What Is Chronic Kidney Disease
Chronic kidney disease, sometimes called CKD, is an umbrella term for several conditions that affect the kidneys, but it generally means permanent and usually progressive damage to the kidneys caused by a variety of conditions.
Learn Your ABCs of Kidney Disease
Johns Hopkins nephrologists Drs. Sumeska Thavarajah and Daphne Knicely offer a free educational class most months, from 5 6 p.m. at Johns Hopkins Bayview Medical Center. For more information, call .
Shortness Of Breath After Very Little Effort
Why this happens:
Being short of breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anemia can leave your body oxygen-starved and short of breath.
What patients said:
At the times when I get the shortness of breath, it’s alarming to me. It just fears me. I think maybe I might fall or something so I usually go sit down for awhile.
I couldn’t sleep at night. I couldn’t catch my breath, like I was drowning or something. And, the bloating, can’t breathe, can’t walk anywhere. It was bad.
Feeling Tired It Could Be Your Kidneys
You only get one liver but you get two kidneys; just as well as the kidneys are not as robust as the liver and are not able to repair and renew themselves like your liver can. So, we thought it opportune to remind you that you need to take care of these 2-cashew nut-shaped organs that lie at the back of the abdominal cavity.
Kidney disease is common and contributes to 15% of all hospitalisations and 10% of deaths.
Patients with kidney disease may present with-
- No symptoms at all thus the importance of regular blood and urine tests to check
- Reduction in the amount of urine produced less than 400 ml over 24 hours is abnormal
- Nausea, poor appetite or vomiting
- Fluid retention
The kidneys perform amazing functions
- Your kidneys filter your blood stream removing the waste products of metabolism from your blood, as well as any drugs you may be taking.
- They control the balance of salt and potassium in your blood.
- They make the hormone called erythropoietin which stimulates your bone marrow to produce red blood cells which carry oxygen to your cells; thus, your energy levels reflect your kidney function
- They make the enzyme called renin which exerts control over your blood pressure
Tests for kidney function include
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Blood And Urine Tests For Kidney Disease
Routine blood and urine testing performed by your doctor will uncover early signs of kidney disease. Regular testing is especially advised if you have risk factors like high blood pressure, diabetes, kidney cancer or family history of kidney disease. When your kidney functioning starts to drop, your doctor can advise lifestyle changes and medicines to slow the progression of disease.
Many people do not visit doctors regularly and are diagnosed with kidney disease after it has become serious. These blood and urine tests become important measures of how the disease is progressing.
Food Tastes Like Metal
Why this happens:
A build-up of wastes in the blood can make food taste different and cause bad breath. You may also notice that you stop liking to eat meat, or that you are losing weight because you just don’t feel like eating.
What patients said:
Foul taste in your mouth. Almost like you’re drinking iron.
I don’t have the appetite I had before I started dialysis, I must have lost about 10 pounds.
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You Can Have Anemia And Not Know It
Allen says he didnt know he had anemia. I didnt know I had a problem until my doctor did a blood test, he says. Make sure you see your doctor. Its a serious disease.
Anemia is most common in people who have diabetes, heart disease or high blood pressure, or who are African-American or older than 75. Anemia can happen with or without symptoms, and many of the symptoms can also be caused by other problems. The only way to be sure you have anemia is to get a blood test.
Why Polycystic Kidney Disease Patients Always Feel Tired
Polycystic Kidney Disease causes damages to the kidneys and tiredness is a common experience for the patients. Why patients always feel tired? It is caused by the different toxins building up in patients blood.
Why Polycystic Kidney Disease Patients Always Feel Tired?
Polycystic Kidneys and Kidney Function
Kidneys work to filter the waste products and excessive water in the blood. As the cyst enlarging gradually, the nearby kidney tissues will be affected, which causes kidney function decline. When kidneys cannot function well, the waste products will deposit in the body. Different toxins will lead to different symptoms in patients.
What toxins are related to the tiredness in patients with PKD?
