Dr. Ahmed Al Qallaf is a consultant at Royale Hayat Hospital. His specialty is in internal medicine, nephrology and transplantation. Dr. Ahmed graduated from Kuwait University, Faculty of Medicine in the year 2003. When only the study of internal medicine was not enough and satisfactory, Dr Qallaf proceeded to Toronto for a fellowship in nephrology that lasted for two years and later for a year in Montreal to study transplantation.

The reason he chose nephrology, is that amongst all specialties in medicine, this specialty is one of the most difficult as you have to study all specialties to excel in it. It is a very challenging specialty and Dr. Ahmed Al Qallaf has been taught and trained by the Gurus of medicine themselves and received a Young Investigator Award for the American Transplant Congress (ATC) 2015 meeting.

Why Are the Kidneys So Important? Most people know that a major function of the kidneys is to remove waste products and excess fluid from the body. These waste products and excess fluid are removed through the urine. The production of urine involves highly complex steps of excretion and re-absorption. This process is necessary to maintain a stable balance of body chemicals. The critical regulation of the body’s salt, potassium and acid content is performed by the kidneys. The kidneys also produce hormones that affect the function of other organs. For example, a hormone produced by the kidneys stimulates red blood cell production. Other hormones produced by the kidneys help regulate blood pressure and control calcium metabolism.

Where Are the Kidneys and How Do They Function? There are two kidneys, each about the size of a fist, located on either side of the spine at the lowest level of the rib cage. Each kidney contains up to a million functioning units called nephrons. A nephron consists of a filtering unit of tiny blood vessels called a glomerulus attached to a tubule. When blood enters the glomerulus, it is filtered and the remaining fluid then passes along the tubule. In the tubule, chemicals and water are either added to or removed from this filtered fluid according to the body’s needs, the final product being the urine we excrete. The kidneys perform their life-sustaining job of filtering and returning to the bloodstream about 200 quarts of fluid every 24 hours. About two quarts are removed from the body in the form of urine, and about 198 quarts are recovered. The urine we excrete has been stored in the bladder for anywhere from 1 to 8 hours.

What Are Some of the Causes of Chronic Kidney Disease? Chronic kidney disease is defined as having some type of kidney abnormality, or “marker”, such as protein in the urine and having decreased kidney function for three months or longer. There are many causes of chronic kidney disease. The kidneys may be affected by diseases such as diabetes and high blood pressure. Some kidney conditions are inherited (run in families). Others are congenital; that is, individuals may be born with an abnormality that can affect their kidneys.

How is Chronic Kidney Disease Detected? Early detection and treatment of chronic kidney disease are the keys to keeping kidney disease from progressing to kidney failure. Some simple tests can be done to detect early kidney disease. They are:

A test for protein in the urine. Albumin to Creatinine Ratio (ACR), estimates the amount of an albumin that is in your urine. An excess amount of protein in your urine may mean your kidney’s filtering units have been damaged by disease. One positive result could be due to fever or heavy exercise, so your doctor will want to confirm your test over several weeks.

A test for blood creatinine. Your doctor should use your results, along with your age, race, gender and other factors, to calculate your glomerular filtration rate (GFR). Your GFR tells how much kidney function you have.

Can Kidney Disease Be Successfully Treated? Many kidney diseases can be treated successfully. Careful control of diseases like diabetes and high blood pressure can help prevent kidney disease or keep it from getting worse. Kidney stones and urinary tract infections can usually be treated successfully. Unfortunately, the exact causes of some kidney diseases are still unknown, and specific treatments are not yet available for them. Sometimes, chronic kidney disease may progress to kidney failure, requiring dialysis or kidney transplantation. Treating high blood pressure with special medications called angiotensin converting enzyme (ACE) inhibitors often helps to slow the progression of chronic kidney disease. A great deal of research is being done to find more effective treatment for all conditions that can cause chronic kidney disease.

What Are the Warning Signs of Kidney Disease? Kidney disease usually affects both kidneys. If the kidneys’ ability to filter the blood is seriously damaged by disease, wastes and excess fluid may build up in the body. Although many forms of kidney disease do not produce symptoms until late in the course of the disease, there are six warning signs of kidney disease: High blood pressure, blood and/or protein in the urine, a creatinine and Blood Urea Nitrogen (BUN) blood test, outside the normal range; BUN and creatinine are waste that build up in your blood when  your kidney function is reduced, more frequent urination, particularly at night; difficult or painful urination, and also puffiness around eyes, swelling of hands and feet.

Dr. Ahmed Al Qallaf Position: Consultant Internal Medicine, Nephrology & Transplantation Department: Internal Medicine. Qualifications: Board in Internal Medicine (KIMS). Nephrology Clinical Fellowship, University of Toronto, Canada. Renal Transplant Fellowship at McGill University, Member of American Society of Nephrology (ASN). Member of American Society of Transplantation (AST).