Chronic Kidney Disease
Chronic kidney disease (or chronic kidney failure) is a gradual loss of kidney function over a period of several months to years. Your kidneys are responsible for filtering out waste products and getting rid of excess fluids from your blood in the form of urine. As the disease advances, it can cause dangerous levels of fluid, electrolytes and wastes to build up in your body, which can affect the function of all other body systems.
Chronic Kidney Disease Symptoms
Some of the common signs and symptoms of chronic kidney disease include:
- Fatigue and generalised weakness
- Increased or decreased urination (than before)
- Reduced mental sharpness and alertness
- Frequent muscle cramps
- Swelling of feet and ankles (oedema)
- Uncontrolled high blood pressure
- Shortness of breath with minimal exertion (due to possible fluid build-up in lungs)
- Chest pain (in case of fluid build-up around the heart).
Stages of Chronic Kidney disease
|Stage||Description||% of kidney function (GFR)|
|1||Normal kidney function||90-100%|
|2||Mild loss of kidney function||89-60%|
|3a||Mild to moderate loss of kidney function||59-45%|
|3b||Moderate to severe loss of kidney function||44-30%|
|4||Severe loss of kidney function||29-15%|
|5||Kidney failure||Less than 15%|
Causes of Chronic Kidney Disease
Chronic kidney disease primarily occurs when a condition interferes with kidney function, leading to kidney damage that worsens over a period. Some of the conditions that cause chronic kidney disease include:
- Persistent uncontrolled blood sugar levels
- High blood pressure that is not managed well
- Glomerulonephritis (inflammation of the kidney's filtering units (glomeruli))
- Interstitial nephritis (causes inflammation of the kidney's tubules and surrounding structures)
- Inherited kidney diseases such as polycystic kidney disease that causes large cysts to form in the kidney
- Long term obstruction of the urinary tract due to conditions like enlarged prostate, kidney stones and some cancers
- Vesicoureteral reflux (a condition where urine moves back up into your kidneys)
- Repeated kidney infection
- Congenital malformations that prevent a normal outflow of urine
- Immune diseases such as Lupus and other diseases
Complications of Chronic Kidney Disease
If chronic kidney disease continues to progress, it can lead to kidney failure. The possible complications are:
- Fluid retention
- High potassium levels (hyperkalaemia)
- Stomach ulcers
- Heart disease
- Increased risk of fracture
- Sexual dysfunction
- damage to the central nervous system
- Poor immunity
Diagnosis of Chronic Kidney Disease
Your doctor will check for signs of chronic kidney disease and ask for a thorough history of your symptoms. Additionally, the following tests may also be ordered:
- Blood test: To determine whether waste substances and metabolic by-products (such as urea and creatinine) are being filtered out correctly.
- Urine test: To find out whether there is either blood or protein in the urine.
- Kidney scans: MRI scan, CT scan, or ultrasound is done to check for any blockages in the urine flow and can help determine how advanced the stage of kidney disease is.
- Kidney biopsy: To analyse the kidney tissue, a small sample is extracted and examined for cell damage.
- Glomerular filtration rate (GFR): To measure how many millilitres (ml) of waste the kidneys can filter each minute.
Treatment of Chronic Kidney Disease
While there is no absolute cure available currently for chronic kidney disease, some therapies can help keep symptoms in check, slow the progression and reduce the risk of complications of the disease.
- Anaemia is treated using iron supplements
- Dietary phosphate regulation
- You will be asked to restrict their fluid intake
- Proper control of high blood pressure
- Skin itching is treated using antihistamines
When kidney function drops to less than 10-15 per cent of normal capacity, diet, medications, and symptomatic treatment are no longer sufficient to manage CKD. Waste and fluid can't be eliminated, and you may need dialysis or a kidney transplant.
Risks of Chronic Kidney Disease (CKD)
There are many factors that can increase your risk of chronic kidney disease. Consider getting tested if you have any of these risk factors:
- High blood pressure
- Heart disease
- Family history of kidney disease
- Abnormal kidney structure
- Older age (CKD is more common than those over 60)
- Frequent use of medications that can damage the kidneys
- Lupus erythematosus
- Overexposure to some toxins
- Sickle cell disease
- Bladder outlet obstruction.
Chronic Kidney Disease (CKD): Prevention
The best course of action for chronic kidney disease is its prevention. Here are some tips that can help:
- Manage any chronic condition such as diabetes and hypertension.
- Eat a healthy diet with plenty of fruits, vegetables, and whole grains.
- Exercise regularly can help manage chronic conditions and your weight.
- Avoid abusing alcohol and drugs and smoking.
- Avoid exposure to heavy metals, toxic fumes, and unnecessary medications.
Frequently Asked Questions
Can chronic kidney disease be healed?
At present, there is no cure for chronic kidney disease (CKD). It can be managed so that the symptoms are less severe and stop the disease from escalating. Depending on the stage of the disease, the most appropriate treatment will be given.
Is drinking a lot of water good for your kidneys?
To an extent, yes. Drinking water around 2.5 to 3 litres helps in preventing urinary calculi and improves hydration but for Chronic Kidney patients. No, drinking large amounts of water can cause your kidneys to work too hard to remove the excess waste. This process stimulates the release of certain hormones that make you feel stressed and tired and can worsen kidney disease.
How can chronic kidney disease affect my daily life?
Chronic kidney disease can cause waste products and fluid to build up in your body. This can result in swelling of your ankles, weakness, poor sleep, and shortness of breath. If the disease progresses, the damage to your kidneys can get worse, and they stop working entirely. This can be life-threatening.
Does Chronic Kidney Disease cause other health problems?
Yes, if left unchecked, kidney disease can lead to other health problems, such as heart disease and stroke.
Dr Muruganandham K
MBBS, MS, DNB, MCh, FMASHOD and Senior ConsultantDepartment of Urology & Renal Transplantation