Chronic Kidney Disease

We are born with two kidneys. They are located just above our waist, on either side of our spine. They are extremely critical for certain body functions.

Functions of Healthy Kidneys

Maintain a balance of water & minerals (like sodium, phosphorous and potassium) in the blood
Excrete waste from blood after any exposure to medications or chemical reactions, muscle activity, and digestion
Make the chemical – erythropoietin – which helps the body to generate RBCs (Red Blood Cells)
Create renin which helps the body to manage blood pressure
Create vitamin D (the active form) to improve the bone health

What is Chronic Kidney Disease (CKD)?

If your kidneys aren’t working well from 3 months or more, then this condition is known as chronic kidney disease. You wouldn’t get any symptom of this disease in its early stages, and it is really the time when this disease is simplest to treat.

Patients having high blood pressure and diabetes (type 1 or 2) are the most commonly affected. High blood pressure causes wear & tear on your blood vessels, which include vessels that go to kidneys as well.

Some other conditions that can cause CKD:

Diseases related to Immune system
Long-lasting viral diseases, such as hepatitis B, hepatitis C and HIV/AIDS
Pyelonephritis – It’s a urinary tract infection which can lead to scarring. If this infection happens several times, it can cause kidney damage
A genetic condition - Polycystic kidney disease - where fluid-filled sacs are formed in kidneys
Inflammation in the tiny filters (glomeruli) within your kidneys. This can happen after a strep infection
Long term use of drugs & toxins containing lead such as naproxen and ibuprofen can cause permanent damage to kidneys

Symptoms

You might not notice any symptoms in the early stages. For some people, it can happen in the advance stages as well. Below listed are few symptoms of chronic kidney disease in the advanced stage. You may:

often feel nauseated or vomiting
urinate either more or less than normal
find “foam” in your urine
experience swelling, especially in the ankles and puffy eyes
feel shortness of breath or feel tired all the time
experience loss of appetite
be unable to taste most of the food items
experience muscle cramps (especially in legs)
get itchy/dry skin
not be able to get proper sleep
start losing weight for no apparent reason

The Right Time to Consult Your Doctor

It is the moment you notice any of the above mentioned symptoms. These could be a result of other possible ailments. However, seeing a doctor will make it clear what the actual problem is and the kind of treatment you’ll need.

If you’ve diabetes or high blood pressure or chronic kidney disease is hereditary in your family, it’s good to ask your doctor how often you should get tested.

First of all, it’s important to find the exact reason behind chronic kidney disease. For example, if you have this condition due to high blood pressure or diabetes, you may consult a nephrologist, cardiologist or diabetologist.

You’ll need to be on medications and change your diet. In case, you are suffering from diabetes, it needs to be managed. In case your kidneys aren’t working properly, you may need to undergo either dialysis or kidney transplant.

Medications

In case of chronic kidney disease caused by high blood pressure, your doctor may prescribe either of “ACE” inhibitors like Captopril (Capoten), Fosinopril (Monopril) or “ARBs” such as Eprosartan (Teveten), Losartan (Cozaar), etc.

Besides keeping your blood pressure in control, these medicines will also help in lowering down the protein in your urine. This will help your kidneys over time.

You’ll also be given medications to help your body make erythropoietin.

It’s a chemical which stimulates your body to make RBCs (Red Blood Cells). It means that you may also end up being prescribed for (Procrit, Epogen) or darbepoetin alfa (Aranesp) to control anemia.

Diet to follow

You may be asked by your doctor to follow a special diet that is lower in protein sodium, phosphate and potassium. As your kidneys are not in good shape, it becomes harder for them to excrete these nutrients from your blood.

This special diet decreases the work required by your kidneys. There might also be a limit set on your daily water intake, like how much water can you drink on a daily basis and how much can be in your food intake.

You can also consult a renal dietitian – a kidney diet specialist - to get a proper diet chart suitable to your medical condition.

Dialysis

In case your kidneys are not working well anymore, you may need to undergo dialysis. In the process of Hemodialysis, a machine with a mechanical filter is used for cleansing your blood. You can get this done at a dialysis center or home.

However, it’s important to know that you’ll need to undergo surgery before the process of Hemodialysis starts. This is done to make your body access the said machine.

Your doctor will perform the surgery to connect a vein and artery in your hand with the help of a ‘fistula’. However, it will need several months to get your body healed to start the Hemodialysis process.

In case, you don’t want to delay the process of dialysis and want to start it sooner, your doctor will make a synthetic graft in your hand instead of a fistula.

And if neither of these options works for you and you want to get started with your dialysis right away, the surgeon will suggest you to get a dialysis catheter. It directly goes into your neck – specifically to the jugular vein.

Peritoneal Dialysis

In this process, the lining of your peritoneal membrane or abdomen is used to cleanse your blood. A tube is implanted in your abdomen and on each treatment day dialysate (dialysis fluid) goes through a tube into your abdomen.

After a few hours, this fluid picks up and drains out the waste products from your body. It’s always better to talk in detail about the pros and cons of every procedure with your doctor before making a decision, as there can be infection risk.

Kidney Transplant

If your chronic kidney disease is already in advanced stage, a kidney transplant is the only option. Points to note before you go for a kidney transplant:

The "matching" kidney needs to be of a closely related family member or you can get the kidney from a recently deceased organ donor
A successful kidney transplant means that you won’t have to undergo dialysis. Once the transplant is done, you’ll need to follow certain medications to get the donated kidney accepted by your body
Here it is important to mention that a donated kidney from an alive donor usually lasts for 12-20 years and the kidney from a recently deceased donor may last for 8-12 years

Prevention

As diabetes & high blood pressure are the biggest threats to the well-being of your kidneys, it will do you good if you focus on these two conditions from the very beginning.

It means that if it has been a while since you had your thorough checkup, you should schedule one. Besides that, maintain habits of eating a healthy diet, take alcohol in limits, quit smoking, stay active and follow prescribed medications.