Creatinine is the waste products of muscular metabolism, which is produced when muscle moves. When creatinine builds up in the blood, it will increase the risk of cell to die and causes fatigue and drowsiness etc.
Polyamine is a waste products, which can causes poor appetite, vomiting, proteinuria etc. It also can improve the dissolution of red blood cells and restrain the production of hemopoietin, causing renal anemia. Anemia is another cause for tiredness.
Urea and Guanidine are toxic to the nervous system. When there is disorder in nervous system, patients may feel cramps, tiredness, low interest in sex etc.
How to alleviate the tiredness in PKD patients?
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I Am Always Weak And Tired: Reflections On Living With Anemia
When the American Kidney Fund launched the ACT on Anemia campaign last year, our goal was to increase awareness of the connection between chronic kidney disease and anemia.
Because the kidneys help regulate the production of red blood cells, anemia is a common side effect of kidney disease. In fact, anemia can be an early warning sign of CKD, and it often gets worse as CKD gets worse.
But neither anemia nor CKD is well understood. A quiz on our website helps people find out their risk for anemia and how to identify symptoms of anemia.
We reached out to some of the people who took the quiz to find out what their experience with anemia is like. Heres what they told us.
Upset Stomach Nausea Vomiting
Why this happens:
A severe build-up of wastes in the blood can also cause nausea and vomiting. Loss of appetite can lead to weight loss.
What patients said:
I had a lot of itching, and I was nauseated, throwing up all the time. I couldn’t keep anything down in my stomach.
When I got the nausea, I couldn’t eat and I had a hard time taking my blood pressure pills.
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Chronic Kidney Disease Stage 4 And Daytime Sleepiness
The symptoms of advanced kidney disease, such as CKD stage4 or stage 5, may happen very slowly and mildly and the patient may fail to notice the change. Daytime sleepiness is a good example.
Daytime sleepiness means feeling tired and sleepy in which people may fail to keep the eyes open during the daytime. Sleepiness in a person is physically identified by consistent yawning and inattentive behavior. Daytime sleepiness can be a consequence of many diseases or bad living habits and it is also a physical change in patients with CKD stage 4 or Stage5.
Why Daytime Sleepiness happens in patients with advanced Kidney Disease Stage?
It was reported that daytime sleepiness and its causes that daytime sleepiness is in facta consequence of sleep deprivation. What should be blamed for sleep deprivation in CKD sufferers?
There are 3 major causes which should be responsible for the sleep deprivation, namely restless leg syndrome, sleep apnea, inadequate Dialysis clearance.
The severity of restless leg syndrome varies from patient to patient. However, because restless leg syndrome occurs when you are trying to relax or fall asleep, it can leave you feeling tired from lack of rest.
Many patients do not remember the apneas they experienced during the night. However, because their sleep is interrupted, they will often feel tired and drowsy during the day.
How to manage the daytime sleepiness in CKD stage4?
With Treatment Anemia Is Manageable
All respondents agree that treatment of anemia is important to their quality of life. With the right diet and nutrients, plus medications, anemia can be alleviated, says Brenda. With renal disease healing a person with anemia is quite a task, but it can be done.
Joyce says its important to ask questions: Work with your anemia doctor to manage your anemia. Dont be afraid to ask questions or get second opinions. Work with your dietitian.
Even with treatment, living with anemia can be challenging. Be realistic about the fact that you have anemia and dont get depressed when youre not able to all of the physical things that you want to do, says Deborah. When you feel exhausted, take a nap.
Brenda suggests that you test your limits to see what can be done easily as well as the hard things. And, always keep your spirit upbeat ALWAYS!
To learn more about anemia and chronic kidney disease, visit KidneyFund.org/anemia. The ACT on Anemia campaign is made possible by Akebia Therapeutics, Inc.
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Anemia Affects Many Aspects Of Their Lives
Two hallmark symptoms of anemiatiredness and feeling coldcame up over and over in the responses. For some, the tiredness is debilitating: I had to stop working because I was always falling asleep on the job, says Barbara. Cynthia tells us that anemia also affected my livelihood. I was bedridden most of the time. Another respondent, Deborah, notes that With anemia, I have intermittent tiredness. It often prevents my performing some of my daily routines and affects plans that I make.
