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In healthy kidneys, blood flows into nephrons that filter water and small particles from the blood to make urine. The waste flows into the bladder and clean blood flows back into the bloodstream.

When kidneys stop working, the main causes are diabetes and high blood pressure.

Diabetes affects the body's ability to produce or use insulin, the hormone that turns food into energy by moving sugar into cells. In a person whose body doesn't produce enough insulin — or whose body doesn't know how to use the insulin — sugar accumulates in the bloodstream.

That sugar accumulation damages blood vessels, including those in the kidneys, and if the diabetes isn't managed, the kidneys can fail.

Of Arizona's 6,747 patients on dialysis, about 54 percent were first diagnosed with diabetes. There's a 25 percent chance that a patient with Type 2 diabetes will show the earliest signs of kidney damage after 10 years, said Dr. Amit Fadia, a nephrologist who has treated patients with kidney problems in Southern Arizona for about six years.

High blood pressure, the primary diagnosis for about 20 percent of dialysis patients, also puts stress on the blood vessels. Over time that damage can lead to kidney failure as blood supply is reduced and the filtering units in the kidneys are damaged.

When people don't realize they have high blood pressure or diabetes, the kidney damage can go on undetected, said Dr. David Whittman, another local nephrologist. For people in their 30s or 40s who don't typically visit a doctor often, it can be years before they realize their kidneys are beginning to show damage, he said.

"When they do show up, they've had organ dysfunction that was smoldering in the background," Whittman said.

Eating junk food, drinking lots of soda and leading a sedentary lifestyle only add to these deadly health conditions, experts said.

Changing your diet, getting exercise and making regular visits to your physician to diagnose and manage diabetes and hypertension can go a long way toward prolonging, or even avoiding, the onset of kidney failure.

"You can prevent a lot of this if you take care of yourself," said Karen Lucero, a kidney dietitian.

Doctors detect kidney problems through blood and urine tests because the disease can develop without any symptoms.

The National Kidney Foundation recommends three tests to screen for kidney disease:

» A blood pressure measurement.

» A spot check for protein or albumin in the urine.

» A calculation of the glomerular filtration rate, which is based on a serum creatinine measurement that shows the flow rate of filtered fluid through a kidney.

Chronic kidney disease progresses in five stages, with Stage 1 being the least severe and Stage 5 being kidney failure when the organs aren't functioning enough to sustain life. At Stage 5, dialysis or a kidney transplant become necessary.

The average life span of a person on dialysis is five years, said Dr. Amit Fadia, a Tucson nephrologist. But he emphasized that number is an average, and it includes patients in their 80s or 90s who may have additional health complications that contribute to their deaths.

Some patients can survive on dialysis for decades, he said.

Transplant patients have a tendency to live longer. Three-quarters of the ones who get a kidney from a living relative survive at least 10 years, Fadia said. Of those who receive an organ from a cadaver, 70 percent are alive after 10 years, he said.

Transplant recipients face the risk that their body will reject the organ, and they must take expensive anti-rejection drugs that have their own side effects.

Still, when patients are eligible, nephrologists said they try to find viable organ donors for their patients.