Chronic Kidney Disease: Symptoms, Diagnosis, Treatment
Chronic kidney disease is a disease in which there is a slow loss of function of the over a long period of time. Kidney failure is becoming increasingly common with the increase in level of health care and also because it is a complication of 2 of the most common diseases: Heart disease and diabetes.
Kidney failure then leads to many more complications in the body. We will be discussing chronic kidney disease in detail and also provide some pointers to help you avoid it.
There are many symptoms in kidney failure but we will focus on some of the common ones.
Azotemia or Increase in urea levels of blood -
Since excretion from the Kidney is affected, you will tend to accumulate urea in the blood. This can cause mental confusion and sometimes inflammation of the heart muscle.
Increase in Potassium levels of blood -
Urine excretion of potassium is reduced and this causes an increased level of potassium. This will cause disorders in cardiac rhythm and can also lead to muscle weakness or cramps in some cases.
Edema or swelling of the legs is a common symptom. This appears as swelling around the ankles and is because of an increased fluid volume.
Low calcium levels -
The kidney produces a hormone that absorbs calcium. This is reduced and calcium absorption is reduced.
Blood pressure -
Blood pressure may get raised because of the fluid volume increase.
There are many causes of Kidney failure but it is more important to understand why kidney failure occurs rather than the causes. The kidney is an organ with a lot of nephrons and a end vessel supply. These end vessels (they have only one way artery supply) supply one nephron. When there is a reduction in blood flow to the kidney like in cholesterol deposition in atherosclerosis and in diabetes, the nephrons will get damaged or die. This reduces the kidney function.
Other causes of kidney failure can be kidney diseases that occur from birth. These are some metabolic disorders or structural problems in the kidney like polycystic kidney disease. In this, there are multiple cysts in the kidney which causes the damage and eventual failure.
The diagnosis of a kidney failure like any disease is made with both the clinical impression and lab tests. Kidney failure can be detected when a Ultrasound is shown. This will show as a change in the structure of the kidney.
A common blood test used is to check the levels of Urea and creatinine. An increase in the level is used to diagnose the kidney failure. Also, the electrolytes like sodium and potassium are tested regularly to prevent other diseases especially of the heart.
Kidney failure is classified by using the GFR (glomerular filtration rate) which is the amount of urine filtered per minute by the kidney. Here are the details.
Stage 1 -
Slight kidney dysfunction and GFR > 90ml/min
Stage 2 -
Some reduction in GFR. GFR is 60 - 89 ml/min
Stage 3 -
More reduction in GFR. GFR is 30 - 59 ml/min
Stage 4 -
Further reduction of GFR. GFR is 15 - 29 ml/min. Haemodialysis or kidney transplant is needed
Stage 5 -
GFR is less than 15 ml/min. Replacement treatment is absolutely needed.
The treatment of CKD is mostly by correcting the symptoms of CKD or the complications of a CKD. Control of blood pressure is one of the most important components.
Replacement of erythropoietin and calcitriol. These hormones will increase the value of hemglobin and of calcium levels.
Along with this, haemodialysis is recommended for patients of kidney. In some cases such as stage 5 kidney failure, you would need a transplant. This is because the symptoms do not start to recover with just the haemodialysis and a permanent kidney is much better.
A few ways you can prevent kidney disease is by:
- getting regular health exams done (once a year)
- exercising and diet to reduce cholesterol levels
- reducing the amount of salt intake
- exercise frequently and at least 30 mins at a time for 3 days
- see a Doctor if you develop fever or any symptom like edema of the legs or some vague pain