Chronic Kidney Disease
Chronic kidney disease is a slow and gradual loss of kidney function that occurs over several years. Due to retention of fluid, it can lead to hypertension(high blood pressure) and swelling. It can get worse over time, leading to kidney failure.
CKD interferes with normal functioning of kidneys.
Some of the functions of the kidney include;
- Erythropoiesis. Kidneys aid in making red cells.
- Regulation and maintenance of blood pressure within normal ranges.
- Elimination of toxic waste materials from the body.
- Balancing vital minerals in the body.
Several tests are conducted in order to diagnose CKD.
Even though it is incurable, CKD can be managed through medications and lifestyle management.
Kidneys that have lost function are unable to filter toxins and other wastes as properly intended. Therefore, wastes build up in the blood
Key Facts & Statistics
- In the United States, CKD occurs in almost 33.5 million people .This translates to approximately 14% of the total population.
- More than 80% of people living with CKD in US do not know they have the condition.
- Of all adults in US, almost 15% have CKD.
- About 1 in 3 people in the US is at risk for kidney disease.
- This condition can lead to kidney failure(end-stage kidney disease).
- Currently, it is unfortunate that there is no cure for CKD. Only slowing down of kidney damage can be done.
- Dialysis and transplantation are among treatment options for kidney failure(end-stage kidney disease).
Risk Factors
Any person is at risk of developing chronic kidney disease. Some of the risk factors include:
- Positive family history of kidney disease.
- Personal history of acute kidney injury(AKI).
- Age. Being 60 years old and above.
- Race. African Americans have higher chance of developing CKD as compared to white Americans.
- Presence of heart disease, diabetes and hypertension.
- Kidney morphology. Abnormal kidney size and structure.
- Long history of NSAID(non-steroidal anti-inflammatory drugs) use.
- Obesity.
- Smoking and utilizing products of tobacco.
Causes
Hypertension(high blood pressure) and diabetes are 2 most common causes of CKD.
Other causes include:
- Glomerular diseases. For example, glomerulonephritis and HIV nephropathy.
- Inherited diseases such as polycystic kidney disease.
- Sepsis.
- Auto-immune diseases such as lupus nephritis.
- Recurrent kidney infection(pyelonephritis)
- Kidney cancer.
- Kidney stones.
- Nephrotic syndrome.
- Diabetes-related nephropathy.
- Untreated UTIs (urinary tract infections).
Signs & Symptoms
Noticeable symptoms might fail to present during early stages of CKD.
During progression, symptoms can include:
- Increased need to urinate
- Loss of appetite
- Dyspnea
- High blood pressure ranges that are difficult to regulate
- Numbness
- Foamy urine
- Fatigue
- Dry, itchy skin
- Darkened skin
- Nausea or vomiting
- Decreased mental sharpness
- Sleep problems
Stages
CKD is divided into 5 main stages.
These are; I, II, IIIa, IIIb, IV and V.
- I: GFR is 90ml/min or higher
- II: 60-89
- IIIa: 45-89
- IIIb: 30-44
- IV: 15-29
- V: Less than 15
Diagnosis
Medical history. This is a patient-doctor conversation where the doctor obtains relevant details regarding the patient’s history through a history-taking process.
Clinical examination.
Blood and urine tests to check for kidney function. Blood tests check for glomerular filtration rate(GFR) and serum creatinine level. Urine tests are meant to look for protein(albumin) and blood in the urine, which normally should be absent.
Imaging tests to look at kidney morphology. These include;
- Ultrasound
- Computer Tomography scan
- Magnetic resonance imaging(MRI)
Kidney biopsy to check for level of damage to the kidney.
Treatment & Management
Currently, it is unfortunate that we lack a cure for CKD.
Several procedures are put in place to preserve kidney function and slow down damage.
Individuals with reduced kidney function are supposed to;
- Avoid smoking.
- Perform regular physical activities.
- Maintain healthy weight.
- Embrace a kidney-friendly diet; limit intake of sodium and potassium, and protein too.
- Maintain normal blood pressure levels.
- Regularly visit a nephrologist.
- Regulate blood glucose levels, if they are diabetic patients.
Medications for CKD.
- Angiotensin-converting enzyme(ACE) inhibitors or angiotensin-receptor blockers(ARBs) to lower high blood pressure.
- Phosphate binders aid the kidney to remove phosphate.
- Diuretic drugs to enhance water loss.
- Erythropoietin(EPO) hormone to improve erythropoiesis(red cell formation) in anaemic patients.
- Vitamin D and calcitriol. These agents prevent bone loss.
For end-stage kidney stage;
- Dialysis(hemodialysis, peritoneal dialysis)
- Kidney transplant
Complications
- Gout.
- Anaemia.
- Metabolic acidosis.
- High blood pressure.
- Edema.
- Hyperkalemia(high intracellular potassium ion concentration)
- Hyperphosphatemia(high phosphorous concentration).
- Heart disease.
Prevention
- Regular check-up sand tests to check for CKD for people who are at high risk. This helps in early recognition of CKD.
- Manage blood pressure within normal ranges.
- Avoid smoking and using tobacco products.
- Embrace physical activities such as daily morning runs.
- Manage blood sugar.
- Use non-prescription pain killers such as NSAIDs as directed.