This is National Kidney Month. The hope is it will lead to activities designed to build kidney disease awareness and educate those at risk about the importance of early detection and the critical role the kidneys play in maintaining overall health.

There are 26 million Americans with kidney disease. One out of nine Americans is affected. As of 2008 there were half a million people in this country on life-sustaining dialysis.

If you have history of diabetes, high blood pressure, or family history of kidney disease, you are at risk of chronic kidney disease.

The recent Jackson Heart Study published in the American Journal of Kidney Disease, the official journal of National Kidney Foundation, reports in this group of people the percentage of chronic kidney disease is 20 percent, or one in five.

Diagnosis of this "epidemic" is now easier. Early detection is now possible by checking urine for albumin. Checking blood for kidney disease may not pick up early kidney injury, which albumin in urine will pick up. The National Kidney Foundation is now recommending a urine test for early detection.

"Most people with kidney disease are not diagnosed until late in the course of illness when there are few opportunities for prevention. We need to alert the public and health policy-makers to this real threat to populations here the U.S. and around the world and to the fact that early detection can make a difference," according to John Davis, CEO of the National Kidney Foundation.

There is now strong scientific evidence that early detection, altering lifestyle factors and aggressively controlling blood pressure, not only slow down the progression to kidney failure, but can also significantly reduce the incidence of cardiovascular disease that leads to premature death in the majority of these patients.

Following is a list of the 10 critical things healthy kidneys do for you:

1. Filter 200 liters, say 50 gallons, of blood a day, removing two liters of toxins, wastes and water.

2. Regulate the body's water balance.

3. Regulate blood pressure by controlling fluid levels and making the hormone that causes blood vessels to constrict.

4. Support healthy bones and tissues by producing the active form of vitamin D.

5. Produce the hormone that stimulates bone marrow to manufacture red blood cells.

6. Keep blood minerals in balance.

7. Keep electrolytes in balance.

8. Regulate blood acid levels.

9. Remove drugs from the blood.

10. Retrieve essential nutrients so that the body can reabsorb them.

Most patients with kidney diseases may not be cured, but careful follow-up and control of blood pressure, weight and other factors (If you smoke — stop!), will reduce continuing damage to one's kidneys.

Most kidney patients die of heart disease or stroke, rather than kidney failure. Dialysis will clean the blood, which is not well cleaned by damaged kidneys.

The National Kidney Foundation urges all Americans to love their kidneys. To learn more about chronic kidney disease risk factors, prevention and treatment, visit www.kidney.org.

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Dr. Kevin Koshy is chief of nephrology at the North Shore Medical Center in Salem.