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All About Chronic Kidney Disease

By Ankit Rawal, DO

According to the National Institute of Diabetes and Digestive and Kidney Diseases, the overall prevalence of chronic kidney disease (CKD) is about 14 percent. CKD is a general term that is used to describe a variety of different conditions that may negatively affect the function of your kidneys. The main job of your kidneys is to:

  • Filter blood and remove toxins
  • Produce urine to remove extra water and salt from your body

If your kidney function is decreased, such as in the case of CKD, you may accumulate toxins over time which may make you feel poorly, develop swelling or high blood pressure.

Causes of chronic kidney disease

The two most common causes of chronic kidney disease (CKD) are diabetes and high blood pressure. Many times it is a combination of the two. Over time diabetes leads to very complex changes in the kidney’s filtration system, which ultimately makes the kidneys filter less. High blood pressure also affects the kidneys in a similar manner. In addition to these factors, CKD can be caused by auto-immune diseases (Lupus or Sjogren’s), viruses (hepatitis or HIV) or obstruction of urine flow out of the bladder.

Symptoms of chronic kidney disease

Unfortunately, the symptoms of chronic kidney disease (CKD) usually do not appear until kidney function has decreased significantly (generally 30% or less). Because there are few symptoms, it is important to have your blood checked routinely as recommended by your primary care physician to screen for kidney disease. Every basic blood test includes a creatinine level, which is the way a physician follows and measures kidney function.

You may notice a few of the following signs and symptoms if your kidney function declines significantly:

  • Decreased energy level
  • Daytime drowsiness
  • Diminished appetite
  • Nausea
  • Itching
  • Leg/ankle swelling
  • Worsening of high blood pressure
Diagnosing chronic kidney disease

CKD is diagnosed by a blood test which tells your physician the level of your kidney function. As we age, everyone naturally loses some kidney function (approximately 1% per year after the age of 40). Having less than normal kidney function at a given age can be a sign of underlying kidney disease.

What can I expect if I have chronic kidney disease?

Your doctor will refer you to a nephrologist (kidney specialist). Your nephrologist will analyze your blood work, do their best to pinpoint the reason for kidney disease and work with you to preserve kidney function for as long as possible. On initial evaluation, commonly your nephrologist will obtain a kidney ultrasound to determine their size, shape, and make sure that there are no problems or blockages in the urinary tract. Sometimes a kidney biopsy may be performed to determine the exact cause of kidney disease, if it is in question, to see how much kidney damage is present, and to help plan future treatment. You and your doctor will discuss this further if needed.

Complications of chronic kidney disease

Your kidneys serve many purposes other than cleaning your blood of toxins. As your kidney function declines these other functions decline as well. Some related complications you may notice or need treatment for are:

  • Anemia (low blood count) – your kidneys produce a hormone (erythropoietin) that tells your body to make more red blood cells.
  • Low vitamin D – your kidneys are responsible for converting vitamin D into the active form that your body uses
  • Weak bones – in addition to vitamin D, weak kidneys affect the calcium and phosphorus levels, which are the main components of your bones
Chronic kidney disease treatment

In general, the progression of chronic kidney disease is a slow process. Current therapy focuses on prevention and preserving one’s existing kidney function for as long as possible. The key to treatment is to control the underlying disease process responsible for affecting your kidneys. For diabetics, this means keeping blood sugar under control. For hypertension, this means keeping blood pressure under control. This is dependent upon taking prescribed medications regularly, not missing any doses and maintaining a healthy lifestyle.

Topics and Subtopics: Kidney Disease

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