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How Can We Identify Kidney Problems

Diagnosing Kidney Disease In Adults

Daring to Ask: How can we provide personalized medicine for patients with kidney disease?

At NYU Langone, specialists called nephrologists diagnose and manage kidney disease. In this chronic condition, the kidneys slowly lose their ability to filter waste from the blood. If this condition isnt managed, it can lead to kidney failure, in which one or both kidneys no longer function. Some people may experience acute kidney failure, in which the organs fail in less than two days.

The kidneys are small, bean-shaped organs, each about the size of a fist, located under the rib cage in the back. They have several important functions, including removing digested food, chemicals, medication, and other waste products from the blood. These are then excreted in urine.

The kidneys also balance the bodys levels of fluids and electrolytes, such as phosphorus, potassium, and sodium. These are essential for the proper functioning of the heart, muscles, and other structures. The kidneys also make hormones that help regulate blood pressure, stimulate the production of red blood cells, and strengthen bones.

When the kidneys are not able to function properly, the body retains toxins and excess fluid and can fail to make enough red blood cells, which carry oxygen to organs and tissue.

Some people with chronic kidney disease experience no symptoms. They may receive a diagnosis only after having blood or urine testing for another condition.

What You Need To Know

You have two kidneys, located near the middle of your back, just below the rib cage. Each is about the size of your fist. Tiny structures called nephrons are inside each kidney and they filter the blood. There are about a million of them.

The kidneys are responsible for removing wastes, toxins and extra water from the body; balancing important salts and minerals in the blood; and releasing hormones to help control blood pressure, manage anemia and help maintain strong bones. The waste and extra water removed by the kidneys become urine. The urine flows through tubes called ureters. It goes to your bladder, which stores the urine until you go to the bathroom.

When the kidneys are damaged, they can’t filter blood as they should. The result can be a build-up of wastes in your body, as well as other problems that can harm your health.

One in three American adults is at high risk for developing kidney disease today. Yet most arent able to identify the signs and symptoms. One in nine American adults has kidney disease and most dont know it.

At first, kidney disease is silent. Symptoms often dont appear until the kidneys are badly damaged. Many people don’t have any symptoms until their kidney disease is advanced. Blood and urine tests are the only way to know if you have kidney disease.;

What Are The Treatment Options For Kidney Failure

If you have kidney failure , you will need dialysis or a kidney transplant to live. There is no cure for ESRD, but many people live long lives while on dialysis or after having a kidney transplant.

There are just a few options for treating kidney failure, including kidney transplant and several types of dialysis. Your doctor can help you figure out which treatment is best for you. Learn more about the treatment options for kidney failure.

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Early Warning Signs Of Kidney Disease

As we all know every human body has two kidneys, which are primarily responsible for filtering the blood free of the nitrogenous waste products like urea, creatinine, acids, etc. and produce urine.

Millions of people are living with various types of kidney diseases and most of them dont even have the faintest idea about it. This is why kidney disease is often known as a Silent Killer as most people do not feel any difference until the disease is advanced. While people get their blood pressure, sugar and cholesterol levels checked on a regular basis, they fail to get a simple creatinine test done in their blood, to detect any unidentified kidney problems. According to the Global Burden Disease study in 2015, chronic kidney disease is ranked as the eighth leading cause of mortality in India.

There are a number of warning signs of a kidney disorder, however, most of the time these are ignored or confused with alternative pathologies . Therefore, one has to be very watchful and should get the confirmatory tests done at the earliest appearance of any sign of a kidney disorder. One should visit a Nephrologist and clarify his/her doubts. But if you have hypertension, diabetes, obesity, metabolic syndrome as one calls it in todays age, or Coronary Artery Disease, and/or a family history of the same or a family history of kidney failure or even if youre older than 60 years of age, it is advisable to get kidney tests done on a regular basis.

What Do Your Kidneys Do

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You have two kidneys. They are bean-shaped organs that are located toward your back, on either side of your spine, just underneath the rib cage. Each kidney is about the size of your fist.

Your kidneys have many jobs, but their main job is to filter your blood, getting rid of toxins and excess salt and water as urine. If your kidneys are damaged and dont work as they should, wastes can build up in your blood and can make you sick. Your kidneys also balance the amount of salts and minerals in your body, make hormones that control blood pressure, make red blood cells and keep your bones strong.

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Do I Need Any Further Tests

As mentioned, the eGFR test is done to diagnose and monitor the progression and severity of CKD. For example, it should be done routinely at least once a year in people with stages 1 and 2 CKD, and more frequently in those with stage 3, 4 or 5 CKD.