Brenda says anemia makes her lethargic. I do try to conserve energy for very important things, she says. Sometimes there is success, sometimes not.
Study Design Setting And Participants
This is a prospective cohort study of consecutively recruited outpatients with CKD-ND. Institutional Review Board approval was obtained in accordance with the ethical standards. CKD-ND patients were approached consecutively during routine clinic visits at the Dallas Veterans Affairs Medical Center. Prior to enrollment, written informed consent was obtained. Inclusion criteria were stages 25 CKD-ND and the ability to participate in informed consent. CKD-ND was defined as either estimated glomerular filtration rate <60 mL/min/1.73 m2 or eGFR 6089 with another marker of kidney disease, such as albuminuria, proteinuria, hematuria, or abnormal pathology on kidney imaging or biopsy, present for at least 3 months prior to enrollment. Stage 2 CKD-ND was defined eGFR 6089 with another marker of kidney disease; stage 3, eGFR 3059; stage 4, eGFR 1529; and stage 5, eGFR <15 . Patients on chronic peritoneal dialysis or hemodialysis and kidney transplant recipients were excluded.
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Stage 3 Kidney Disease
Kidney disease happens when the kidneys become damaged, inhibiting their ability to filter waste from the blood. This isn’t a sudden event; rather, kidney function is lost slowly over time. Kidney disease is divided into five stages, according to the glomerular filtration rate . GFR measures kidney function, with respect to your age, gender, ethnic origin, and levels of serum creatinine. Stage 3 kidney disease can be further divided into stage 3A, with 45-59 mL/min GFR, and stage 3B, 30-44 mL/min GFR, according to research by DaVita, a dialysis services provider.
Living With Stage 3 Kidney Disease
Aside from taking your prescribed medications and eating a healthy diet, adopting other lifestyle changes can help you manage CKD stage 3. Talk to your doctor about the following:
- Exercise. Aim for a minimum of 30 minutes of moderate activity per day on most days of the week. A doctor can help you begin an exercise program safely.
- Blood pressure management. High blood pressure can be a precursor for CKD, and it can make your condition worse. Aim for a blood pressure of 140/90 and below.
- Stress management. Techniques can include exercise, getting better sleep, and meditation.
- Smoking cessation. Talk to a doctor about the right methods of quitting smoking for you.
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Factors Contributing To Fatigue
The causes of fatigue in individuals with ESRD remain poorly understood. Fatigue can be experienced regardless of race, gender, and age. depicts recent studies that have examined the association of demographic factors with fatigue and the fatigue measure utilized, design, strengths, and weaknesses of these studies. Based on examined studies, there is inconclusive evidence regarding difference in prevalence among race, gender, or age for those living with ESRD.
Why Kidney Failure Patients Always Feel Tired
Having treated many patients within more than two years, I usually come across this condition: many patients with kidney failure complain weakness, tiredness or fatigue. Why patients with kidney failure always feel tired?
Actually, there are many possible causes for tiredness, weakness, etc. but the most common causes for patients with kidney failure are mainly anemia, electrolytes disturbance, including low sodium, low potassium, etc. acidosis, and so on.
First, anemia: it is a very common complication among patients with kidney failure, because one of the kidney functions is to secrete erythropoietin, prostaglandin, etc. erythropoietin can promote hemoglobin synthesis, while hemoglobin is the raw material for red blood cells, and its major function is to transport oxygen and carbon dioxide. Once kidney is impaired to certain extent, generation of erythropoietin will be reduced, as a result, hemoglobin decreases. Accordingly, generation of red blood cells and its transportation function will be affected. Lack of oxygen in brain will lead to dizziness and tiredness. That is why anemia causes tiredness.
