chronic kidney disease, ckd, ckd management

All about Chronic Kidney Disease

Chronic kidney disease (CKD) is long standing damage to kidneys. The function of kidney is filtration of your blood. But in CKD this function is impaired. Finally in this article you can find stages of CKD, symptoms, causes, complications and treatments.

Stages of Chronic kidney disease

Current classification of CKD incorporates the GFR (Glomerular Filtration Rate). It is calculated from serum creatinine level using an equation called MDRD. There are main 5 stages of CKD.

  • Stage 1 with normal or high GFR (GFR > 90 mL/min)
  • Stage 2 Mild CKD (GFR = 60-89 mL/min)
  • Stage 3a Moderate CKD (GFR = 45-59 mL/min)
  • Stage 3b Moderate CKD (GFR = 30-44 mL/min)
  • Stage 4 Severe CKD (GFR = 15-29 mL/min)
  • Stage 5 End Stage CKD (ESKD) (GFR <15 mL/min)

Those stages are important in the management of chronic kidney disease.

Causes of Chronic kidney disease

There is a wide geographical variation. For example, the most common cause of chronic kidney disease in sub-Saharan Africa is malaria. Schistosomiasis is a common cause of CKD due to urinary tract obstruction in parts of the Middle East, including southern Iraq. The incidence of ESKD varies between racial groups. ESKD is three to four times as common in black Africans in the UK and USA as it is in whites, and hypertensive nephropathy is a much more frequent cause of ESKD in this group.

Over 70% of all cases with CKD are due to diabetes mellitus, hypertension and atherosclerosis.

Here are some other causes for chronic kidney disease:

  • Polycystic kidney disease
  • Congenital obstructive uropathy
  • Primary glomerular diseases
  • Systemic lupus (SLE)
  • Kidney stones
  • Recurrent urinary tract infections
  • Multiple myeloma
  • Tuberculosis
  • Some drugs

Symptoms

In early stage of chronic kidney disease (CKD), most of the times, there are no symptoms. But your blood tests may be abnormal.

Later stages of disease may have many symptoms.

  • Loss of energy
  • Loss of appetite
  • Insomnia
  • Increase urine output
  • Nausea, vomiting and diarrhea
  • Itching of the body
  • Restless legs
  • Bone pain
  • Swelling of the face and legs
  • Sleepiness
  • Shortness of breath
  • Poor memory

Complications

Chronic kidney disease is associated with many complications. Some of them are listed below.

  • Anemia
  • Acidosis
  • Bone fractures
  • Heart disorders
  • Encephalopathy
  • Pulmonary edema

Diagnosis

Several blood tests and ultrasound scan can diagnose CKD. Blood tests are Full blood count, Fasting blood sugar, Blood urea, Serum electrolytes, Serum calcium and phosphate levels.

Treatment

Treatment of chronic kidney disease is depends on the stage. Therefore it is better to stage disease before commencing treatments.

In early stages of disease, the underlying cause should be identified and treatments are given. Diabetes and blood pressure control is very important.

But in end stage kidney disease an optimum management is necessary. For that patients may have a clear knowledge regarding chronic kidney disease. Also available options of management.

Drug treatments are given to control shortness of breath and other co morbidities.

Diet

You should cut down the protein intake. Because CKD become worse with high protein in your blood. So having food with high protein contents such as meat, fish and diary products should be restricted. In addition to protein you can add adequate calories into your diet.

In the meantime you have to restrict potassium and phosphate containing foods also. Those include banana, mango and papaya and some green leafy vegetables. Cutting, soaking and boiling of vegetables also reduce the potassium content.

If there is significant edema consumption of salt also need to be restricted.

Other measures

If you have anemia iron, folic acid, erythropoietin and even blood transfusion is given.

For itching, swelling and restless legs drug treatments are given.

Renal replacement therapy

If your kidneys function is lost we have to replace it somehow. In modern world there are new techniques available for renal replacement.

  • Hemodialysis – your blood is filtered using a machine. For that you have to admit to a hospital at least 3 times per week.
  • Peritoneal dialysis – you don’t want to admit to the hospital everyday. You can do this at home.
  • Renal transplant – Doctors will transplant a new kidney from a donor. Finally this is the best method according to new studies. But you have to find a healthy and matching donor for you.

Lifestyle advice

Stop smoking. It will save you from progressive disease and final bad outcome.

You have to maintain a healthy weight. Because higher the weight complications are more. Also you should do some aerobic exercises at least few minutes per week.

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