You are likely to have routine urine dipstick tests from time to time to check for blood and protein in the urine. Also, blood tests may be done from time to time to check on your blood level of chemicals such as sodium, potassium, calcium and phosphate. The need for other tests then depends on various factors and your doctor will advise. For example:

  • An ultrasound scan of the kidneys or a kidney biopsy may be advised if certain kidney conditions are suspected. For example, if you have a lot of protein or blood in your urine, if you have pain that seems to be coming from a kidney, etc.
  • A scan or having a sample taken is not needed in most cases. This is because most people with CKD have a known cause for the impaired kidney function, such as a complication of diabetes, high blood pressure or ageing.
  • If the CKD progresses to stage 3 or worse then various other tests may be done. For example, blood tests to check for anaemia and an altered level of parathyroid hormone . PTH is involved in the control of the blood level of calcium and phosphate.

Five Organs May Be Affected By Kidney Failure

At present, no matter nephrologists or kidney patients, they are more concerned about which foods, drugs and behaviors can damage the kidney, and which diseases can damage the kidney, as well as proteinuria, serum creatinine and other indicators. They seldom concern after kidney damage, which organs will be affected. After all, the kidney is not an isolated organ. In other words, a person with kidney disease whose creatinine levels rise rapidly is more likely to have heart, liver, brain, lung, gastrointestinal tract and other problems. Which organs will be affected by kidney failure?

1. Lung

Acute lung injury is a common complication of kidney disease.

In patients with end-stage renal disease , the accumulation of toxins in the body may have adverse effects on pulmonary ventilation. Fluid overload can cause alveolar edema and metabolic acidosis, leading to hyperventilation in kidney patients.

In clinical practice, respiratory complications caused by acute kidney injury, include pulmonary edema and respiratory failure, which often require mechanical ventilation, and mechanical ventilation time is longer, and the possibility of withdrawal is less.

2. Heart

The heart and kidney are connected, so damage to one organ can lead to dysfunction of another organ, which is clinically known as cardiorenal syndrome .

3. Brain

The lower the kidney function, the higher the creatinine, and the more severe the brain damage.

4. Liver

5. Gastrointestinal tract

Summary

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What Clinical Studies For Anemia In Ckd Are Looking For Participants

You can view a filtered list of clinical studies on anemia in CKD that are open and recruiting at www.ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure they are safe. Always talk with your health care professional before you participate in a clinical study.

What Is Kidney Dialysis

How Can we recognize Kidney failure or kidney diseases

Because there is no cure for CKD, if you are in late-stage disease, you and your healthcare team must consider additional options. Complete kidney failure, left untreated, will result in death. Options for end stages of CKD include dialysis and kidney transplantation.

Dialysis is a procedure that uses machines to remove waste products from your body when your kidneys are no longer able to perform this function. There are two major types of dialysis.

Hemodialysis: With hemodialysis, your blood is circulated through a machine that removes waste products, excess water and excess salt. The blood is then returned to your body. Hemodialysis requires three to four hours, three times a week and is performed at a clinic, hospital or dialysis center.

Peritoneal dialysis: In peritoneal dialysis, a dialysis solution is run directly into your abdomen. The solution absorbs waste and then is removed via catheter. Fresh solution is added to continue the process of cleaning. You can perform this type of dialysis yourself. There are two types of peritoneal dialysis: continuous ambulatory peritoneal dialysis , which involves a change in dialysis solution four times a day; and continuous cycling peritoneal dialysis . CCPD uses a machine to automatically fill, remove wastes, and refill the fluid during the nighttime.

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Blood Tests For Kidney Disease

The best measure of kidney function is the glomerular filtration rate , which can be estimated from a blood test that checks the blood for creatinine .;

A normal GFR result is higher than 90 mL/min/1.73 m2. If the result is persistently less than 60 mL/min/1.73 m2 for at least three months, this confirms that the person has chronic kidney disease.;

Blood tests can reveal other abnormalities of kidney function, such as:;

  • high levels of acids
  • anaemia
  • high levels of potassium
  • low levels of salt
  • changes to the levels of calcium and phosphate.

When Should I Call The Doctor

A nephrologist receives special training in kidney evaluation and treatment. You may benefit from a kidney specialists expert opinion if:

  • You have trouble keeping your blood pressure levels in a normal range, even with medication.
  • Your blood sugar levels fluctuate widely.

Last reviewed by a Cleveland Clinic medical professional on 01/11/2018.

References

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What Are The Symptoms Of Kidney Failure

In early stages of kidney disease, many people experience few or no symptoms. Its important to note that chronic kidney disease can still cause damage even though you feel fine.

Chronic kidney disease and kidney failure can cause different symptoms for different people. If your kidneys arent working properly, you may notice one or more of the following signs:

  • Fatigue
  • Poor appetite or metallic taste of food

Treatment For Kidney Disease

kidney

If detected early enough, the progress of kidney disease can be slowed and sometimes even prevented. In the early stages, changes to diet and medication can help to increase the life of your kidneys.;

If kidney function is reduced to less than 10 per cent of normal, the loss of function must be replaced by dialysis or a kidney transplant. Dialysis is a treatment for kidney failure that removes waste products and extra water from the blood by filtering it through a special membrane .;

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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 .

