An organ responsible for filtering waste and excess fluid from the blood is the kidney, which is affected by chronic kidney disease (CKD). In addition to high blood pressure and anemia, CKD can also lead to weak bones, nerve damage, heart disease, and kidney failure, which requires dialysis or a kidney transplant in order to survive.
Almost two-thirds of cases of CKD are caused by diabetes and high blood pressure. Diabetes causes high blood sugar levels, which over time can cause damage to the kidneys. In addition to damaging the kidneys and increasing the risk of heart disease, high blood pressure causes a high force of blood to strike against the walls of the blood vessels.
Other causes of CKD include:
Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units
Polycystic kidney disease, a genetic disorder that causes large cysts to grow in the kidneys and impair their function
Kidney and urinary tract abnormalities, such as kidney stones, infections, or blockages, that affect the flow of urine and damage the kidneys
Autoimmune diseases, such as lupus or rheumatoid arthritis, that cause the immune system to attack the kidneys
Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, or chemotherapy, that can have toxic effects on the kidneys
Exposure to environmental toxins, such as heavy metals, pesticides, or solvents, that can harm the kidneys
Early stages of CKD often do not cause any symptoms, because the kidneys can compensate for the loss of function. However, as CKD worsens, the buildup of waste and fluid in the body can cause various symptoms.
Nausea and vomiting
Loss of appetite and weight loss
Fatigue and weakness
Trouble sleeping and concentrating
Changes in urination, such as more or less frequent, foamy, bloody, or dark urine
Swelling of the feet, ankles, legs, hands, or face
Itching and dry skin
Muscle cramps and twitches
Shortness of breath and chest pain
Headaches and dizziness
CKD can be diagnosed by a doctor based on the medical history, physical examination, and laboratory tests. The main tests used to diagnose CKD are:
Several blood tests are used to determine the kidney's function, including serum creatinine and blood urea nitrogen (BUN). In these tests, the doctor can calculate the glomerular filtration rate (GFR), which is the best way to determine kidney function. If the GFR is lower than 60 mL/min/1.73 m2 for three months or more, it indicates kidney failure.
This test detects protein or blood in urine, which may indicate kidney damage or infection. It can be used by doctors to calculate the urine albumin-to-creatinine ratio (UACR), which measures how much albumin is leaking out of the kidneys into the urine. If the UACR exceeds 30 mg/g, CKD is present.
Various imaging tests can reveal the size, shape, and structure of the kidneys and detect abnormalities, such as cysts, stones, and tumors, using ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI).
The kidney biopsy is a procedure that involves examining a small sample of kidney tissue under a microscope in order to identify the specific type and cause of kidney disease.
In CKD, treatment can slow the progression of the disease and avoid or manage complications. Treatment of CKD depends on the stage, cause, and symptoms of the disease, and may include:
Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), diuretics, beta-blockers, calcium channel blockers, statins, erythropoietin, iron, vitamin D, phosphate binders, or bicarbonate are among the medications that can reduce blood pressure, cholesterol, anemia, bone health, acidosis, and swelling.
The kidney function and overall health can be improved by limiting salt, protein, potassium, phosphorus, and fluid intake, eating more fruits, vegetables, and whole grains, quitting smoking, limiting alcohol consumption, exercising regularly, and maintaining a healthy weight.
The kidneys fail or the symptoms become severe and life-threatening, so dialysis, a procedure which filters blood and removes waste and excess fluid from the body, is needed. There are two main types of dialysis: hemodialysis, which uses a machine and an artificial kidney to filter the blood outside the body, and peritoneal dialysis, which uses a catheter and a fluid to filter the blood within the abdomen.
In a kidney transplant, a diseased kidney is replaced with a healthy one from a donor, restoring normal kidney function and improving quality of life. Kidney transplants are not suitable for everyone, and there are risks and challenges involved, including finding a compatible donor, waiting for a long time, taking immunosuppressive drugs, and being at risk for rejection and infection.
CKD can be prevented or delayed by taking care of the kidneys and reducing the risk factors. Some of the preventive measures include:
Getting regular checkups and screenings for kidney function, especially if you have diabetes, high blood pressure, or a family history of kidney disease
Managing chronic conditions, such as diabetes and high blood pressure, by following the doctor’s advice and taking the prescribed medications
Avoiding or limiting the use of medications, substances, or products that can damage the kidneys, such as NSAIDs, antibiotics, contrast dye, herbal supplements, or illegal drugs
Drinking enough water and staying hydrated
Eating a balanced and nutritious diet that is low in salt, sugar, and fat and high in fiber, vitamins, and minerals
Staying physically active and exercising regularly
Quitting smoking and limiting alcohol
Seeking medical attention promptly if you have any signs or symptoms of kidney disease or infection
If you are aware of the causes, symptoms, diagnosis, treatment, and prevention of CKD, you can take charge of your kidney health and live a longer, happier life.
