Chronic Kidney Disease: All You Must Know

Properly functioning Kidneys are essential for maintaining good health. The kidney filters all the blood every 30 minutes to remove wastes, poisons, and excess fluid from the body. It also helps control blood pressure and produces several vital hormones. 

Chronic Kidney Disease (CKD) represents the loss of kidney function over time, indicating that the kidneys cannot filter fluids as well as they should. The excess fluid and waste that aren't filtered stay in the body, which may cause other health problems, including heart disease and stroke.

CKD includes five stages, with kidney failure as the final stage. When the kidney is severely damaged, and its function is very low, dialysis or a kidney transplant may be needed to survive. 

Sign and Symptoms of CKD

Signs and symptoms of chronic kidney disease evolve gradually if kidney damage progresses slowly. Depending on the severity, loss of kidney function can cause:

• Nausea and Vomiting

• Appetite loss

• Fatigue and weakness

• Sleep issues

• More or less urination

• Reduced mental sharpness

• Muscle cramps

• Swelling of feet and ankles

• Dry and itchy skin

• Difficult to manage high blood pressure (hypertension)

• Shortness of breath on the fluid accumulation in the lungs

• Chest pain, if fluid accumulates close to the lining of the heart

Signs and symptoms of a kidney disorder are usually nonspecific, indicating other illnesses can also cause them. Since kidneys may compensate for lost function, a person might only develop signs and symptoms once irreversible damage occurs.

Seriousness and progression

CKD has different levels of seriousness. It usually worsens over time though treatment can slow progression. If left untreated, CKD can advance to kidney failure and early cardiovascular disease. Kidney failure, when managed with dialysis or a kidney transplant, is called end-stage renal disease (ESRD). 

Not all patients with kidney disease may advance to kidney failure. To prevent CKD and lower the risk for kidney failure, manage risk factors for CKD, get tested annually, make lifestyle modifications, take medicine as prescribed, and see your health care team periodically.

Moreover, CKD can trigger several other conditions, like-

• Anemia or low red blood cells

• Increased events of infections

• Low blood calcium, high blood potassium, and high blood phosphorus levels 

• appetite loss

• Depression or decreased quality of life

Triggers and Risk Factors

The two main reasons for the occurrence of CKD are diabetes and high blood pressure. The other risk factors for kidney diseases include:

• Heart conditions

• Family history of CKD

• Obesity

The probability of having kidney disease increases with age. The longer the person has diabetes, high blood pressure, or heart disease, the more likely they will get kidney disease.

African Americans, Hispanics, and American Indians have a greater risk for CKD, probably due to higher rates of diabetes and high blood pressure among these groups. Scientists are investigating other possible reasons for this increased risk.

Diagnosis and treatment

In the early stages of chronic kidney disease, a person may have a few signs or symptoms. However, the patient may only realize this once the condition is advanced. 

People can only find out if they have CKD through simple blood and urine tests. The blood test assesses creatinine (a waste product) in the blood to see the functioning of the kidneys. The urine test estimates protein in the urine (an early sign of kidney damage).

In case of suspicion, the doctor may refer the patient to a kidney specialist (nephrologist).

Kidney Numbers - Kidney numbers are the kidney function test that includes two examinations:

• Estimated glomerular filtration rate (eGFR)—a measure of how much blood the kidneys filter each minute and indicate their working. A low eGFR indicates that the kidneys are not working as well as they should. As kidney disease progresses, eGFR declines further.

• Urine albumin estimation. Albumin protein passes into the urine when the kidneys are damaged. Excessive albumin in the urine symbolizes an early sign of kidney damage.

Treatment for chronic kidney disease focuses on delaying the progression of kidney damage, often by controlling the cause. But, even risk factor management might not prevent the progression of kidney damage. Chronic kidney disease can progress to end-stage kidney failure, requiring artificial filtering (dialysis) or a kidney transplant.

Caring for Kidneys

Not all people with kidney disease have kidney failure. These tips can help lower the risk of developing kidney failure:

• Keep your blood pressure below 140/90 (or the doctor's goal).

• If you have diabetes, maintain your blood sugar range as much as possible.

• Work with your healthcare team to observe your kidney health.

• Take medications as prescribed.

• Work with a dietitian to create a kidney-healthy eating plan. 

• Indulge in adequate physical activity as it helps control blood pressure and blood sugar levels. 

• Maintain a healthy weight.

• Get adequate sleep.

• Quit Smoking as it can worsen kidney disease and interfere with blood pressure-lowering medications. 

• Keep up your Mental health and explore healthy ways to cope with stress and depression.

• Avoid conditions or exposures that can harm the kidneys or worsen kidney function.

The bottom line

Many people fear kidney disease because they think all kidney disease leads to dialysis. However, most people with kidney disease do not need dialysis. Individuals with kidney disease can live a productive life, work, spend time with friends and family, remain physically active, and do other things they enjoy. They may need to change their diet and add healthy habits to their daily routine to help protect their kidneys.

Seeking early medical advice can help people with kidney disease to work, be active, and enjoy life.