Chronic kidney disease (CKD) is the progressive lasting damage to the kidneys that can get worse over time. Progressive and gradual damage to the kidneys leads to End Stage Renal Disease (ESRD).
CKD interferes with the functions of kidneys, that is filtration of blood and removal of waste products, which contributes to the growing concentration of toxins in blood and cells.
STAGES OF CKD
Glomerular filtration rate (GFR) is the best measure of kidney function. Various stages of kidney failure are mapped using the GFR as reference.
1) Stage 1 with normal or high GFR (GFR > 90 mL/min)
2) Stage 2 Mild CKD (GFR = 60-89 mL/min)
3) Stage 3A Moderate CKD (GFR = 45-59 mL/min)
4) Stage 3B Moderate CKD (GFR = 30-44 mL/min)
5) Stage 4 Severe CKD (GFR = 15-29 mL/min)
6) Stage 5 End Stage CKD (GFR <15 mL/min)
SYMPTOMS OF CKD
- Nausea & vomiting
- Loss of appetite
- Fatigue and weakness
- Change in urine volume and foamy urine
- Muscle twitches and cramps
- Fluid retention and swelling in the lower limbs
- Persistent itching
- Shortness of breath and chest pain that is the result of of fluid build up.
- High blood pressure (hypertension)
CAUSES & RISK FACTORS
Chronic Kidney Disease (CKD) is a direct or indirect causes of various comorbidities:
- Diabetes type I and type II
- High blood pressure (Hypertension)
- Glomerulonephritis: It is a condition in which the glomeruli (the filter units of the kidney) are inflamed.
- Polycystic kidney disease, a genetic condition where fluid-filled sacs form in the kidneys.
- Obstruction of the urinary tract due to cancers, kidney stones or cysts.
- Diet which has a high concentration of salt and spices.
- Renal damaging drugs LIKE NSAIDs
- Elimination of Potassium and carbonates from the blood, leading to hypokalemia an hypernatremia.
- Scarring of the nephrons (Kidney cells).
- Cardiovascular disease
- Fluctuation in the body electrolytes like Sodium, Potassium, Chlorine, etc
- Gout – Buildup of uric acid
- Disruption in bone structure and repair
- Fluid retention in the lungs (Pulmonary Edema)
- High serum creatinine levels
- End Stage Renal Disease (ESRD)
DIAGNOSIS OF CKD
- Blood Tests – are conducted to check if the creatinine and urea levels are in the normal range.
- Urine test – to check presence of excess potassium or an elevated levels of electrolytes and waste products.
- Imaging – of the kidneys is done to see if there is any structural change or obstructions in the urinary tract.
- Blood Pressure – to know if the patient has hypertension and the normal range.
- Kidney Biopsy – A sample of the kidney tissue is taken and observed for making detailed inference.
TREATMENTS FOR CKD
- Medicines to treat high blood pressure, like ACE inhibitors, ARBII blockers, CCB’s like Amlodipine, Cilnidipine, etc.
- Diuretics, that are drugs to induce urination, to remove excess build up fluid, like furosemide.
- Iron and hemoglobin promoting supplements.
- Vitamin D supplements.
- In ESRD, renal dialysis or renal transplant is required.
PREVENTION & MANAGEMENT
- Control intake of salt in diet.
- Limit the amount of protein in your diet.
- Lower the potassium concentrated foods like banana, spinach, etc
- Limit intake of sugars, high starch diets or any foods that may contribute to diabetes.
- Increase intake of foods that increase hemoglobin and RBCs.
- Do not abuse medicines like ibuprofen, aspirin, that can contribute to kidney damage.
- Give yourself a break, relieve your stress, high blood pressure will not just put you in stress, but plan to kill you as well.