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What Is Chronic Kidney Disease

What Is Kidney Disease

Chronic kidney disease – causes, symptoms, diagnosis, treatment, pathology

Having kidney disease means that there is damage to your kidneys and they arent working as well as they should. Kidney disease is called chronic because kidney function slowly gets worse over time. Kidney disease leads to kidney failure, which is also called end-stage kidney disease. At this point, youll need dialysis or a kidney transplant.

Anemia And The Role Of Erythropoietin In Ckd

Anemia is among the most common complications of CKD. In a study that included 19 CKD cohorts from across the world, 41% of the 209 311 individuals had low levels of hemoglobin .92 The initial workup of anemia should include assessment of iron stores: those who are iron deficient may benefit from oral or intravenous iron repletion. Patients with hemoglobin levels persistently below 10 g/dL despite addressing reversible causes can be referred to a nephrologist for consideration of additional medical therapy, including erythropoietin-stimulating agents however, erythropoietin-stimulating agents have been associated with increased risk of death, stroke, and venous thromboembolism, and these risks must be weighed against any potential benefits.93

What Are The Symptoms Of Chronic Kidney Disease

About 90% of people with kidney disease don’t realize that they have it, says the NKF.

“Most patients don’t develop signs of the disease until it’s fairly advanced,” Staci Leisman, MD, a kidney specialist at Mount Sinai Hospital in New York City tells Health. That being said, there may be some symptoms that start earlier, she notes. These include:

Swollen ankles and feet. As your kidney function goes down, your body is less able to filter out salt, explains Dr. Leisman. It can build up, causing swelling in your feet and ankles .

Anemia. When you have kidney disease, your kidneys have trouble producing erythropoietin , a hormone that tells your body to make red blood cells, explains the NIDDK. As a result, your red blood cell count drops. Your doctor may pick this up on a routine lab test, or you may notice that you feel weak and tired, and have other symptoms such as dizziness, shortness of breath, and trouble thinking clearly.

A metallic taste in your mouth. When you have kidney disease, waste products build up in your body, including one known as urea, says Dr. Leisman, which can affect your taste buds.

Peeing more at night. When your kidney filters are damaged, you can feel the urge to pee more often. This can be especially noticeable at night when you lie down, since the extra fluid around your ankles, feet and legs can now flow up to your kidneys, explains Dr. Leisman.

Later signs of kidney disease include:

  • Trouble concentrating.
  • Blood or “foamy” urine.

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Electrolyte Mineral And Bone Abnormalities In Ckd

Electrolyte abnormalities are present in 3% to 11% of patients with CKD.92 Initial treatment strategies usually involve dietary restrictions and prescription of supplements. For example, primary care clinicians should recommend low-potassium diets for patients with hyperkalemia and low-phosphorus diets for patients with hyperphosphatemia.5,18,94,95 For patients with a serum bicarbonate level persistently below 22 mmol/L, oral bicarbonate supplementation should be considered, as studies have suggested that chronic metabolic acidosis is associated with faster CKD progression.5,18,9699

Mineral and bone disorders are also common. In a study that included 42 985 patients with CKD, 58% had intact parathyroid hormone levels greater than 65 pg/mL.92 Although the optimal intact parathyroid hormone level for CKD remains unclear, most nephrologists agree that concomitant hyperphosphatemia, hypocalcemia, and vitamin D deficiency should be addressed, such as with a low-phosphate diet, phosphate binders, adequate elemental calcium intake, and vitamin D supplementation .94,95

What You Need To Know

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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.

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What Causes Chronic Kidney Disease

Chronic kidney disease is caused by damage to the kidneys. The most common causes of this damage are:

  • Uncontrolled high blood pressure over many years.
  • High blood sugar over many years. This happens in uncontrolled type 1 or type 2 diabetes.

Other things that can lead to chronic kidney disease include:

  • Kidney diseases and infections, such as polycystic kidney disease, pyelonephritis, and glomerulonephritis, or a kidney problem you were born with.
  • A narrowed or blocked renal artery. A renal artery carries blood to the kidneys.
  • Long-term use of medicines that can damage the kidneys. Examples include non-steroidal anti-inflammatory drugs , such as celecoxib and ibuprofen.

Who Created Who Came Up With The Kidney Disease Solution Program

The Kidney Disease Solution was created by Duncan Capicchiano and his wife, Fiona Chin, from Melbourne, Australia. They started a wellness clinic in Melbourne with more than 13 health professionals who are natural.

