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 tests 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 long-term kidney damage that can get worse over time. Kidney damage is irreversible, and over time neglect may lead to your kidneys stop working altogether. This is called end-stage renal failure. When this happens, one will need dialysis or a kidney transplant to survive.

Causes of Chronic Kidney Disease

Some common conditions contributing to CKD are:

  • Elevated blood pressure
  • Glomerulonephritis or inflammation of the filtering units of your kidney
  • Diabetes
  • Polycystic kidney disease
  • Kidney tubules and adjacent structures get inflamed
  • Urinary tract obstruction due to cancers, kidney stones, or an enlarged prostate
  • A condition where the urine backs up into the kidneys
  • Repeated kidney infection

Risk factors

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

Early signs of kidney failure

Some common symptoms indicating that your kidneys are starting to fail may include:

  • Muscle cramps
  • Itchy skin
  • Vomiting and nausea
  • Loss of hunger
  • Swelling in the ankles and feet
  • Too much/less urine
  • Breathing problem
  • Difficulty sleeping

In case of acute kidney failure, your kidneys may abruptly stop working and you may likely notice these symptoms:

  • Pain in the back and abdomen
  • Diarrhoea
  • Nosebleeds
  • Fever
  • Vomiting
  • Rash

On experiencing one or more of these symptoms, consult a doctor immediately.

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 the body is working and cause complications like:

  • Fluid retention leading to pulmonary oedema (fluid in the lungs), swollen legs and arms, and high blood pressure
  • A sudden increase in the level of potassium in the blood can impede with your heart’s functional ability, thus leading to a life-threatening condition
  • Cardiovascular diseases
  • A high risk of fractures due to weak, fragile bones
  • Anaemia
  • Reduced sex drive, reduced fertility, and erectile dysfunction
  • Damage to the central nervous system causing personality changes, difficulty in concentrating, or seizures
  • Decreased immunity that may increase your vulnerability to infections
  • May lead to Pericarditis, which is an inflammation of the saclike membrane surrounding your heart
  • Pregnancy complications carrying risks for both mother and child
  • Irreversible kidney damage eventually requiring a kidney transplant or dialysis for survival

Chronic kidney disease refers to five stages of renal failure or damage, ranging from mild damage (Stage 1) to complete renal failure (Stage 5). These stages are determined based on how efficiently your kidneys can filter extra fluid and waste 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.

A doctor can measure how efficiently your kidneys can flush out wastes from blood by monitoring eGFR or estimated glomerular filtration rate.

Diagnosing Chronic Kidney Disease

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

  • Blood tests – A kidney function test shows the level of waste products, like urea and creatinine, in the blood.
  • Urine tests – Urine sample analysis can reveal abnormalities and detect the reason for 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 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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