Chronic Kidney Disease and End Stage Renal Disease

Dr. McDowall sees patients that have various types of primary and secondary kidney problems. These include protein in the urine, blood in the urine, acute kidney injury. He will do the necessary diagnostic tests to determine your condition. Incorporating his preventive care approach helps effectively manages these problems.

What Do Kidneys Do?

Your kidneys are two bean-shaped organs, each about the size of your fist. They’re located behind your abdominal organs, one on each side of your spine. Their primary role is to help maintain the body in a state of balance by controlling the make-up and volume of blood. They do this by removing excess fluid and electrolytes from your blood. The kidneys also control the production of red blood cells as well as activation of Vitamin D, and regulates your blood pressure. Inside each kidney are more than a million small filtering units called nephrons. As blood circulates through your kidneys, the nephrons filter out waste products as well as unneeded minerals and water. This liquid waste — urine — flows through two narrow tubes (ureters) into your bladder from the kidneys, where it’s stored until it’s eliminated from your body through another tube, the urethra.

Why Do Kidneys Fail?


Most kidney diseases attack the nephrons, causing them to lose their filtering capacity. Damage to the nephrons can happen quickly, often as the result of injury or poisoning. But most kidney diseases destroy the nephrons slowly and silently. Only after years or even decades will the damage become apparent. Most kidney diseases attack both kidneys simultaneously.

Healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate a blood protein called albumin from the wastes. At first, only small amounts of albumin may leak into the urine, a condition known as microalbuminuria, a sign of deteriorating kidney function. As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria.

The two most common causes of kidney disease are diabetes and high blood pressure. People with a family history of any kind of kidney problem are also at risk for kidney disease.

Diabetic Kidney Disease

Diabetes is a disease that keeps the body from using glucose, a form of sugar, as it should. If glucose stays in the blood instead of breaking down, it can act like a poison. Damage to the nephrons from unused glucose in the blood is called diabetic kidney disease. Keeping blood glucose levels down can delay or prevent diabetic kidney disease. Use of medications called angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) to treat high blood pressure can also slow or delay the progression of diabetic kidney disease.

High Blood Pressure


High blood pressure can damage the small blood vessels in the kidneys. The damaged vessels cannot filter wastes from the blood as they are supposed to.

High blood pressure can lead to kidney disease. It can also be a sign that the kidneys are already impaired. The only way to know whether a person’s blood pressure is high is to have a health professional measure it with a blood pressure cuff. The result is expressed as two numbers. The top number, which is called the systolic pressure, represents the pressure in the blood vessels when the heart is beating. The bottom number, which is called the diastolic pressure, shows the pressure when the heart is resting between beats. A person’s blood pressure is considered normal if it stays below 120/80, stated as “120 over 80.” The NHLBI recommends that people with kidney disease use whatever therapy is necessary, including lifestyle changes and medicines, to keep their blood pressure below 130/80.

Dr. McDowall treats various kidney disorders like acid-base disorders, electrolyte disorders, uncontrolled high blood pressure, nephrolithiasis (kidney stones), acute kidney disease, chronic kidney disease and end-stage renal disease. McDowall will run diagnostic tests including blood and urine tests and kidney ultrasound on site to determine your condition and the appropriate treatment.

Don’t hesitate to discuss any aspect of your health. We can advise and consult with you on your nutrition, level of activity, and other things that can have an effect on your blood pressure, and kidneys.