Where it is
Behind the peritoneum (retroperitoneal) on each side of the spine, from about T12 to L3; the right kidney sits slightly lower because of the liver. Each has an adrenal gland on top.
What it does
Filter blood, regulate fluids, electrolytes, acid–base balance and blood pressure, and release erythropoietin and active vitamin D.
Clinical relevance
- CVA tenderness suggests pyelonephritis.
- Chronic kidney disease causes anemia (low erythropoietin) and bone disease (low active vitamin D, high phosphorus).
- Contrast dye, aminoglycosides and NSAIDs can injure the kidneys.
Nursing focus
- Check creatinine before contrast studies and encourage fluids afterward when allowed.
- After a kidney biopsy, monitor for hematuria and bleeding and keep the client on bed rest as prescribed.