Kidney Disease

What is Kidney Disease?

Kidney disease refers to a condition where the kidneys lose their ability to filter waste and excess fluids from the blood effectively. It can be acute (sudden) or chronic (gradual and progressive). Common causes include diabetes, high blood pressure, infections, and genetic factors.

Because kidney function gradually deteriorates over time, kidney disease is referred to as “chronic.” renal failure, commonly known as end-stage renal disease, can result from chronic kidney disease (CKD). Although kidney failure does not happen to everyone with CKD, the condition will frequently get worse if therapy is not received.

Chronic renal disease cannot be cured. However, there are things you can do to prevent kidney injury from happening. Dialysis and kidney transplantation are two possible treatments for kidney failure, often known as end-stage renal disease.

What do your kidneys do?

You have two kidneys. These bean-shaped organs are situated right below your rib cage, toward your back, on either side of your spine. Your fist is around the size of each kidney.

Although your kidneys perform a variety of functions, their primary function is to purify your blood by eliminating waste, toxins, and extra water in the form of urine. Along with producing hormones that regulate blood pressure, red blood cells, and strong bones, your kidneys also maintain the proper balance of minerals and electrolytes (such potassium and salt) in your body. Waste products can accumulate in your bloodstream and cause illness if your kidneys are damaged and not functioning properly.

Which five phases of chronic renal disease are there?

Chronic renal disease is divided into five stages. Your kidneys’ capacity to remove waste from your blood determines the phases. Your CKD stage is determined by blood and urine tests.

Stage 1 is extremely moderate, while Stage 5 is kidney failure. The glomerular filtration rate (GFR) is used by medical professionals to identify the stage of your kidney function. The amount of creatinine, a waste product, in your blood determines your GFR.

When your GFR in milliliters per minute is 90 or above, you are in stage 1, which indicates that your kidneys are functioning normally but that you have minimal renal damage.

Your kidneys are functioning normally at stage 2, which is 60 to 89 GFR in milliliters per minute, but you exhibit more symptoms of minor renal impairment.

Your kidneys aren’t functioning as effectively as they should and exhibit mild to severe impairment if your GFR is between 45 and 59 ml/min, which is stage 3A. The most typical stage is this one. At this point, you might start to experience symptoms.

When your GFR is between 30 and 44 milliliters per minute, or stage 3B, it indicates that your kidneys are somewhat damaged and not functioning as well as they should. Many people can remain at this stage and never move on to stage 4 with the correct care.

Stage 4 indicates that your kidneys are extensively damaged and nearly non-functional, with a GFR of 15 to 29 ml/min.

If your GFR is less than 15 milliliters per minute, you are at stage 5, which indicates that your kidneys are either completely failing or have stopped functioning. At this point, you might require kidney dialysis or a kidney transplant.

How common is this condition?

In the US, chronic kidney disease affects 15% of adults. In the United States, 37 million people suffer from chronic renal disease.

Symptoms and Causes:

What signs of chronic renal disease are present?

You typically don’t have any symptoms when kidney disease is first developing. The following symptoms could appear as the illness worsens:

• Weakness, exhaustion, and poor vitality.
• Appetite loss.
• Swelling in the ankles, feet, and hands.
• Breathlessness.
• Frothy or foamy urine.
• Eye puffiness
• Skin that is dry and scratchy.
• Difficulty focusing.
• Difficulty falling asleep.
• Numbness.
• Nausea or vomiting.
• Muscle cramps.
• High blood pressure.
• Darkening of your skin.
• Remember, waste accumulation in your blood might take years before symptoms appear.

When something is wrong with your kidneys, how does it feel?

When kidney disease is still in its early stages, you usually don’t show any symptoms. When symptoms start to appear, swelling in your hands and feet, itchy skin, or increased frequency of urination may be the first indication that something is amiss. If you think something is amiss, it’s wise to give your doctor a call because symptoms can differ.

What are common causes of kidney disease?

When your kidneys are damaged and unable to filter your blood, you have kidney disorders. Chronic renal disease typically causes damage over a number of years.

Diabetes and hypertension, sometimes known as high blood pressure, are the two most common causes of chronic kidney disease. Chronic kidney disease can also result from the following other factors and situations that impair kidney function:

Glomerulonephritis: The glomeruli, the kidneys’ internal filtering units, are harmed in this kind of kidney disease.

Polycystic kidney disease: This is a hereditary condition that impairs kidney function by causing many fluid-filled cysts to form in the kidneys.

Membranous nephropathy: This condition occurs when the immune system of your body targets the kidney’s waste-filtering membranes.

Malignancy that blocks the urinary tract, kidney stones, or an enlarged prostate.

Reflux of the vesicoureters: Pee flows backwards up your ureters to your kidneys in this case.

Nephrotic syndrome: This group of symptoms is indicative of renal impairment. Pyelonephritis, or recurrent kidney infection.

Diabetes-related nephropathy: This is diabetes-related injury or malfunction of one or more nerves.

Polyarteritis nodosa, sarcoidosis, Goodpasture syndrome, and lupus are among the immune system conditions that can lead to kidney issues.

Is kidney disease hereditary?

It is true that renal illness can run in families. It is also common for diabetes and other CKD risk factors to run in families.

Who is at risk for chronic kidney disease?

Chronic renal disease can strike anyone. Your risk of developing chronic renal disease is higher if you:

• Have diabetes.
• Have high blood pressure.
• Have heart disease.
• Have a family history of kidney disease.
• Have abnormal kidney structure or size.
• Are over 60 years old.
• Have a lengthy history of using painkillers called NSAIDs (nonsteroidal anti-inflammatory medications). This covers both prescription and over-the-counter (OTC) painkillers.

