| Dr. Frederick Kaskel |
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What is your occupation and position?
I am a Pediatric Nephrologist (children’s kidney doctor) and a Professor of Pediatrics. I am the Director of the Division of Pediatric Nephrology at the Children’s Hospital at Montefiore, Bronx, N.Y. (http://www.montefiore.org/prof/clinical/ped/ progserv/nephrology)
What are some of your major professional accomplishments? For example: positions, publications or awards?
I am President of the American Society of Pediatric Nephrology and also Chairman of the Enuresis Committee of the National Kidney Foundation. I am also Medical Director of the Ruth Gottscho Children’s Kidney Program at Frost Valley YMCA (http://www.frostvalley.org) which allows children who are on dialysis or who have received a kidney transplant to attend summer camp.
What are kidneys, where are they, and why do we need them?
The kidneys are organs which are part of the genito-urinary system. Normally, you have two kidneys, each about the size of an adult fist, located on either side of the spine just below the rib cage. Although they are small, your kidneys perform many complex and vital functions that keep the rest of the body in balance.
The kidneys filter waste (from what we eat and drink) out of our blood, and turn this waste into urine. The kidneys also produce hormones which build red blood cells and prevent anemia (which make us feel weak and tired), and control blood pressure. The kidneys also help maintaining healthy bones (very important for growing teens!). They help balance fluids, chemicals, and nutrients in our bodies.
What can go wrong with the kidneys? What are some of the causes of kidney problems?
Certain diseases can affect the kidney’s ability to maintain a normal blood pressure and eliminate waste products. These problems can be congenital (something you’re born with), genetic (something that “runs in the family”) or post-infectious (something you “catch” from the environment or another person)
Recently, we have seen taht many more teens are overweight, and thus many more teens who are developing type II (non-insulin dependent) diabetes. Diabetes can cause kidney problems and the person with diabetes may need dialysis or transplant in the long run.
Some diseases, like lupus or focal segmental glomerulosclerosis” (FSGS) are often diagnosed when patients are in their teens.
Can you give an example of an interesting case of a teenager with a kidney disorder?
A 13 year old girl with no health problems gets sick after dinner. Her mother takes her to the emergency room, but they are in a car accident while on the way. Once she gets to the hospital, the doctors find that her kidneys have completely stopped working. She starts on dialysis immediately. Three months later, her mother is able to donate a kidney to her. She is able to stay in school and attend her junior high school prom , and takes immunosuppressant medicine to protect her transplant every day.
A teenage boy develops swelling around the eyes upon awakening and is found to have protein leaking in the urine. This may be a meaningless finding, a sign of a minor infection, or may represent serious kidney disease. He is followed by nephrologist in addition to his pediatrician, to determine if his symptoms continue, increase, or disappear.
Another example is a teen who suddenly has red or dark colored urine indicating that blood in now leaking into the urine from the kidneys. Again, this may be a minor symptom, the sign of a recent injury, or may represent a serious kidney condition.
What has recently been discovered about kidney problems?
Many kidney problems start in childhood and if not properly controlled can lead to failure of the kidneys in adolescence or adulthood, requiring dialysis or kidney transplantation.
New medicines have been introduced that allow us to better control blood pressure, to slow down kidney damage, and to protect kidney transplants.
How would you know if you had kidney problems?
You might feel tired, notice swelling around the eyes and feet, have headaches, nausea and/or weight loss.
What tests are available for the diagnosis of kidney problems?
Urine tests for protein, and blood pressure monitoring are common ways of identifying and monitoring kidney problems. A patient with ongoing kidney problems may receive a biopsy to determine what type of disease they have and how they are responding to treatment. Certain chemicals in the blood, such as creatinine, can tell us how well the kidneys are working.
What type of treatments are available for kidney problems?
Some conditions can be controlled with medications and diets.
More serious conditions require replacement of kidney function with dialysis (“the artificial kidney”), or kidney transplant.
Dialysis comes in two forms – hemodialysis which requires a person to be connected to a machine which filters their blood for several hours, several times a week; or peritoneal dialysis, which can be done at home every night using a machine which filters fluid in and out of the belly.
A kidney transplant can be “living” - received from someone who “matches” the patient (a family member or sometimes a stranger) or “cadaveric” – received from someone who has died and who has decided to donate their organs. There are many thousands of people waiting for transplants in the United States, and a teenager who needs a transplant may wait at least two years if no donor is available in his/her family
Where would a teen go to get more information about kidney problems?
