Chronic kidney disease (CKD), or chronic kidney failure, is slow and progressive loss of kidney function over several years. Kidney disease is a term used by doctors to include any abnormality of the kidneys even if there is only very slight damage. Chronic means a condition that does not get completely better. CKD is a long-term condition where the kidneys do not work effectively. A person is said to have CKD if they have abnormalities of kidney function or structure present for more than three months. Signs and symptoms of CKD may include
- No symptoms initially
- Blood in urine
- Loss of appetite
- Decreased mental sharpness
- Muscle cramps
- Swelling of the feet
- Persistent itching
- Ammonia breath (breath smells foul like urine)
- Swollen ankles, feet, or hands (due to water retention)
- Moon face
- Severe increase in blood pressure
- Passing too much urine or no urine
- Difficulty breathing
- Nausea and vomiting
- Loss of consciousness
The risk of CKD is higher in people with diabetes, high blood pressure, cardiovascular disease, smoking, obesity, and a family history of kidney disease. Complications of CKD are evident as swelling of the arms and legs due to fluid retention; an increase in potassium levels in the blood; an increased risk of bone cancer, erectile dysfunction, nerve damage, difficulty concentrating; decreased immunity; pregnancy problems, and kidney damage.
What are the different stages of kidney disease?
There are five stages of kidney disease. The stage is determined by how much kidney function one still has. To estimate kidney function, doctors will perform several simple tests to find out glomerular filtration rate (GFR). GFR is a calculation the doctor will use to check if a patient has chronic kidney disease (CKD) and to determine the stage of the disease. Gender, age, weight and the results of a simple blood test are used to determine GFR.
- Acute kidney injury: It may start suddenly and may be reversible. It may occur due to injury, infections, medication side effects or sometimes pre-existing diseases.
- Chronic/severe kidney disease: It progresses slowly over at least three months and can lead to permanent kidney failure. It may be caused by various medical conditions including diabetes, high blood pressure, hereditary kidney disease, etc. It usually does not exhibit any symptoms until it progresses to advanced stages.
- Stage 1: 90 percent of kidney function is usually preserved.
- Stage 2: 60 ti 89 percent of kidney function is preserved.
- Stage 3: Symptoms may include tiredness, puffiness, changes in appetite, dull back pain, and urine changes. Kidney functioning may be reduced to 40 to 59 percent. See a nephrologist to learn about treatments and lifestyle changes to prevent further damage.
- Stage 4: People experience fatigue, swelling, changes in appetite, back pain, changes in urine, hypertension and slowed digestion. Kidney function may be reduced to 15 to 29 percent (severe kidney disease). Learn how to protect remaining kidney function, prepare for dialysis or find out more about a kidney transplant.
- Stage 5: It is end-stage kidney failure. The kidneys are only functioning at 10 to 15 percent. Dialysis or a kidney transplant is necessary to prolong life.
What are the treatment options for kidney disease?
There is no cure for chronic kidney disease (CKD), although treatment can slow or halt progression of the disease and prevent development of other serious conditions. Treatment of CKD depends on the stage and results of blood tests and other associated ailments. It includes
- Treatment of high blood pressure (take prescribed medicines, restrict salt, lose weight and perform regular exercise)
- Controlling blood sugar if diabetes is present (diet, regular exercise and diabetic medications)
- Treatment of anemia (iron supplements and erythropoietin stimulation agents)
- Treatment of mineral and bone disorders (to correct calcium, phosphorus, and parathyroid hormone levels with diet restrictions and medications)
- Control cholesterol levels with diet and medications
- Regular exercise
- Follow a diet program with low purine and low protein content
If a person has kidney failure (glomerular filtration rate [GFR] less than 15 mL/min/1.73 m2), they may require initiation of dialysis based on their symptoms and GFR. A kidney transplant is also an option.
When a person is diagnosed with CKD and confronted with the scope of all restrictions and treatments that now become necessary, they probably will feel like their ailment is the end of the world. However, there is still hope. Lifestyle changes can likely slow down disease progression significantly. Being diagnosed with CKD can be anxiety-producing, but support and advice are available to help patients cope. Kidney transplantation is an excellent option for those who are eligible for it.
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United States. CDC. "Chronic Kidney Disease Basics." Feb. 28, 2022. <https://www.cdc.gov/kidneydisease/basics.html>.
World Kidney Day. <https://www.worldkidneyday.org/facts/chronic-kidney-disease/>.