A disease such as Chronic Kidney Disease might have a lot of hype around it but for the patient to understand its intensity and gain a better insight into the ‘what’s’ and ‘how’s’ of it is important. When the patient understands that the disease is no definer of one’s life is when the patient can gain a life that blooms with mental peace and physical wellness. Understanding the rational options and practical measures to slow down the advancement of a disease such as CKD, which is irreversible in nature, is integral to reclaim hope and look forward to a future which shines as bright as a diamond.

CKD education gives the patient not just hope but a will to live, a will so strong that it makes them feel empowered and in control of their situation. CKD diagnosis might catch them off-guard but educating them about their condition and future possibilities and to possibly form an action plan, might ease off health anxiety and help gain a better perspective towards life.

Knowledge is power. Knowledge can heal.

An extensive education program defining CKD and making the patients understand its complexity must include certain themes that need to be elucidated in detail.

Chronic Kidney Disease: A brief Sketch

CKD is a condition because of which the kidney is unable to function to its maximum potential. This gradual deterioration of the kidney and its ability to remove waste products and excess fluid from the blood directly influences the condition of the other body systems. 

What does a healthy kidney do?

  • Excretion of waste
  • Production of hormones
  • Regulation of blood pH
  • Regulation of blood volume
  • Regulation of ions in blood

The smooth functioning of the body is partly dependent on the smooth functioning of the kidney. The kidneys control the amount of sodium, potassium, calcium and other such substances in the body along with removing excess waste and fluids in the form of urine. This filtering is achieved through the nephrons which must be healthy enough to perform its function along with the glomeruli and the tubules. When this filtering is affected, there is an imbalance in the body which further bundles up a list of complications for the individual, who might develop symptoms related to kidney disease.

Kidney disease is referred to as a “Quiet Disease” because its signs and symptoms develop gradually and might even go unnoticed in the early stages. Recognition of these early signs, spreading of awareness of the same and knowing when to get tests done are some of the critical factors that determine the individual’s journey with CKD.

Risk factors:

Some people are more prone to develop CKD than others. These risk factors include:

  • Having autoimmune diseases
  • Obesity
  • Smoking
  • Old age
  • Family history of kidney disease
  • High blood pressure
  • Diabetes
  • Ethnic minorities such as African-Americans, Hispanics, American Indians etc
  • Having protein in the body
  • People suffering from hypertension

Two main groups of people that must take extra precautions are people with diabetes and high blood pressure.

Diabetes: When the blood sugar is too high, many organs might face serious damage such as kidney and heart.

High blood pressure or Hypertension: when the pressure of the blood against the walls of the blood vessels increases, it may lead to strokes or CKD. Diseases that cause inflammation and damage to the kidney’s filtering units such as Glomerulonephritis, repeated urinary infection and other diseases like lupus increases the likelihood of kidney damage.

Some indicators of CKD:

Initial symptoms may include:

  • Tiredness
  • Trouble concentrating
  • Muscle cramping especially at night
  • Dry or itchy skin
  • Need to urinate more often
  • Puffiness around eyes
  • Swollen feet or ankles

People with Advanced Kidney Disease:

  • Edema (swelling of feet, ankles or legs)
  • Loss of appetite
  • Increased sleepiness
  • Nausea
  • Vomiting
  • Difficulty in thinking

This might also lead to nerve problems, build-up of fluid around the heart, high blood pressure, anemia, high potassium concentration, seizures etc.

CKD: Detection and Evaluation

Tests are done to:

  • Measure serum creatinine levels in order to evaluate the GFR levels and to therefore monitor kidney function
  • Measuring of the urinary albumin/creatinine ratio to detect proteinuria and therefore to monitor kidney damage
  • Urinalysis can further detect signs of tubulointerstitial disease, lupus nephritis, hereditary nephritis and other such complications that might become the cause of kidney disease.
  • Imaging tests such as ultrasound may help determine the presence of kidney stones or any other blockage of the urinary tract
  • Kidney biopsy might be done to examine a piece of kidney tissue and observe it under a microscope to identify the cause of the kidney disease

Points of consideration:

  • Reduction in GFR indicates the worsening of the kidney disease or development of another kidney problem.
  • Increase in GFR indicates improvement in kidney function.
  • A stable GFR indicates stable disease.
  • Even small amounts of albumin or protein might be an early sign of CKD.

Stages of CKD

Chronic Kidney Disease-the 5 stages

Stage 1: Kidney damage with normal or increased GFR of ≥ 90 ml/min/1,73m2.The aim is to treat comorbid conditions, reduce cardiovascular risk and slow down the progression of CKD.