What Are The Complications Of Anemia In Someone With Ckd

In people with CKD, severe anemia can increase the chance of developing heart problems;because the heart is getting less oxygen than normal and is working harder to pump enough red blood cells to organs and tissues. People with CKD and anemia may also be at an increased risk for complications due to strokes.

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Can Kidney Failure Be Prevented

While kidney failure from chronic kidney disease cant be reversed, you can do many things to help preserve the kidney function you have today. Healthy habits and routines may slow down how quickly kidneys lose their functional abilities.

If you have chronic kidney disease or kidney failure, youll want to:

  • Monitor your kidney function, with your doctors help.
  • Keep your blood sugar levels under control, if you have diabetes.
  • Keep your blood pressure levels in a normal range.
  • Avoid smoking.
  • Make healthy diet choices, such as limiting foods high in protein and sodium.

Chronic Kidney Disease: Detection And Evaluation

How can I prevent kidney disease and its progression?

TODD GEHR, MD, Virginia Commonwealth University School of Medicine, Richmond, Virginia

Am Fam Physician.;2011;Nov;15;84:1138-1148.

Chronic kidney disease affects an estimated 27 million adults in the United States, and is associated with significantly increased risk of cardiovascular disease and stroke. Patients should be assessed annually to determine whether they are at increased risk of developing chronic kidney disease based on clinical and sociodemographic factors. Diabetes mellitus, hypertension, and older age are the primary risk factors that warrant screening. Other risk factors include cardiovascular disease, family history of chronic kidney disease, and ethnic and racial minority status. Serum creatinine levels can be used to estimate the glomerular filtration rate, and spot urine testing can detect proteinuria. After the diagnosis of chronic kidney disease is made, staging based on estimated glomerular filtration rate determines prognosis, evaluation, and management. Further evaluation should focus on the specific type of kidney disease and on identifying complications related to the disease stage. Patients should be assessed for risk factors leading to the further loss of kidney function and cardiovascular disease. Patients with estimated glomerular filtration rates less than 30 mL per minute per 1.73 m2, significant proteinuria, or rapid loss of kidney function should be referred to a nephrologist for further evaluation and management.

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How Common Is Anemia In Ckd

Anemia is common in people with CKD, especially among people with more advanced kidney disease. More than 37 million American adults may have CKD,1 and it is estimated that more than 1 out of every 7 people with kidney disease have anemia.2

Most people who have kidney failurewhen kidney damage is so advanced that less than 15 percent of the kidney is working normallyalso have anemia.3

What Is The Treatment For Chronic Kidney Disease

Treatment for most cases of CKD is usually done by GPs. This is because most cases are mild-to-moderate and do not require any specialist treatment. Your GP may refer you to a specialist if you develop stage 4 or 5 CKD, or at any stage if you have problems or symptoms that require specialist investigation.

Research studies have shown that, in many people, treatment at early stages of CKD can prevent or slow down progression through to eventual kidney failure.

The aims of treatment include:

  • If possible, to treat any underlying kidney condition.
  • To prevent or slow down the progression of CKD.
  • To reduce the risk of developing cardiovascular disease.
  • To relieve symptoms and problems caused by CKD.

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What Is The Outlook

Stages 1-3 CKD are common, with most cases occurring in older people. It tends to become gradually worse over months or years. However, the rate of progression varies from case to case, and often depends on the severity of any underlying condition. For example, some kidney conditions may cause your kidney function to become worse relatively quickly. However, in most cases, CKD progresses only very slowly.

For many people with CKD there is a much higher risk of developing serious CVD than of developing end-stage kidney failure.

In short, the following can make a big difference to your outlook :

  • Attention to blood pressure control.
  • Careful review of medications to make sure that the only ones used are those which put least strain on kidneys.
  • Tackling factors that reduce your risk of developing CVDs.

Diabetes And Kidney Disease

Pin by Cherie Bailey on Kidneys in 2020

About 20 to 30 per cent of people with diabetes develop a type of kidney disease called diabetic nephropathy. This is a serious disease and may worsen other diabetic complications such as nerve and eye damage, as well as increasing the risk of cardiovascular disease.;

Diabetic nephropathy is the main cause of kidney failure;.;

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What Is Kidney Disease

Kidney disease can affect your bodyâs ability to clean your blood, filter extra water out of your blood, and help control your blood pressure. It can also affect red blood cell production and vitamin D metabolism needed for bone health.

Youâre born with two kidneys. Theyâre on either side of your spine, just above your waist.

When your kidneys are damaged, waste products and fluid can build up in your body. That can cause swelling in your ankles, nausea, weakness, poor sleep, and shortness of breath. Without treatment, the damage can get worse and your kidneys may eventually stop working. Thatâs serious, and it can be life-threatening.

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