Chronic Kidney Disease (CKD)
Chronic Kidney Disease
Chronic kidney disease (CKD) is the progressive and irreversible destruction of the kidneys. Your kidneys are essential parts of your body.
Their main functions include:
- helping maintain the balance of minerals and electrolytes in your body (calcium, sodium, potassium, etc.)
- playing an essential role in the production of red blood cells
- maintaining the delicate acid-base (pH) balance of your blood
- excreting water-soluble wastes from your body
Damaged kidneys lose their ability to perform these crucial functions.
Risk Factors of Chronic Kidney Disease
The risk of CKD increases for people older than 65 years. The condition also runs in families. It’s more likely to occur in African-Americans, Native Americans, and Asian-Americans. Other risk factors for CKD include:
- smoking tobacco products (especially cigarettes)
- high cholesterol
- diabetes (Types 1 and 2)
- autoimmune disease
- obstructive kidney disease (including bladder obstruction)
- cirrhosis and liver failure
- narrowing of the artery that supplies your kidney
- kidney cancer
- bladder cancer
- kidney stones
- kidney infection
- systemic lupus erythematosus
- vesicoureteral reflux (a condition where urine flows backward, into your kidney)
Causes of Chronic Kidney Disease
Each kidney contains about 1 million tiny filtering units, called nephrons; any condition that injures or scars this filtering system can cause kidney disease.
There are diseases that can cause Chronic Kidney Disease, including:
High Blood Pressure and Diabetes
Diabetes and high blood pressure both cause serious damage to the nephrons within your kidneys. High blood pressure can also damage the blood vessels of your kidneys, heart, and brain.
Blood Vessel Diseases
Blood vessel diseases are generally dangerous to your kidneys, being that the kidneys are highly vascularized (they contain a large number of blood vessels).
Autoimmune diseases (like lupus) can damage blood vessels and can make antibodies that work against kidney tissue.
Many hereditary conditions, including Polycystic Kidney Disease, can cause Chronic Kidney Disease.
Symptoms of Chronic Kidney Disease
Unfortunately, symptoms of CKD don’t usually appear until most of your kidney has been destroyed. Once the kidney is severely damaged, symptoms begin to appear.
These symptoms can include:
- swelling around your eyes
- swelling of your legs
- shortness of breath
- vomiting (especially in the morning and after eating)
- a urine-like odor to your breath
- bone pain
- abnormally dark or light skin
- an ashen cast to your skin (uremic frost)
- mental cloudiness
- numbness in your hands and feet
- restless leg syndrome
- brittle hair and nails
- weight loss
- a loss of muscle mass
- muscle twitching and cramps
- easy bruising and bleeding
- blood in your stools
- excessive thirst
- decreased interest in sex
- sleep apnea
You may also have the symptoms of any diseases that are contributing to your kidney problems.
Diagnosis of Chronic Kidney Disease
CKD requires a proactive approach to diagnosing because when noticeable symptoms appear it is usually too late. Your doctor should review your medical history. A family history of kidney failure, high blood pressure, or diabetes may alert your doctor. However, other tests are necessary to confirm that you have Chronic Kidney Disease.
These tests include:
Complete Blood Count
A complete blood count can be a good indicator of how well your kidneys are functioning. One important function of your kidneys is the production of erythropoietin, which is a hormone that stimulates your bone marrow to make red blood cells. When kidneys are damaged, this causes a decline in red blood cells, or anemia.
Electrolyte Level Test
Chronic Kidney Disease can affect your electrolyte levels. Common issues with CKD include high potassium levels, low bicarbonate levels, and an increase of acid in the blood.
Blood Urea Nitrogen Test
Blood urea nitrogen levels can become elevated when your kidneys begin to fail. Healthy kidneys clear these byproducts of protein breakdown, however, after kidney damage these byproducts start to build up in your bloodstream. High levels of blood urea nitrogen indicate that your kidneys are not functioning properly, which can be a sign of Chronic Kidney Disease.
As kidney function declines, your creatinine levels increases. This protein is also related to muscle mass.
Parathyroid Hormone (PTH) Test
Your kidneys and parathyroid glands work together to regulate calcium and phosphorus. A change in kidney function affects the release of PTH.
After severe damage, your kidneys can no longer excrete enough phosphorus which impairs Vitamin D synthesis. Ultimately, the calcium is taken from your bones, causing your bones to weaken over time.
A renal scan is an imaging test that helps show kidney function.
This noninvasive test provides images to help your doctor determine whether there’s an obstruction.
Additional tests for Chronic Kidney Disease include:
- Kidney Biopsy
- Bone Density Test
- Abdominal CT Scan
- Abdominal MRI
Treatment of Chronic Kidney Disease
Chronic Kidney Disease results from the irreversible damage of one’s kidneys. Therefore, there is no cure. Treatment focuses on managing symptoms and complications, and treating underlying causes, including hypertension (high blood pressure) and diabetes.
Treatments for Chronic Kidney Disease and End Stage Renal Disease include:
decrease the fat, salt, protein, and potassium in your diet. Reducing salt and fluid intake can help control blood pressure and prevent fluid overload. Be sure to still get adequate calories to maintain your weight. If you have diabetes, restrict your carbohydrate intake.
Be sure you get adequate exercise. Quitting smoking if you smoke can also help.
Supplements and Medication
- Kidney Biopsy
- Iron and Vitamin supplements (to manage anemia)
- Calcium and Vitamin D supplements
- Erythropoietin Injections (to stimulate the production of red blood cells)
- Phosphate Binders
- Stool Softeners (for constipation)
- Antihistamines (for itching)
End-Stage Renal Disease (ESRD) occurs when your kidneys begin to shut down completely. Once your kidney function reduces to 10 percent or less, you may need dialysis or a kidney transplant.
Dialysis is a medical treatment involving a machine that acts as healthy kidneys, used to purify your blood. Chronic Kidney Disease and End-Stage Renal Disease are irreversible, dialysis would be a permanent treatment until a healthy kidney is available for transplant.
You should also talk to your doctor about controlling your blood sugar and diabetes, if you have it.
You may be more susceptible to infection if you have CKD or ESRD.
The following vaccinations are recommended:
- pneumococcal vaccine
- hepatitis B vaccine
- influenza vaccine
- H1N1 (swine flu) vaccine
Complications of Chronic Kidney Disease
- fluid overload
- congestive heart failure
- brittle bones
- weight loss
- electrolyte imbalance
- End-stage renal disease (ESRD)
Outlook of Chronic Kidney Disease
If detected early, there are many countermeasures you can take to help slow the progression of Chronic Kidney Disease. However, if you are diagnosed after your kidneys have already suffered significant damage, or you are diagnosed with ESRD, it is likely that your only option is to start dialysis until a healthy kidney becomes available for transplant.
It is crucial that you talk to your doctor about the health of your kidneys, especially if you have a family history of kidney failure, high blood pressure, or diabetes, in order to avoid total kidney failure.