As fully qualified Naturopaths and Naturopaths, they have a combined background in herbal and natural therapy.

The program started as an alternative treatment method for Fionas grandmother, suffering from stage-4 renal failure. The couple devised an all-natural treatment plan that helped improve her condition in only 12 weeks. After six months, her condition changed from stage 4 to stage 1, and she lived healthily for the remainder of 10 years.

After the success they have had with Fionas grandmother They decided to start a company and share their treatment approach to those suffering from kidney disease.

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Chronic Kidney Disease Is A Long

The following information is also available as a downloadable leaflet:Chronic kidney disease leaflet

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What is CKD?

Chronic kidney disease means that your kidneys do not work as well as they should. They cant remove waste products from your body. Damage to the kidneys filter system can also allow blood and protein to leak into the urine. This is not always visible but can be found with a urine test.

The term chronic means that it is a long-term condition. It does not necessarily mean your kidney damage is severe as many cases of CKD are mild and can be managed with help from your GP and without hospital involvement.

Think Kidneys – www.thinkkidneys.nhs.uk

How is CKD diagnosed?

Most people are diagnosed by a blood and urine test. You may have these tests as part of a routine check-up or because you are at risk of developing CKD

Once you are diagnosed your doctor will work out what stage of CKD you have. This is done by measuring the amount of creatinine, a waste product which builds up in kidney disease. Your doctors can use this to estimate how well your kidneys are working. You may hear this referred to as your estimated glomerular filtration rate . It is based on how quickly your kidneys are cleaning your blood and is measured in milliliters per minute

Is it common?

Reducing Risk Of Cardiovascular Disease

What is Chronic Kidney Disease and how does dialysis work?

The prevalence of cardiovascular disease is markedly higher among individuals with CKD compared with those without CKD. For example, in a Medicare 5% sample, 65% of the 175 840 adults aged 66 years or older with CKD had cardiovascular disease compared with 32% of the 1 086 232 without CKD.47 Moreover, presence of CKD is associated with worse cardiovascular outcomes. For example, in the same population, the presence of CKD was associated with lower 2-year survival in people with coronary artery disease , acute myocardial infarction , heart failure , atrial fibrillation , and cerebrovascular accident/transient ischemic attack .47

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Blood And Urine Tests

If your doctor thinks you might have chronic kidney failure, they will order blood and urine tests.

Blood tests for kidney function measure the levels of electrolytes and waste in your blood. They measure waste products such as creatinine and blood urea. Creatinine is a byproduct of muscle metabolism. Blood urea is leftover when your body breaks down proteins. When your kidneys are working properly, they excrete both substances.

Urine tests will be performed to check for abnormalities. For example, protein is normally only present in trace amounts in your urine. An elevated protein level might indicate kidney problems months or even years before other symptoms appear. Your urine sediment and cells found in your urine will also be examined in a laboratory.

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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Stages Of Chronic Kidney Disease

About chronic kidney disease

With chronic kidney disease, the kidneys dont usually fail all at once. Instead, kidney disease often progresses slowly years. If caught early, medicines and lifestyle changes may help slow or prevent CKD progression.

Five stages of chronic kidney disease

The National Kidney Foundation divided kidney disease into five stages. This helps doctors provide the best care, as each stage calls for different tests and treatments.

Doctors determine the stage of kidney disease using the glomerular filtration rate , a math formula using a person’s age, gender, and their serum creatinine level . Creatinine, a waste product that comes from muscle activity, is a key indicator of kidney function. When kidneys are working well they remove creatinine from the blood but as kidney function slows, blood levels of creatinine rise.

Use the links below to learn about each stage of kidney disease:

What Is Kidney Transplantation

What is Dialysis and Chronic Kidney Disease?

Kidney transplantation involves placing a healthy kidney into your body where it can perform all of the functions that a failing kidney cant. Kidneys for transplantation come from two sources: living donors and deceased donors. Living donors are usually immediate family members or sometimes spouses. This is possible because a person can live well with one healthy kidney.

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How Do Doctors Treat Stage 3 Ckd

Doctors treat Stage 3 CKD with medicines that help with your symptoms and with 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
  • Iron supplements to help with anemia

You may also need to stop taking certain medicines that can worsen the damage to your kidneys, such as pain medicines called NSAIDs and some arthritis medicines. Tell your doctor about all the medicines you takeeven ones they did not prescribe.

