March is designated National Kidney Month to mark the growing impact of kidney disease on public health. National Kidney Foundation data suggest that more than 26 million Americans have kidney disease, a 30 percent increase over the past decade.

Most people are born with two kidneys. They are bean-shaped, and about the size of a fist. Located on the left and right sides of the spine, just below the rib cage, their main job is to filter extra salt, water and wastes out of the blood and make urine. They also help control blood pressure and make hormones the body needs to stay healthy. Kidney disease occurs when the small blood vessels in the kidneys are damaged, making the kidneys unable to do their job. Waste then builds up in the blood, harming the body.

Early kidney disease has no symptoms. Most people don’t know they have it until their kidneys begin to fail. The only way to tell if you have kidney disease is through simple blood and urine tests. Primary risk factors include diabetes, heart disease, high blood pressure, family history and being over age 60. Secondary risks include obesity, autoimmune diseases, urinary tract infections and systemic infections.

Over the coming years, the rate of kidney disease in the United States is expected to rise because of high obesity rates, the link between obesity, diabetes and high blood pressure and the aging of the Baby Boom generation.

In addition to being one of the top kidney transplant centers in the nation, University of Alabama at Birmingham (UAB) researchers are working on groundbreaking research into chronic kidney disease and acute kidney injury, in an effort to expand the knowledge base in the development, treatment and outcomes for patients with chronic kidney disease and acute kidney injury. This includes:

– UAB is one of eight George M. O’Brien Kidney Research Centers in the country, as designated by the National Institutes of Health, putting UAB at the forefront in the development of new methods to treat and prevent kidney failure. Acute kidney injury, or acute kidney failure, is a rapid loss of renal function due to damage to the kidneys. It develops in 5 to 7 percent of medical-surgical patients, complicates the recovery of 15 to 25 percent of intensive care patients, and can double the length of a patient’s hospital stay. “Despite major advances in renal replacement therapy, the mortality of patients with acute kidney injury has not significantly decreased in the past 30 to 40 years,” said Anupam Agarwal, M.D., director of UAB’s nephrology division and principal investigator of the O’Brien Center grant. “With this center, we hope to gain a better understanding of the reasons acute kidney injury occurs, expand diagnostic abilities, and expand therapeutic and preventative approaches to treating the disease.”

– UAB is performing the largest investigation to understand why the rate of stroke death is significantly higher in the Southeast, and blacks are more likely to die from stroke than whites, the Reasons for Geographic and Racial Differences in Stroke (REGARDS), which is led by George Howard, D.Sc. An ancillary study of the REGARDS project, Renal REGARDS, is being carried out by UAB nephrologist David Warnock, M.D., and colleagues, to see if there are common factors that will associate the risk for developing stroke with the risks for kidney disease. “If you look at the number of strokes per year, per population base, there are about three times more incidents of stroke among blacks. The incidence and severity of kidney disease is clearly greater among blacks than whites in the same population base. Why is that? We are working to find out,” Warnock said. Study results already have shown several things. The most important efforts to date have identified the importance of family history of kidney disease, and the fact that more white subjects have less severe kidney disease than blacks, but blacks seem to have more severe kidney disease.

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