What If I Have Chronic Kidney Disease Stage 3
Stage 3 means moderate chronic kidney disease. This often means that you are unlikely to need to see a kidney specialist. However, your GP will need to see you regularly for monitoring, including blood and urine tests.
You may need treatments to reduce your risk of progressing to more severe chronic kidney disease. You will probably also need other treatments to reduce your risk of any other problems, particularly cardiovascular diseases .
However if regular blood and urine tests show that your chronic kidney disease is progressing to stage 4 then you will usually need to be referred to a kidney specialist to consider further assessments and treatment.
Stage : Gfr < 15ml/min Kidney Failure
End stage renal disease is the final stage of chronic kidney disease , also known as kidney failure. This occurs when the kidneys function below 10-15 percent and is often a result of years of chronic kidney disease. After being diagnosed with ESRD, it is important to decide what treatment option you will use, such as home dialysis, incenter hemodialysis, transplantation, or palliative care.
How Do Doctors Treat Stage 5 Ckd
You will need to see a nephrologist . Your nephrologist will discuss your treatment options, which include:
- Dialysis, which is a treatment to clean your blood when your kidneys are not able to. Learn more about the two types of dialysis.
- A kidney transplant, which is surgery to give you a kidney from someone else’s body. Learn more about kidney transplants.
Your doctor will help you decide which treatment is best for you and create a plan to manage your kidney disease. As part of the plan, your doctor may give you medicines to help with your symptoms and other health problems kidney disease can cause, such as diabetes and high blood pressure.
These medicines include:
- Blood pressure medicines like ACE inhibitors and ARBs
- Diabetes medicines to keep your blood sugar at a healthy level
- Calcium and vitamin D supplements to keep your bones strong
- Diuretics to help with swelling
- Phosphorus binders, which prevent your body from absorbing phosphorus from foods you eat
- Erythropoiesis-stimulating agents or iron supplements to help with anemia
Your doctor may tell you to stop taking medicines that can damage your kidneys, such as pain medicines called NSAIDs .
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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 chronic kidney disease. For example, it should be done routinely at least once a year in people with stages 1 and 2 CKD, and more frequently in some people with stage 3 and in everyone with stage 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 chronic kidney disease have a known cause for the impaired kidney function, such as a complication of diabetes, high blood pressure or ageing.
- If the chronic kidney disease 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.
What Are The Stages Of Ckd
Your childs stage of CKD is primarily determined by her glomerular filtration rate a measurement of how effectively their kidneys are filtering blood. According to the National Kidney Foundation, there are five stages of chronic kidney disease:
- Stage 1: Kidney damage with normal or increased GFR
- Stage 2: Kidney damage with mild decreased GFR
- Stage 3: Moderate decreased GFR
- Stage 4: Severe increased GFR
- Stage 5: Kidney failure
Keep in mind that this chart is a guide, and every child may experience symptoms differently. Since chronic kidney disease is progressive, many who have it will eventually reach Stage 5, but there are things we can do to slow the progression and minimize complications.
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What Is Stage 1 Ckd
In Stage 1 CKD, the damage to your kidneys is mild. Your kidneys are still working well, but you may have signs of kidney damage or physical damage to your kidneys.
Stage 1 CKD means you have a normal estimated glomerular filtration rate of 90 or greater, but there is protein in your urine . The presence of protein alone means you are in Stage 1 CKD.
At stage 1 CKD, you may not notice any effects on your health. While the damage to your kidneys may not be reversible, there is a lot you can do at this stage to keep your kidneys working well for as long as possible.
What Medications Are Prescribed For People With Chronic Kidney Disease
Depending on the cause of your kidney disease, you may be prescribed one or more medications. Medications your nephrologist may prescribe include:
- An angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker to lower your blood pressure.
- A diuretic to help your body eliminate extra fluid.
- Medications to lower cholesterol levels.
- Erythropoetin, to build red blood cells if you are anemic.
- Vitamin D and calcitrol to prevent bone loss.
- Phosphate binder if your kidneys cant eliminate phosphate.
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What Steps Can I Take To Manage Stage 5 Ckd
At Stage 5 CKD, there is usually no cure and you cannot reverse the damage to kidney function. There are treatment options for kidney failure that can help you live life.