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. Your nephrologist will also do lab tests to check your kidney health often, usually every 90 days .

The Facts About Chronic Kidney Disease

  • 37 million American adults have CKD and millions of others are at increased risk.
  • Early detection can help prevent the progression of kidney disease to kidney failure.
  • Heart disease is the major cause of death for all people with CKD.
  • Glomerular filtration rate is the best estimate of kidney function.
  • Hypertension causes CKD and CKD causes hypertension.
  • Persistent proteinuria means CKD is present.
  • High risk groups include those with diabetes, hypertension and family history of kidney failure.
  • African Americans, Hispanics, Pacific Islanders, American Indians and Seniors are at increased risk.
  • Two simple tests can detect CKD: blood pressure, urine albumin and serum creatinine.

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Which Is The Kidney Disease Solution

What Is The Worst Diet For Chronic Kidney Disease

This Kidney Disease Solution is an all-in-one step-by-step program created to boost renal health as well as reverse the effects of kidney disease. It will teach you everything you must know about kidneys and how to naturally cure kidney disease.

The program provides a variety of innovative holistic treatment methods that are based on the most recent findings in the field of naturopathic research. Since its a natural approach that targets the root cause of the problem. Through simple lifestyle changes people can eradicate kidney disease once and for all.

This program comes with a variety of ebooks and cookbooks. The ebooks are focused on the changes to your lifestyle. They offer specific guidelines for how to assess your condition, interpret the results of your test and establishing a custom treatment and diet plan for you.

The books also provide advice on what diet is most effective for your condition. Here, you can discover healthy herbal remedies as well as tea recipes and more.

Other useful materials include meditation audiobooks, nutrition programs, videos on yoga, and treatment trackers. The content is written in easily understood language, to ensure that everyone gets the most out of it.

What Is Stage 3 Ckd

Mayo Clinic Explains Kidney Disease

In Stage 3 CKD, your kidneys have mild to moderate damage, and they are less able to filter waste and fluid out of your blood. This waste can build up in your body and begin to harm other areas, such as to cause high blood pressure, anemia and problems with your bones. This buildup of waste is called uremia.

Stage 3 CKD is split into 2 sub-stages based on your eGFR:

Stage 3a means you have an eGFR between 45 and 59, and Stage 3b means you have an eGFR between 30 and 44.

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Treatment For Kidney Failure

When your kidney function has fallen below a certain point, it is called kidney failure. Kidney failure has harmful effects throughout your body. It can cause serious heart, bone, and brain problems and can make you feel very ill.

After you have kidney failure, either you will need to have dialysis or you will need a new kidney. Both choices have risks and benefits.

Dialysis

Dialysis is a process that does the work of healthy kidneys by clearing wastes and extra fluid from the body and restoring the proper balance of chemicals in the blood. You may use dialysis for many years, or it may be a short-term measure while you are waiting for a kidney transplant.

To learn more about dialysis, see Other Treatment.

Kidney transplant

Kidney transplant is often a better treatment option than dialysis for kidney failure, because it may allow you to live a fairly normal life. But there are some drawbacks. For example, you will probably need to have dialysis while you wait for a kidney.

To learn more about kidney transplants, see Surgery.

Making treatment decisions when you are very ill is difficult. It is normal to be fearful and worried about the risks involved. Discuss your concerns with your family and your doctor. It may be helpful to visit the dialysis centre or transplant centre and talk to others who have chosen these options.

About Chronic Kidney Disease

CKD is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke.

15% of US adults are estimated to have chronic kidney disease, that is about 37 million people.

Some other health consequences of CKD include:

  • Anemia or low number of red blood cells
  • Increased occurrence of infections
  • Low calcium levels, high potassium levels, and high phosphorus levels in the blood
  • Loss of appetite or eating less
  • Depression or lower quality of life

CKD has varying levels of seriousness. It usually gets worse over time though treatment has been shown to slow progression. If left untreated, CKD can progress to kidney failure and early cardiovascular disease. When the kidneys stop working, dialysis or kidney transplant is needed for survival. Kidney failure treated with dialysis or kidney transplant is called end-stage renal disease . Learn more about ESRD.

Not all patients with kidney disease progress to kidney failure. To help prevent CKD and lower the risk for kidney failure, control risk factors for CKD, get tested yearly, make lifestyle changes, take medicine as needed, and see your health care team regularly.

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