What Is The Best Description Of Chronic Kidney Disease

Can Kidney Disease Be Prevented

Seeing your healthcare provider on a regular basis throughout your life is a good start for preventing kidney disease. About one in every three people in the United States is at risk for kidney disease. Identify and manage any risk factors for developing kidney disease.

• Control your high blood pressure. Normal blood pressure is 120/80.
• Control your blood sugar if you have diabetes.
• Eat a healthy diet. Follow a low-fat, low-salt diet.
• Dont smoke.
• Be active for 30 minutes at least five days a week.
• Maintain a healthy weight.
• Take nonprescription pain relievers only as directed. Taking more than directed can damage your kidneys.

Questions To Ask Your Doctor About Stage 3 Kidney Disease

• What do my lab values mean? The results of your regular bloodwork help your doctor monitor your kidney health and calculate your estimate glomerular filtration rate , which determines your CKD stage. Changes in your lab values may indicate a change in your kidney function.
• What should I expect next with CKD? A stage 3 kidney disease diagnosis doesn’t necessarily mean that your condition will progress to stage 4 or stage 5. With lifestyle changes and a treatment plan from your doctor, it’s possible to slow the progression of CKD and preserve kidney function.
• Am I doing everything I can to slow CKD progression? Your doctor may have additional guidance on what you can do to stay your healthiest, including eating well and managing your existing medicationsespecially if you are managing other health conditions like high blood pressure or diabetes. Looking after your overall health can help you protect your kidney health and feel your best.

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.

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Stages Of Chronic Kidney Disease

www.kidneyfund.orgKidney DiseaseChronic Kidney Disease Stages of Chronic Kidney DiseaseMedical Advisory Committee

Please note: eGFR is an estimate of how well your kidneys are working. The way eGFR is calculated will be changing. Currently the test considers your age, sex and race, among other things. A task force led by the National Kidney Foundation and the American Society of Nephrology is working on recommendations that may remove Black race as a factor in the eGFR calculation. The task force has been seeking the input of kidney disease experts to come up with the best way to make the eGFR test as accurate as possible. American Kidney Fund advised the task force to remove race from the eGFR so there is no bias in testing kidney function. This would help to make sure that every person will receive health care that is fair and of the highest quality. When the NKF-ASN task force makes its recommendations, AKF will promptly review them and then update our educational materials.

Chronic kidney disease refers to all five stages of kidney damage, from very mild damage in stage 1 to complete kidney failure in stage 5. The stages of kidney disease are based on how well the kidneys can filter waste and extra fluid out of the blood. In the early stages of kidney disease, your kidneys are still able to filter out waste from your blood. In the later stages, your kidneys must work harder to get rid of waste and may stop working altogether.

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 Is Kidney Dialysis

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.

Medicines To Treat High Blood Pressure

Most people who have chronic kidney disease have problems with high blood pressure at some time during their disease. Medicines that lower blood pressure help to keep it in a target range and stop any more kidney damage.

Common blood pressure medicines include:

• Diuretics.
• Vasodilators.

You may need to try several blood pressure medicines before you find the medicine that controls your blood pressure well without bothersome side effects. Most people need to take a combination of medicines to get the best results. Your doctor may order blood tests 3 to 5 days after you start or change your medicines. The tests help your doctor make sure that your medicines are working correctly.

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Chronic Kidney Disease Of Unknown Aetiology

The cause of chronic kidney disease is in some cases not known it is referred to as chronic kidney disease of unknown aetiology . As of 2020 a rapidly progressive chronic kidney disease, unexplained by diabetes and hypertension, had increased dramatically in prevalence over a few decades in several regions in Central America and Mexico, a CKDu referred to as the Mesoamerican nephropathy . It was estimated in 2013 that at least 20,000 men had died prematurely, some in their 20s and 30s a figure of 40,000 per year was estimated in 2020. In some affected areas CKD mortality was five times the national rate. MeN primarily affects men working as sugarcane labourers. The cause is unknown, but in 2020 the science found a clearer connection between heavy labour in high temperatures and incidence of CKDu improvements such as regular access to water, rest and shade, can significantly decrease the potential CKDu incidence. CKDu also affects people in Sri Lanka where it is the 8th largest cause of in-hospital mortality.

Although CKDu was first documented among sugar cane workers in Costa Rica in the 1970s, it may well have affected plantation labourers since the introduction of sugar cane farming to the Caribbean in the 1600s. In colonial times the death records of slaves on sugar plantations was much higher than for slaves forced into other labour.

What If I Have Chronic Kidney Disease Stage 3

Stage 3 means moderate CKD. This often means that you do not need to see a kidney specialist but your GP will need to see your regularly for monitoring, including blood and urine tests.

You may need treatments to reduce your risk of progressing to more severe CKD. 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 CKD is progressing to stage 4 then you will usually need to be referred to a kidney specialist to consider further assessments and treatment.

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Chronic Kidney Disease Stage 3

Stage 3 of CKD is diagnosed based on estimated glomerular filtration rate readings. This is a blood test that measures creatine levels. An eGFR is used to determine how well your kidneys are working at filtering wastes.

An optimal eGFR is higher than 90, while stage 5 CKD presents itself in an eGFR of less than 15. So the higher your eGFR, the better your estimated kidney function.

Stage 3 CKD has two subtypes based on eGFR readings. You may be diagnosed with stage 3a if your eGFR is between 45 and 59. Stage 3b means your eGFR is between 30 and 44.

