Chronic kidney disease (CKD) is a medical condition in which the kidney function is gradually lost over a period of time. Consequently, the waste materials get accumulated in the body and lead to a wide variety of complications. Based on the severity of the condition, CKD is categorized into five stages.
Usually symptoms are not evident in the initial stages of CKD. As the condition advances, the following symptoms can be noticed:
- Swelling of hands, feet, and ankles
- Puffiness around the eyes especially after a night’s sleep
- Shortness of breath
- Blood in urine
- Frequent urination especially at night times
- Fatigue and tiredness due to anemia
- Decrease in appetite
- Difficulty to concentrate
- Dry and itchy skin
Check with a health care provider if there are persistent and bothersome symptoms. Only a doctor can assess the condition and check for the presence of CKD.
There are multiple causes for chronic kidney disease. The primary causes are uncontrolled diabetes and high blood pressure which account to about two-thirds of the CKD patients.
- Diabetes involves an increase in the blood sugar levels which effects several organs including the kidneys.
- Hypertension is an increase in the pressure on the walls of the blood vessels, which supply blood to the organs, including kidneys.
The other causes of chronic kidney disease may include the following:
- Glomerulonephritis, i.e. inflammation and damage of glomeruli (filtering units of the kidneys).
- Frequent urinary tract infections.
- Obstruction in the kidneys due to an enlargement of prostate gland in men or formation of stones or tumors.
- High cholesterol which gets deposited in the renal blood vessels.
- Genetic disorders such as polycystic kidney disease in which fluid filled bags known as cysts develop in the kidneys and cause structural damage.
- Certain malformations which occur during the development of the baby in the mother’s womb.
- Autoimmune disorders such lupus
- Use of certain drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) and use of lithium on a long-term basis
The following factors make a person more prone to develop CKD:
- A family history of kidney disease
- Old age
- Asian origin
Early detection of kidney disease can prevent or delay the progression of the condition. The following tests may be required to diagnose CKD:
- Glomerular filtration rate (GFR) is performed to estimate the kidney function. This is the best method to determine the stage of CKD
- Urine tests detect the presence of proteins (albumin) in urine
- Blood tests detect the levels of waste materials called creatinine
- Ultrasound or CT scan may be performed to detect any structural defects in the kidneys and urinary tract
- A kidney biopsy may be performed to check for specific defects by observing a sample of kidney tissue under the microscope
Based on the results of the above tests, the stage of CKD is determined.
Chronic kidney disease cannot be cured. Treatment aims at improving the symptoms and delays the disease progression. Specific treatment plan is chosen depending on the stage of CKD. Treatment approaches are:
- Medications such as angiotensin converting enzyme inhibitors or angiotensin II receptor blockers are used to treat high blood pressure.
- Diuretics or water pills help in eliminating excess fluid and salts from the body and reduce edema and blood pressure.
- Medicines are used to decrease the bad cholesterol levels and reduce the risk of heart problems.
- Erythropoeitin stimulating agents and iron supplements help in treating anemia.
- Calcium and vitamin D supplements improve bone strength and prevent the risk of fractures.
Additionally, certain dietary modifications will be suggested. These include:
- low protein diet to reduce the work load on the kidneys
- low salt intake to prevent edema
- low potassium foods to prevent worsening of the condition
If the disease has progressed to final stage (end-stage kidney disease), the treatment options are:
- Dialysis, i.e. an artificial method of removing wastes from the body using a filtering machine
- Kidney transplant is another treatment option in which a healthy kidney is transplanted from a donor and medicines are given to prevent rejection
The below mentioned complications can occur with the progress of CKD:
- High blood pressure
- Poor nutritional health
- Damage to the nervous system
- Week bones
Cardiovascular problem (affecting heart and blood vessels) is the main cause of death in CKD patients.
The below steps can lower the risk of developing CKD:
- Taking medicines regularly for diabetes and hypertension
- Maintaining a healthy weight
- Quitting the habit of smoking