Second, electrolytes disturbance, for example, low sodium can cause change of nerve-muscle irritability, such as decreased muscular tension, weak tendon reflex, duly leading to tiredness; Or low potassium can cause decrease of nerve-muscle excitability and conductivity, then patient also feel tired.
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Clinical Management Of Fatigue
Fatigue in this patient population is unique due to the multidimensional nature of dialysis, and in turn, is difficult to manage. Effective treatment of fatigue is further complicated in this patient population because we do not understand the cause of fatigue. Currently, there is nominal research examining genetic associations with fatigue. Some research has examined potential medical treatment options for fatigue, such as the correction of anemia and physical activity to improve clinical outcomes with varying success . Many of the research studies examining interventions to prevent or mitigate fatigue in individuals with ESRD are limited by small sample sizes and a lack of randomization . Interventions to prevent and mitigate fatigue include pharmacological and non-pharmacological strategies . Pharmacological interventions to mitigate fatigue include vitamin C and L-carnitine . Nonpharmacological interventions to mitigate fatigue include exercise, acupressure, trans cutaneous electrical acupoint simulation , psychological interventions, and correction of anemia . depicts the most recent and sentinel studies addressing pharmacological and non-pharmacological interventions for fatigue in individuals with ESRD.
Fatigue Being Tired All Of The Time
Why this happens:
Healthy kidneys make a hormone called erythropoietin , or EPO, that tells your body to make oxygen-carrying red blood cells. As the kidneys fail, they make less EPO. With fewer red blood cells to carry oxygen, your muscles and brain tire very quickly. This is anemia, and it can be treated.
What patients said:
I was constantly exhausted and didn’t have any pep or anything.
I would sleep a lot. I’d come home from work and get right in that bed.
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Sleep Issues And Chronic Kidney Disease
People with chronic kidney disease often have trouble falling asleep and staying asleep. Your physical and mental health can contribute to your sleep problems. These are some common causes for disrupted sleep patterns in kidney disease patients.
Restless leg syndrome
Restless leg syndrome often occurs when the legs are at rest, such as when a person is sitting or lying in bed. The sensation varies from patient to patient. It can be irritating, itchy or painful. Some patients find that moving their legs makes the uncomfortable sensations lessen or go away entirely.
Doctors have ;determined that iron deficiency, caffeine, alcohol, tobacco, diabetes and certain medications can contribute to RLS.
Sleep apnea causes your breathing to be interrupted or stopped for more than 10 seconds while youre in a deep sleep. These non-breathing intervals are called apneas. Patients with sleep apnea often snore heavily. The snores continue until breathing is interrupted or stops, which signals an apnea. The person will then snort or gasp to take in air and the snoring continues until the next apnea.
A doctor can determine if you have sleep apnea by conducting a physical exam and a sleep study.
Inadequate dialysis clearance
Worry, anxiety and sadness can keep you up at night. If your sadness, anxiety or depression lasts more than two weeks, tell your doctor immediately.
Changes in your sleep pattern
For those on cycler-assisted PD
Adjust your sleep clock
Testing For Kidney Disease
If you or someone you love is at risk for developing kidney disease and begins experiencing any of the above symptoms, it is crucial to make an appointment with a doctor for blood and urine tests right away.
The blood test that indicates how well the kidneys are working measures creatinine, a waste product. When kidney function is compromised, the organs have difficulty removing creatinine from the blood. A patients creatinine levels are then used in a formula that takes their age, sex and race into account to determine their glomerular filtration rate . A persons GFR describes their overall level of kidney function.
Urinalysis is important for determining kidney health as well. A urine test to measure the amount of albumin, a type of protein, in the urine can point to compromised kidney function. Repeated tests that are positive for protein in the urine are an indicator of kidney disease.
These simple tests are vital for those who are at risk of developing kidney disease. Without prompt diagnosis and treatment, end-stage renal disease can be fatal. However, if CKD is caught early on, lifestyle changes and medications to control high blood pressure, cholesterol levels, anemia and swelling can be effective in slowing down the progression of kidney disease and minimizing complications.
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