What are the complications of chronic kidney disease?

The following are a few consequences of chronic renal disease:

• A low red blood cell count (anemia).
• Weak and brittle bones.
• Gout.
• Metabolic acidosis: Your blood has an acid-base chemical imbalance as a result of declining kidney function.
• High blood pressure.
• Disease of the heart and blood vessels, which increases the risk of heart attack and stroke.
• Nerve damage.
• Hyperkalemia, or elevated potassium, impairs the proper operation of your heart.
• High phosphorus (hyperphosphatemia).
• High risk of infection because to weakened immunity.
• Accumulation of fluid that causes swelling in your hands, ankles, and feet.

Diagnosis and Tests:

How is kidney disease diagnosed?

In addition to asking about any current drugs, your healthcare practitioner will examine you physically, go over your medical history, and ask about any symptoms you may have had.

Your doctor will recommend blood and urine tests to evaluate kidney function.

Specifically, the blood tests will check:

The rate of glomerular filtration (GFR). This indicates the number of milliliters per minute that your kidneys are filtering blood, or how effectively they are doing so. The stage of your kidney illness is determined by your GFR.

Your kidneys’ ability to eliminate this waste product is indicated by your serum creatinine level. Usually excreted in urine, creatinine is a waste product of muscle metabolism. A high blood creatinine level means that your kidneys aren’t functioning well enough to remove it from your urine.

Pee tests will look for protein (albumin) and blood in your pee. Both should be absent from kidneys that are functioning properly.

To look for problems with the size and shape of your kidneys, additional testing may include imaging tests including computerized tomography (CT) scans, magnetic resonance imaging (MRI), and ultrasound. Your doctor may also recommend a kidney biopsy to check for a specific type of kidney disease or to determine the degree of kidney damage.

Management and Treatment:

How is chronic kidney disease treated?

Chronic kidney disease (CKD) cannot be cured, but there are things you may do to prolong the life of your kidneys. If your kidney function is diminished:

Establish and maintain routine consultations with your physician and nephrologist (kidney specialist). Your kidney health is monitored by these providers.

Steer clear of painkillers and other drugs that could exacerbate your renal illness.

Control your blood pressure.

Eat in a way that is good for your kidneys. Limiting protein, consuming foods that lower blood cholesterol, and consuming less sodium (salt) and potassium are a few examples of dietary adjustments.

Don’t smoke.

Do exercise on most days of the week.

Medications for kidney disease:

You might be prescribed one or more drugs, depending on the cause of your kidney condition. Your nephrologist may recommend the following medications:

Use an angiotensin receptor blocker (ARB) or an angiotensin-converting enzyme (ACE) inhibitor to reduce blood pressure.

If your kidneys are unable to remove phosphate, use a phosphate binder.

Drugs that reduce cholesterol levels.

If you’re anemic, erythropoietin will help you make red blood cells.

To stop bone loss, use calcitriol and vitamin D.

What is kidney dialysis?

If you have end-stage renal disease, you and your medical team need to think about other possibilities because there is no cure for CKD. If complete renal failure is not treated, it will lead to death. Dialysis and kidney transplantation are options for end-stage renal disease.

When your kidneys are unable to eliminate waste from your body, a process known as dialysis is used to do so using machines. Dialysis can be divided into two main categories:

Hemodialysis: Hemodialysis involves passing your blood through a machine that filters out waste, extra water, and extra salt. After that, the blood is put back into your body. Three times a week, four-hour treatments are necessary for hemodialysis.

Peritoneal dialysis: A catheter is used to inject a dialysis solution straight into your abdomen during peritoneal dialysis. After absorbing waste, the solution is extracted using the same catheter. The cleaning procedure is continued by adding fresh solution. This kind of dialysis is something you can do on your own. Peritoneal dialysis comes in two varieties: continuous cycling peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD), which alternates the dialysis solution four times daily. During the night, a machine is used by CCPD to automatically fill, drain, and replace the fluid.

What is a kidney transplant?

During a kidney transplant, a healthy kidney is used to replace an unhealthy one. There are two sources of kidneys for transplantation: living donors and deceased donors. Typically, living donors are friends, relatives, or partners. One healthy kidney can provide a person with a good quality of life, making a living kidney donor possible.

Kidneys from deceased donors typically come from organ donors. Every donor is thoroughly examined to ensure a good fit and to rule out any problems or communicable infections.

People typically have to wait three to five years to receive a kidney from a deceased donor. Receiving a kidney from a living donor is typically faster.

Prevention:

One of the best ways to prevent kidney disease is to see your doctor frequently throughout your life. In the US, renal illness is a risk factor for almost one in three people. To detect CKD as soon as feasible, high-risk individuals may undergo routine testing. Additional steps you can take to avoid CKD include:

• Manage your high blood pressure.
• Eat a well-balanced diet.
• Don’t smoke or use tobacco.
• Be active for 30 minutes at least five days a week.
• Maintain a healthy weight.
• Only take over-the-counter pain medicines as prescribed. Your kidneys may suffer if you take more than is recommended.
• Limit drinks that include alcohol.

Summary:

You may still lead a productive life at home and at work, as well as spend quality time with your loved ones, even if you have renal disease. To have the best outcome possible, it’s crucial for you to become an active member of your treatment team.

Kidney failure can be prevented or postponed by decreasing the disease’s course with early detection and suitable therapy. You will need to take your medications as directed, maintain a healthy diet, attend your doctor’s appointments, and keep an eye on your blood pressure and blood sugar levels.

FAQ:

References:

• Chronic kidney disease. (2024, May 1). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15096-chronic-kidney-disease
• Kidney Disease – NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease
• Chronic kidney disease – Symptoms and causes. (n.d.). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521