Stage 2: Kidney damage with mildly decreased GFR of 60 to 89 ml/min/1,73m2. The aim is to estimate progression and conduct regular tests. 

Stage 3: Kidney damage with moderately decreased GFR of 30 to 59 ml/min/1,73m2. The aim is to evaluate the complications and treat them.

Stage 4: Kidney damage with severely decreased GFR of 15 to 29 ml/min/1,73m2. The patient is now in the stage of preparing for a kidney transplant or dialysis.

Stage 5: Kidney failure.< 15 ml/min/1,73m2 (or dialysis). The patient is in the need of a kidney transplant or dialysis if uremia is present.

CKD: Treatment and Management

Chronic Kidney Disease’s treatment depends on the severity of the damage on the kidney. Although it is difficult to cure CKD however its progression can be slowed down through various measures. These measures control the various complications and symptoms that tag along with the kidney disease. It includes medications, self-care, medical procedures or surgery.

Medications: Your doctor might suggest certain medications to keep the bodily functions operational and balanced.

  • High blood pressure medications: medicines to lower the blood pressure which eventually helps the kidney perform its functions efficiently.
  • Medication to lower cholesterol level: often, people with kidney disease experience high cholesterol levels which in due course might lead to heart diseases. So medications are prescribed to lower the cholesterol levels and prevent the kidney from malfunctioning.
  • Medication to treat anemia: some patients experience fatigue and weakness which might be associated with anemia. Medications and supplements to treat the same and to produce more red blood cells are recommended for healthy living.
  • Medication to relieve swelling: swelling of the legs or ankles is one of the primary symptoms of kidney disease. To ease the puffiness, medications such as diuretics are given that also maintain the balance of fluids in the body.
  • Medication to protect the bones: The bones might become weak for a CKD patient and it is likely to add onto the misery. Calcium and Vitamin D supplements are recommended to treat the same.

Self care: Certain self-care practices might slow down or delay the damage on the kidneys.

Some tips to slow down the progression:

  • Eat healthy
  • Stay at a healthy weight
  • Quit smoking or the use of tobacco
  • Control blood sugar and blood pressure
  • Become more active by engaging in activities such as walking or jogging
  • Have regular appointments with your nephrologist and go for regular check-ups
  • Meet with a dietician and follow a proper and healthy diet plan

Medical procedures/surgery:

As the disease worsens, it might lead to the end stage of kidney disease. At this point, the patient needs either dialysis or kidney transplant.

Two main types of kidney dialysis are:

  • Hemodialysis: the blood is pumped out of the patient’s body which then removes salt, water and other waste products from the blood via a dialyzer. The filtered blood is then returned to the body. The treatments go on for 3 to 4 hours and might be taken three times a week, at home or at a kidney care centre.
  • Peritoneal dialysis: the blood is filtered in the patient’s own abdomen whereby a thin tube known as catheter fills the abdominal cavity with a dialysis solution which further absorbs the waste and other waste products and fluids. After a while, this dialysis solution is drained from the body, removing the waste from the blood.

Kidney transplant:

This surgery places a healthy kidney from a donor’s body to the patient’s body. However, you need to take medications for the rest of your life in order for your body to accept this new organ and run smoothly. For a seamless surgery and to prevent the possibility of the body to reject the new kidney, the donor and recipient must have same blood type, cell-surface proteins and antibodies.

Stronger together: You + Your health care team

You and your health care team should be as close as bread is to butter. The role of this A team is as crucial as it can get. It includes your 

  • Primary care provider i.e. your nurse, doctor or physician. You must make frequent visits, get yourself tested regularly and follow the plan they have laid out for you. They help you monitor and ease off any troublesome symptoms.
  • Dietician: your diet may make or break your progress as a CKD patient. Playing one of the most essential parts in delaying the progression of the disease, your diet requires extra attention which only a registered dietician might help you with.
  • Nephrologist: as a kidney specialist, they strive to make your journey smooth by helping you cope with the disease by not only imparting knowledge about your present and future options but also practically easing your pain.
  • Therapist: the link between physical and mental health is a tight one. Physical illness is capable of translating into a mental disorder. Visiting a therapist might help in achieving mental peace which is likely to aid physical wellbeing.

Chronic Kidney disease is not a passing illness; however it should not define you or your life. By understanding the disease with help from Nephdoc, you can lead a better quality of life. We are there to help you face the disease with appropriate medical and lifestyle strategies to make your life comfortable, both physically and mentally. 

Share your queries and apprehensions, and our team will provide the best assistance and guidance. 

The more you know, the more you cure.