Kidney problems (Chronic Kidney Disease)

Kidney problems (Chronic Kidney Disease)

What are Kidney problems (Chronic Kidney Disease)?

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

What are the symptoms of Kidney problems (Chronic Kidney Disease)?

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:

• feel more tired and have less energy
• have trouble concentrating
• have a poor appetite
• have trouble sleeping
• have muscle cramping at night
• have swollen feet and ankles
• have puffiness around your eyes, especially in the morning
• have dry, itchy skin
• need to urinate more often, especially at night.

Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:

• have diabetes
• have high blood pressure
• have a family history of kidney failure
• are older
• belong to a population group that has a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians.

What are the causes of Kidney problems (Chronic Kidney Disease)?

The two main causes of chronic kidney disease are diabetes and high blood pressure , which are responsible for up to two-thirds of the cases. Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes. High blood pressure, or hypertension, occurs when the pressure of your blood 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. Other conditions that affect the kidneys are:

• Glomerulonephritis , a group of diseases that cause inflammation and damage to the kidney's filtering units. These disorders are the third most common type of kidney disease.
• Inherited diseases, such as polycystic kidney disease , which causes large cysts to form in the kidneys and damage the surrounding tissue.
• Malformations that occur as a baby develops in its mother's womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
• Lupus and other diseases that affect the body's immune system.
• Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men.
• Repeated urinary infections.

How is Kidney problems (Chronic Kidney Disease)treated?

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:

• feel more tired and have less energy
• have trouble concentrating
• have a poor appetite
• have trouble sleeping
• have muscle cramping at night
• have swollen feet and ankles
• have puffiness around your eyes, especially in the morning
• have dry, itchy skin
• need to urinate more often, especially at night.

Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:

• have diabetes
• have high blood pressure
• have a family history of kidney failure
• are older
• belong to a population group that has a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians.
• There is no current cure for chronic kidney disease. However, some therapies can help control the signs and symptoms, reduce the risk of complications, and slow the progression of the disease.
• Patients with chronic kidney disease typically need to take a large number of medications. Treatments include:
• Anemia treatment
• Hemoglobin is the substance in red blood cells that carries vital oxygen around the body. If hemoglobin levels are low, the patient has anemia.
• Some kidney disease patients with anemia will require blood transfusions. A patient with kidney disease will usually have to take iron supplements, either in the form of daily ferrous sulphate tablets, or occasionally in the form of injections.
• Phosphate balance
• People with kidney disease may not be able to eliminate phosphate from their body properly. Patients will be advised to reduce their nutritional phosphate intake - this usually means reducing consumption of dairy products, red meat, eggs, and fish.
• Vitamin D
• Patients with kidney disease typically have low levels of vitamin D. Vitamin D is essential for healthy bones. The vitamin D we obtain from the sun or from food has to be activated by the kidneys before the body can use it. Patients may be given alfacalcidol, or calcitriol.
• High blood pressure
• High blood pressure is a common problem for patients with chronic kidney disease. It is important to bring the blood pressure down to protect the kidneys, and subsequently slow down the progression of the disease.
• Fluid retention
• People with chronic kidney disease need to be careful with their fluid intake. Most patients will be asked to restrict their fluid intake. If the kidneys do not work properly, the patient is much more susceptible to fluid build-up.
• Skin itching
• Antihistamines, such as chlorphenamine, may help alleviate symptoms of itching.
• Anti-sickness medications
• If toxins build up in the body because the kidneys don't work properly, patients may feel sick (nausea). Medications such as cyclizine or metaclopramide help relieve sickness.
• Diet
• Following a proper diet is vital for effective kidney failure treatment. As mentioned above, restricting the amount of protein in the diet may help slow down the progression of the disease. Diet may also help alleviate symptoms of nausea. Salt intake needs to be carefully regulated to control hypertension. Potassium and phosphorus consumption, over time, may also need to be restricted.
• NSAIDs (nonsteroidal anti-inflammatory drugs)
• NSAIDs, such as aspirin or ibuprofen should be avoided and only taken if a doctor recommends them.
• End-stage kidney disease treatment
• This is when the kidneys are functioning at less than 10-15 percent of normal capacity. Measures used so far - diet, medications, and treatments controlling underlying causes - are no longer enough. The kidneys of patients with end-stage kidney disease cannot keep up with the waste and fluid elimination process on their own - the patient will need dialysis or a kidney transplant in order to survive.
• Most doctors will try to delay the need for dialysis or a kidney transplant for as long as possible because they carry the risk of potentially serious complications.

Kidney dialysis
Kidney transplant