The goal with stage 3 CKD is to prevent further kidney function loss. In clinical terms, this can mean preventing an eGFR of between 29 and 15, which indicates stage 4 CKD.

You may not notice symptoms of chronic kidney problems in stages 1 and 2, but the signs start to become more noticeable in stage 3.

Some of the symptoms of CKD stage 3 may include:

• dark yellow, orange, or red urine
• urinating more or less frequently than normal

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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How Is Chronic Kidney Disease Treated

There is no cure for chronic kidney disease , but steps may be taken in early CKD to preserve a higher level of kidney function for a longer period of time. If you have reduced kidney function:

• Make and keep your regular healthcare provider / nephrologist visits.
• Keep your blood sugar under control .
• Avoid taking painkillers and other medications that may make your kidney disease worse.
• Keep your blood pressure levels under control.
• Consult a dietitian regarding useful changes in diet. Dietary changes may include limiting protein, eating foods that reduce blood cholesterol levels, and limiting sodium and potassium intake.
• Exercise/be active on most days of the week.
• Stay at a healthy weight.

Medicines Used During Dialysis

Both erythropoietin therapy and iron replacement therapy may also be used during dialysis to treat anemia, which often develops in advanced chronic kidney disease.

• Erythropoietin stimulates the production of new red blood cells and may decrease the need for blood transfusions. This therapy may also be started before dialysis is needed, when anemia is severe and causing symptoms.
• Iron therapy can help increase levels of iron in the body when EPO therapy alone is not effective.
• Vitamin D helps keep bones strong and healthy.

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Medicines To Treat Symptoms And Complications Of Chronic Kidney Disease

Medicines may be used to treat symptoms and complications of chronic kidney disease. These medicines include:

• Erythropoietin therapy and iron replacement therapy for anemia.
• Medicines for electrolyte imbalances.
• Diuretics to treat fluid buildup caused by chronic kidney disease.
• ACE inhibitors and ARBs. These may be used if you have protein in your urine or have heart failure. Regular blood tests are required to make sure that these medicines don’t raise potassium levels or make kidney function worse.

What Is Kidney Transplantation

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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What Is Diabetic Kidney Disease

Diabetic kidney disease is a type of kidney disease caused by diabetes.

Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.1

The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.

When your kidneys are damaged, they cant filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.

Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.

Watch a video about diabetes and kidney disease.

S To Take At Stage 3 Kidney Disease

• Make healthy lifestyle choicesEating a kidney-friendly diet, quitting smoking, exercising, and maintaining a healthy weight can help you slow progression at stage 3 kidney disease.
• Monitor your healthManaging underlying conditions and risk factors such as high blood pressure, diabetes, and/or infection can also help slow the progression of CKD. Talk to your doctor about whether or not you need to modify any of the vitamins, supplements, or medications you may be taking for other health conditions , or if you start taking any new medications.
• Talk to your doctor about a referral to see a kidney doctorSeeing a kidney doctor can help you manage your kidney health. Your doctor can help you determine when it’s time to see a nephrologist and give you a referral. Once you start seeing a nephrologist, you’ll still see your regular doctor to monitor you overall health.
• Meet with a renal dietitianFollowing a kidney-friendly diet is key to slowing the progression of CKD, and you dont have to do it alone. A renal dietitian can help you address any nutrition concerns and learn about eating well.
• Learn everything you can about CKDTaking a KidneyCare:365 class can help you learn more about how to manage and slow the progression of CKD.

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Learn More About Glomerular Filtration Rate

GFRglomerular filtration rate is the best test to measure your level of kidney function and determine your stage of kidney disease. Your doctor can calculate it from the results of your blood creatinine test, your age, race, gender and other factors.

The earlier kidney disease is detected, the better the chance of slowing or stopping its progression.

I Definition And Classification Of Ckd

Kidney damage for 3 months, as defined by structural or functional abnormalities of the kidney, with or without decreased GFR, that can lead to decreased GFR, manifest by either:

Pathologic abnormalities or

Markers of kidney damage, including abnormalities in thecomposition of the blood or urine, or abnormalities in imaging tests

GFR < 60 mL/min/1.73 m2 for 3 months, with or without kidney damage

• To whom is the classification system addressed?
• Can we build a system that is useful to most clinicians, with additional complexity that is useful to some?
• Can the classification system be linked to Action Plans? An action plan should be evidence-based, but modifiable based on considerations for different populations, and individualized based on patient circumstances.

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What Are The Complications Of Kidney Failure

Your kidneys do many jobs to keep you healthy. Cleaning your blood is only one of their jobs. They also control chemicals and fluids in your body, help control your blood pressure and help make red blood cells. Dialysis can do only some, not all, of the jobs that healthy kidneys do. Therefore, even when you are being treated for kidney failure, you may have some problems that come from having kidneys that donât work well. Learn more about the complications of kidney failure.

What Are The Symptoms Of Kidney Failure

You may notice one or more of the following symptoms if your kidneys are beginning to fail:

• Itching
• Swelling in your feet and ankles
• Too much urine or not enough urine
• Trouble catching your breath
• Trouble sleeping

If your kidneys stop working suddenly , you may notice one or more of the following symptoms:

• Abdominal pain
• Rash
• Vomiting

Having one or more of any of the symptoms above may be a sign of serious kidney problems. If you notice any of these symptoms, you should contact your doctor right away.

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