Chronic Kidney Disease

The pair of kidneys perform the vital function of the filtration of waste from our body. Though a person can sustain comfortably on one kidney, damage to both the kidneys is an alarming situation. Chronic kidney disease results due to the gradual failure of both the kidneys. In this growing age of healthcare advancement, renal (kidney) failure and chronic kidney diseases can be comfortably managed and treated.  Let’s read to know all about the Chronic kidney disease!

The reasons for chronic kidney disease:

1. Diabetes and High Blood Pressure are the major causes. If diabetes and Blood Pressure are well managed, the risk of chronic kidney disease reduces significantly.

2. Polycystic kidney disease

3. The inflammation of the kidney’s filtering units and tubules

4. Prolonged obstruction of the urinary tract due to conditions like enlarged prostate, kidney stones and some cancers

5. Vesicoureteral reflux: A condition that causes urine to back up into your kidneys

6. Recurrent kidney infection

Symptoms associated with Chronic Kidney disease: (do we need an explanation?)

Due to the high adaptability of kidneys, in many cases, the signs and symptoms may not appear until irreversible damage has occurred. Keeping a check on these symptoms could help you get an idea if you have a kidney disease:

1. Weakness and lethargy: In the case of kidney failure, the hormone erythropoietin is not made which leads to a decrease in the oxygen-carrying red blood cells. (RBC) The muscles and brain tire quickly due to the lack of RBCs

2. Abnormal heartbeats: Inability to remove potassium from the bloodstream may cause abnormal heartbeats

3. Vomiting: A severe build-up of wastes (uraemia) in the blood causes nausea and vomiting.

4. Changes in urine output: There can be changes in the consistency and frequency of urination. The urine may be foamy, bubbly or may contain blood. The frequency of urination may increase or decrease. Some people may feel certain pressure or difficulty while urinating.

5. Decreased mental sharpness: Due to kidney failure, the brain may not get enough oxygen which may lead to memory problems, lack of concentration and dizziness.

6. Swelling of feet and ankles: The inability to remove extra fluid causes swelling

7. Persistent itching: The failure to remove waste can cause severe itching.

8. Chest pain:  A person may experience chest pain if fluid builds up around the lining of the heart

9. Breathing difficulty: Difficulty in breathing can be due to two reasons. Firstly, extra fluid in the body may build up in the lungs which would cause difficulty in breathing. Secondly, a decrease in the oxygen-carrying red blood cells can leave body oxygen-starved causing shortage of breath.

10. Ammonia Breath: A build-up of wastes in the blood (called uraemia) can cause bad breath.

(add a star here and put in a box) In case you have any of the symptoms it is advisable to take any one of the following tests to be on the safer side:

·  The blood tests

·   Urine test

·  Imaging tests

·  Kidney biopsy

Stages:

The stages of Chronic Kidney Disease are based on estimated Glomerular Filtration Rate. The rate estimates how much blood passes through the kidney filters in a minute. There are five stages in Chronic Kidney disease which indicate the severity of the disease.

StageProblemTreatment
1The kidney function is normal but urine test or genetic trait indicate a kidney diseaseFinding the cause of disease and commencing treatment.Regular monitoring
2Mildly reduced kidney functionThe progression of the disease is estimated. Controlling blood pressure and blood sugar levels continuing regular monitoring
3Moderately reduced kidney functionThe doctor will check for complications, such as anemia and bone disease and begin treatment if needed. Some lifestyle changes like quitting smoking and exercising would be advisedRegular review of medication
4Severely reduced kidney functionDecide the type of treatment to be done if kidney failure develops. Continuing medication and blood pressure and sugar reviews
5End-stage kidney failure (Renal failure)(Fatal if not treated)Start dialysis or opt for palliative care dialysis doesn’t fulfill the need, opt for kidney transplant continues to see doctor for treatment and testing.

Color Meaning:

Green- Noncritical stages

Yellow – In this stage attention is needed and treatment/ medication needs to start

Pink- Advanced stages in which dangerous levels of fluid, electrolytes and wastes build up in the body.

Kidney failure treatment options:

Renal failure is no more a fatal disease. A person can continue living a healthy life by getting regular dialysis sessions done. In severe cases where dialysis fails to give desired results, patients need not worry. They can opt for a kidney transplant and live a normal and comfortable life.

Dialysis:

Dialysis is the life-support treatment process that eliminates waste and unwanted water from the blood. It is recommended for the people who have damaged kidneys or kidney function below 10%-15%.

There are two types of kidney dialysis:

Haemodialysis

Peritoneal dialysis

The dialysis method opted for depends on the individual cases.

Haemodialysis:

In haemodialysis, blood is filtered using a dialyzer and dialysis machine. Before the first dialysis session, the doctor will create a vascular access. It is an entrance into one of the blood vessels so that the body can be connected to the filtering machine during the sessions. The frequency of dialysis session depends on the kidney’s functional capacity..

Peritoneal dialysis:

In peritoneal dialysis, blood is filtered inside the body uses the lining of abdominal area as a filter. This method allows blood to be cleaned while you sleep, work, or perform everyday activities. It can be done at home.

It is imperative to get regular tests done to see if the dialysis is working well or not. In case it fails to provide the desired results, then the patients need to opt for kidney transplant.

Kidney Transplant:

A kidney transplant is the last stage treatment option for renal failure. It is an operation in which a new kidney is planted in the body which would take over the work of cleaning blood.

Who can be a donor?

Since only one kidney is planted after the transplant, both living and nonliving (dead) people can be donors.

A living donor is usually a person related to the person like their immediate family or close friend.  A stranger too can donate a kidney if he wishes to.

Tests done to ensure success of transplant:

Before a transplant the donor and patient need to undergo various health tests. These tests help in determining whether patient’s body will accept the donor kidney.

1. Blood tests

2. Tests to check your heart and other organs.

3. Blood type and other matching factors

Rejection of Kidney after transplant:

The body’s immune system guards against anything foreign like bacteria. This defense system may recognize transplanted kidney from as “foreign” and may attack it. To prevent rejection, the immuno-suppressant medicines need to be taken but they may have side-effects.

Renal failure is not a threat if it is treated and looked after well.  Regular monitoring of your health can help you learn the early signs of a probable kidney disease. Managing diabetes, blood pressure, kidney stones and polycystic kidney disease can help in delaying or preventing chronic kidney disease.

We are here for your care! If you’d like to book an appointment for dialysis or transplant you can contact us and we shall arrange special discounts for you.