They could start by asking their family physician or school nurse. The National Kidney Foundation website (http://www.kidney.org) is also a good place to start. The Coalition for Donation (http://www.shareyourlife.org) has information about organ donation.
Is there anything teens can do to keep their kidneys healthy?
Avoid toxins like drugs and alcohol. Keep a healthy life style with plenty of exercise, good food and rest. Have a yearly check up and report any new findings to your doctor.
This interview was made possible through an unrestricted medical education grant from Amgen, Inc.
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| Post a Comment |
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Mandi |
08-18-05 |
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Hi Dr.Kaskel!
My Name is amanda and you diagnosed me with my kidney problem around christmas time 1991 when i was about three weeks old. i had one kidney that completly didn't work and one that had a problem with it..... i used to come bak to you every year until you switched offices and then i had to switch doctors! My parents tell me what a great doctor you are and everything! I am very healthy now and haven't had a problem with it since!! i still get it checked and i thank you greatly for all you did for me!
Thank you!!!!
Amanda!!!
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courtney |
06-22-04 |
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i wonder if i have a kidney problem? like every year or sometimes every 6 months i'd just be walking up the stairs or running nothing hard on me and my knee would just start hurting, and it would hurt so much that i couldn't contiue what i was doing, but it would only last for maybe 10 minutes then stop.
anyone know anything?
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rasha |
11-28-03 |
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way to go doctory dude
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tracy |
01-28-03 |
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I once wanted to donate my kidney to someone I knew that was dying, but it wasn't a good match. Luckily, the doctors found a match and the person lived.
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Angelbaby |
11-22-02 |
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This was an interesting article and very informational.
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Andrew |
11-09-02 |
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This really tells it all. Thanx.
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Nicole |
07-24-02 |
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Wow, this was very informative. Thank you Dr. Kaskel.
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Joey |
07-10-02 |
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I never realized what an important  ction the kidneys served.
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Kelly |
06-14-02 |
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I knew that the kidneys were responisble for filtering the blood but i didn't know all the other imprtant ctions they had. QUESTION is HOW DOES DRINKING EFFECT THE KIDNEY"S
Also, i just want to tell everyone who reads this that they should sign up to be OGRAN DONORS when they die. You can do it really simply by going on the web and ordering your declaration to be an organ donor when you dio. Make sure you tell all your family members! Your already dead, why not  MANY others live!!!! SAVE LIVES
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Joey |
06-13-02 |
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I always thought the kidneys were expendable.
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Court |
05-08-02 |
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THANK YOU DR.FREDERICK KASKEL FOR THE GREAT INFORMATION ON KIDNEY PROBLEMS.
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Nicole |
05-08-02 |
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The interview by Dr.Federick Kaskel was very interview. It makes you aware of all the dificulties that can occur in your body. And finding more information about kidney problems have elightned me. Especially to take care of myself.
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05-08-02 |
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The information that Dr. Frederick Kaskel gave about kidneys and disorders. Was very informative. We should have more interviews like this, so that we can keep informed about our health and bodies. Thanks Doc.
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Michele |
11-22-01 |
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Hi I am the one who wrote a reply about my kidney transplant and this is to Sarah: Yes, it is a bad habit. My doctor said so. Cause when you hold it until like you feel it's gonna "explode", there is a part of the urine that goes back into your kidneys cause your bladder is too full. It can cause an infection.
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Janet |
11-21-01 |
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Yeah Sarah, I think thats really bad. You should go more. Just my opinion, but I think I am right on this one.
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Sarah |
11-20-01 |
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I only go pee 1 time a day, thats probably bad right? And I only go, when my kidneys start to hurt, like they'll blow, thats a habit now, thats gotta be bad as well right?
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BLOWOUT |
11-20-01 |
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I wonder if ur kidney can explode from holdin ur urine to long........
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Michele |
11-20-01 |
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and I have been hemodialysed during 4 years and a half because I caught a disease "in the air"... it was a bacteria.
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Michele |
11-20-01 |
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I received a kidney transplant when I was 12 and it saved my life. The kidneys are very important. People don't realize it. I will celebrate my 10th anniversary with a new kidney in July and I live a normal life now.
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COURTNEY |
11-20-01 |
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Never realized how important the kidneys are. This is very informative.
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