Chronic Kidney Disease (CKD)

  • September 4, 2020
Chronic Kidney Disease (CKD)

55-year-old Sunil Srivastava had not been feeling well lately. He had lost his appetite, was feeling nauseous all the time and not sleeping very well. He was feeling tired all the time. His wife noticed his hands and feet looked a little swollen. Being a diabetic, he initially thought his blood sugar was the problem. His diabetologist, however, told him he needed to run a few test to see his kidney function. His test reports revealed his kidneys were not functioning normally and there were some abnormalities. The doctor referred him to a nephrologist, who diagnosed that he was suffering from Chronic Kidney Disease and would need life-long treatment and lifestyle modifications to prevent kidney failure.

Chronic Kidney Disease refers to lasting damage to the kidneys that can get worse over time. Kidney damage is irreversible, and over time neglect can lead to your kidneys stop working altogether. This is called kidney, or end stage renal, failure. When this happens, one will need dialysis or a kidney transplant to survive.

Some factors that increase the risk of CKD:

  • Diabetes
  • High blood pressure (hypertension)
  • Heart disease
  • Having a family member with kidney disease
  • Being African-American, Hispanic, Native American or Asian
  • Being over 60 years old

Common causes for Chronic Kidney Disease

Causes and conditions that cause chronic kidney disease include:

  • Diabetes
  • High blood pressure
  • Glomerulonephritis or inflammation of the kidney’s filtering units
  • Kidney tubules and surrounding structures get inflamed
  • Polycystic kidney disease
  • Obstruction of the urinary tract, from enlarged prostate, kidney stones and some cancers
  • A condition where the urine backs up into the kidneys
  • Recurrent kidney infection

Symptoms of kidney failure

Some common symptoms if your kidneys are beginning to fail are:

  • Itchy skin
  • Muscle cramps
  • Nausea and vomiting
  • Loss of hunger
  • Swelling in your feet and ankles
  • Too much urine/less urine
  • Breathing problem
  • Trouble sleeping

If your kidneys stop working suddenly (acute kidney failure), you may notice one or more of the following symptoms:

  • Abdominal pain
  • Back pain
  • Diarrhoea
  • Fever
  • Nosebleeds
  • Rash
  • Vomiting

If you notice one or more of these symptoms, contact a doctor right away.

Complications of CKD

Your kidneys help your body work properly and get rid of the unwanted substances from the body. When you have CKD, you can also have problems with how the rest of your body is working and cause complications like:

  • Fluid retention leading to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary oedema)
  • A sudden rise in potassium levels in your blood could impair your heart’s ability to function and may be life-threatening
  • Heart and blood vessel (cardiovascular) disease
  • Weak bones and high risk of fractures
  • Anaemia
  • Decreased sex drive, erectile dysfunction or reduced fertility
  • Damage to the central nervous system causing difficulty in concentrating, personality changes or seizures
  • Decreased immunity which makes you vulnerable to infection
  • May lead to Pericarditis, an inflammation of the saclike membrane that envelops your heart
  • Pregnancy complications that carry risks for the mother and the developing foetus
  • Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival

Chronic kidney disease (CKD) refers to five stages of kidney damage or failure, from very mild damage in stage 1 to complete kidney failure in stage 5. These stages are based on how well the kidneys can filter waste and extra fluid out of the blood. In the early stages the kidneys are still able to filter out waste from your blood, however in the later stages they need to work harder and ultimately may stop working altogether.

The doctors measure how well your kidneys filter waste from your blood by studying the estimated glomerular filtration rate, or eGFR based on the blood test for creatinine, a waste product in the blood.

Diagnosing Chronic Kidney Disease

The doctors may ask you to carry out certain tests and procedures to diagnose Kidney disease:

  • Blood tests – Kidney function tests show level of waste products, such as creatinine and urea, in your blood.
  • Urine tests – Analyzing a sample of the urine may reveal abnormalities and identify the cause of chronic kidney disease.
  • Imaging tests – Ultrasound help to assess your kidneys’ structure and size
  • Kidney tissue biopsy – Your doctor may recommend a biopsy where a sample is sent to a lab for testing to help determine what is causing your kidney problem.

How is CKD treated?

Kidney damage cannot be reversed, but by following certain steps you can slow the progress of the disease.

  • Control your blood sugar level
  • Keep a healthy blood pressure
  • Follow a low-salt, low potassium and low-fat diet
  • Exercise at least 30 minutes on most days of the week
  • Keep a healthy weight
  • Do not smoke or use tobacco
  • Limit alcohol
  • Talk to your doctor about medicines that can help protect your kidneys

Diagnosis of kidney disease early, may help to prevent kidney failure.

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