Your doctor will recommend that you:
- Have visits with a nephrologist to check your blood levels and overall health.
- Meet with a dietitian to help you create and follow a kidney-friendly eating plan. Your eating plan may involve limiting certain things to prevent them from building up in your body, such as fluids, potassium, salt or phosphorus. Learn more about a kidney-friendly diet for CKD.
- Keep your blood pressure at a healthy level. They may prescribe blood pressure medicines like ACE inhibitor and ARBs.
- Keep your blood sugar at a healthy level if you have diabetes.
- Be active for at least 30 minutes on most days of the week. This can be anything from walking or riding a bike to swimming or dancing.
- Quit smoking or using tobacco.
The 5 Stages Of Chronic Kidney Disease
By Virginia Irwin-Scott, DO, Nephrologist Virtua NephrologyThe kidneys play an important role in your health, filtering your blood to remove waste, toxins, and excess fluid. They help to regulate your blood pressure, stimulate the production of red blood cells, and keep your bones healthy.So how do you know if your kidneyseach about the size of a fistare not working properly? Unfortunately, in the early stages of chronic kidney disease , the gradual loss of kidney function, you may have few clues. Thats because the body is usually able to cope with a decrease in kidney function. As you generally feel fine, its easy to attribute symptoms to another condition, or ignore them altogether. Often, CKD is only diagnosed if a routine blood or urine test detects an abnormality.
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Ckd Symptoms At Stages 3 And 4
Most people only begin to experience symptoms once they reach stage 3. The most common initial symptoms are:
- Swelling, or edema, in your hands, legs, feet, or ankles as the body is unable to get rid of extra fluid and salt
- Changes in urination habits, peeing more or less than normal
- Kidney pain felt in the back
Additionally, you may have:
- Higher protein levels in urine
- Blood or excessive bubbles in your urine
- Urinary tract infections
- Sleep problems due to muscle cramps or restless legs
What Is The Treatment For Chronic Kidney Disease
Treatment for most cases of chronic kidney disease is usually done by GPs. This is because most cases are mild-to-moderate and do not need 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 need to be investigated by a specialist.
Research studies have shown that in many people, treatment at early stages of chronic kidney disease 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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Enhancing Healthcare Team Outcomes
CKD has a multitude of manifestations and is optimally managed by an interprofessional team of health care professionals who practice at a single location such as a CKD clinic. These clinics focus on guideline-driven kidney care, evaluate and treat complications, suggest patient lifestyle modifications, and provide adequate patient education regarding the various modalities of dialysis. Fishbane et al. compared a standard care model with a healthy transitions program where a nurse care manager works with a protocol-driven informatics system that provides daily reports with incomplete steps of the process for each patient. It showed a reduction in hospitalizations, increased use of AV fistulas, a decrease in emergent dialysis, and less use of catheters. Such models decrease the overall cost of health care by saving billions of dollars.
Evidence shows that an interprofessional approach to chronic renal failure avoids duplication of studies, is cost-effective, results in less patient morbidity, and ensures better outcomes.
Glomerular Filtration Rate: Gfr And Egfr
The main function of the kidneys is to clear water-soluble waste products from the blood. The efficiency of clearance is measured using the GFR
- The GFR is a measure of how much blood is cleaned by the kidneys in one minute. By using a blood test to measure creatinine levels we can calculate the estimated GFR, known as eGFR. We do this using a formula that takes body size into account. The average adult body size is 1.73 m2. A normal GFR is around 100 ml/min/1.73m2
- Because the average normal eGFR is 100, the eGFR can be seen as a percentage of normal kidney function. However, values as low as 60 are considered normal if there is no other evidence of kidney disease
- The eGFR is used to calculate the G stage of CKD
- The eGFR calculation can be inaccurate in people who have much more, or much less muscle than average people of their age, sex, and ethnic origin. For instance, it can be falsely low in body builders, and falsely high in people with anorexia nervosa.
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What Will Happen If My Doctor Suspects Chronic Kidney Disease
Your doctor will want to pinpoint your diagnosis and check your kidney function to help plan your treatment. The doctor will perform these blood and urine tests:
Albumin to creatine ratio urine test: Albumin is a protein that shouldn’t be found in urine and indicates kidney function problems.
Blood test for creatinine: This determines if there is too much creatinine, a waste product, in the blood.
