoietin (eh-RITH-ro-POYeh-tin), or EPO, which Stimulates the bones to make red blood cells.

• Renin (REE-nin), which regulates blood pressure.

• The active from of vitamin D, which helps maintain calcium for bones and for normal chemical balance in the body.