The Kidneys…   
Number: 2
Appearance: bean-shaped
Location: either side of the  backbone (waist level)
The kidneys’ role…
- Remove waste products
- Fluid control
- BP control
- RBC production
- Keeping bones health

Test  for Kidney disease  
Creatinine: Normal value 0.7 to 1.3 mg/dL for men    
0.6 to 1.1 mg/dL for women.
Blood urea nitrogen Normal value: 7 to 20 mg/dL        
Normal Value : above 90 ml/min/1.73 m2

The kidneys are two bean-shaped organs that extract waste from blood, balance body fluids, form urine, and aid in other important functions of the body.
They reside against the back muscles in the upper abdominal cavity. They sit opposite each other on either side of the spine. The right kidney sits a little bit lower than the left to accommodate the liver.

When it comes to components of the urinary system, the kidneys are multi-functional powerhouses of activity. Some of the core actions of the kidneys include:
Waste excretion: There are many things your body doesn’t want inside of it. The kidneys filter out toxins, excess salts, and urea, a nitrogen-based waste created by cell metabolism. Urea is synthesized in the liver and transported through the blood to the kidneys for removal.
Water level balancing: As the kidneys are key in the chemical breakdown of urine, they react to changes in the body’s water level throughout the day. As water intake decreases, the kidneys adjust accordingly and leave water in the body instead of helping excrete it.
Blood pressure regulation: The kidneys need constant pressure to filter the blood. When it drops too low, the kidneys increase the pressure. One way is by producing a blood vessel-constricting protein (angiotensin) that also signals the body to retain sodium and water. Both the constriction and retention help restore normal blood pressure.
Red blood cell regulation: When the kidneys don’t get enough oxygen, they send out a distress call in the form of erythropoietin, a hormone that stimulates the bone marrow to produce more oxygen-carrying red blood cells.
Acid regulation: As cells metabolize, they produce acids. Foods we eat can either increase the acid in our body or neutralize it. If the body is to function properly, it needs to keep a healthy balance of these chemicals. The kidneys do that, too.
Most people are born with two kidneys, but many people can live on just one. Kidney transplant surgeries with live donors are common medical procedures today.
Because of all of the vital functions the kidneys perform and the toxins they encounter, the kidneys are susceptible to various problems.
Diabetic nephropathy 
Diabetic kidney disease (diabetic nephropathy) is a complication that occurs in some people with diabetes. In this condition the filters of the kidneys, the glomeruli, become damaged. Because of this the kidneys 'leak' abnormal amounts of protein from the blood into the urine. The main protein that leaks out from the damaged kidneys is called albumin. In normal healthy kidneys only a tiny amount of albumin is found in the urine. A raised level of albumin in the urine is the typical first sign that the kidneys have become damaged by diabetes.

Alarming Facts about Kidney Disease
1 The incidence kidney failure (or chronic Kidney disease   CKD ) has doubled the last 15 years.
2. It is estimated that currently there are over 1 million people worldwide who are alive on dialysis or with a functioning graft.
3. Diabetes is an important cause of kidney failure and diabetes is five times more common in the Asians when compared to the white population
4. Another lifestyle related disorder - hypertension is an important cause of kidney failure and it too has seen a global increase in its incidence. Asians again are twice more prone to develop this condition in comparison to the white population.
5. Almost 66% kidney failure occurs due to hypertension or diabetes.(Urinary  tract infection may also cause kidney failure) 
6. There are approximately 7.85 million people suffering from chronic kidney failure in India.
7. In India 90% patients who suffer from kidney disease are not able to afford the cost of treatment.
8. The crisis of kidney shortage is a global phenomenon and it is worst in Asian countries.

Diabetic kidney disease is divided into two main categories, depending on how much albumin is lost through the kidneys:
What  is  GFR
GFR Glomerular filtration rate is the best test to measure your level of kidney function and determine your stage of kidney disease. Your doctor can calculate it from the results of your blood creatinine test, your age, race, gender and other factors.
The earlier kidney disease is detected, the better the chance of slowing or stopping its progression.
What Happens If  Kidneys Fail Completely?
Complete and irreversible kidney failure is sometimes called end-stage renal disease, or ESRD. If your kidneys stop working completely, your body fills with extra water and waste products. This condition is called uremia.
Your hands or feet may swell. You will feel tired and weak because your body needs clean blood to function properly.
Untreated uremia may lead to seizures or coma and will ultimately result in death. If your kidneys stop working completely, you will need to undergo dialysis or kidney transplantation.

Dialysis 
A method of removing toxic substances (impurities or wastes) from the blood when the kidneys are unable to do so. 
Most frequently used for patients who have kidney failure, but may also be used to quickly remove drugs or poisons in acute situations. This technique can be life saving in people with acute or chronic kidney failure.
Two methods: hemodialysis and peritoneal dialysis
Main causes of Kidney Failure 
- Diabetes
- Prolonged low BP (below 80 mmHg)
- Sudden cardio-vascular collapse due to any reason (hemorrhage, anaphylaxis, acute cardiac failure, shock, etc.)
- Kidney stones obstructing the urethra or both ureters