What Do Your Kidneys Do
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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How Do Doctors Treat Stage 1 Ckd
At Stage 1 CKD, doctors mostly focus on slowing down kidney damage and keeping your kidneys working well for as long as possible.
Doctors will work with you to:
- Control your blood sugar if you have diabetes.
- Keep your blood pressure in a healthy range .
If you do not have a nephrologist , talk to your regular doctor about finding one. You and your nephrologist can work together to make a treatment plan just for you.
The Stages Of Chronic Kidney Disease
Chronic kidney disease is a gradual, progressive condition where the kidneys suffer damage over time and lose their ability to properly filter the blood. Approximately 26 million adults in the U.S. have CKD and millions more are at risk. In the early stages, you may not know your kidneys are not working optimally because they have a remarkable ability to compensate. High risk groups include those with diabetes, hypertension , and family history of kidney disease. Early detection and treatment to manage CKD can slow the progression of the disease and prevent kidney failure so it is critical to be tested routinely if you are in a high risk group.
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How Your Child Feels
In addition to the results of these tests, we also look at your childs symptoms and how he feels. Despite having a high creatinine level, if hes feeling well and going to school, its probably not time to go on dialysis or have a kidney transplant.
After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child’s condition. Then well meet with you and your family to discuss the results and outline the best treatment options.
It’s entirely natural that you might be concerned right now about your child’s health a diagnosis of chronic kidney disease can be frightening. But you can rest assured that at Boston Children’s Hospital, your child is in good hands. Our physicians are bright, compassionate and committed to focusing on all of your child’s needs, not just his condition.
Estimated Glomerular Filtration Rate
A normal eGFR is 90 ml/minute/1.73 m or more. If some of the glomeruli do not filter as much as normal then the kidney is said to have reduced or impaired kidney function.
The eGFR test involves a blood test which measures a chemical called creatinine. Creatinine is a breakdown product of muscle. Creatinine is normally cleared from the blood by the kidneys. If your kidneys are not working very well and the glomeruli are not filtering as much blood as normal, the level of creatinine in the blood goes up.
The eGFR is calculated from your age, sex and blood creatinine level. An adjustment to the calculation is needed for people with African-Caribbean origin. See the separate leaflets called Routine Kidney Function Blood Test and Estimated Glomerular Filtration Rate .
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What Can I Expect If I Have Kidney Disease
If you have kidney disease you can still live a productive home and work life and enjoy time with your family and friends. To have the best outcome possible, its important for you to become an active member of your treatment team.
Early detection and appropriate treatment are important in slowing the disease process, with the goal of preventing or delaying kidney failure. You will need to keep your medical appointments, take your medications as prescribed, stick to a healthy diet and monitor your blood pressure and blood sugar.
What Causes Chronic Kidney Disease In Children
Its a complicated question. Remember that chronic kidney disease refers to a state in which the kidneys arent working properly. This could be due to a malformation, a build-up of scar tissue on the kidneys or other causes.
About half of all childhood cases of CKD are due to congenital abnormalities of the kidneys or bladder, such as:
- obstruction to kidneys that can prevent blood from getting to them
- reflux from bladder back up into kidneys that can cause chronic infection
- dysplastic kidneysthat were never formed correctly, and cannot function as they should
For the other half of children with CKD, it may be caused by one or more acquired conditions. Many cases are linked to nephrotic syndrome, a collection of symptoms and signs centered around four major components:
- protein in urine
- low levels of protein in the blood since its being lost in the urine
- swelling in the body , particularly around the ankles and eyes. This happens because the proteins that hold water inside your childs blood vessels are lost in the urine, so water seeps into the bodys tissues.
- high cholesterol – to compensate for the low levels of protein, the body makes fat in the form of cholesterol.
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What Are The Main Causes Of Chronic Kidney Disease
Diabetes and high blood pressure, or hypertension, are responsible for two-thirds of chronic kidney disease cases.
Diabetes: Diabetes occurs when your blood sugar remains too high. Over time, unmanaged blood sugar can cause damage to many organs in your body, including the kidneys and heart and blood vessels, nerves, and eyes.
High blood pressure: High blood pressure occurs when your blood pressure against the walls of your blood vessels increases. If uncontrolled or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes, and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.