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    Chronic Kidney Disease

    Narothama Reddy, MD Deaconess Clinic Nephrology 03/14/2018

    Chronic kidney disease (CKD) is very common—affecting about 14 percent of the US adult population. It’s closely related to diabetes and high blood pressure, and can cause serious complications. But before I dive into details on the disease, I want to provide a quick lesson on the kidneys.


    The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Kidneys are so important that we are born with two of them! They do several things for the body, such as:

    • Regulate the body’s fluid levels and filter wastes and toxins from the blood.
    • Release a hormone that regulates blood pressure and activates vitamin D to maintain healthy bones.
    • Release the hormone erythropoietin that directs production of red blood cells.
    • Keep blood minerals in balance (sodium, phosphorus, potassium).

    When someone has chronic kidney disease, their kidneys’ ability to perform these functions is impaired.
     
    Who is at risk?
    The main risk factors for developing CKD are:

    • Diabetes
    • High blood pressure

    People with these chronic conditions are more likely to have CKD. However, there are additional risk factors that increase the chances of having the disease. They include:

    • African-American, Hispanic, Asian, Pacific Islander or Native American heritage
    • Obesity
    • Prolonged use of NSAIDs (ibuprofen, full-dose aspirin and Aleve are the most common over-the-counter NSAIDS)
    • Being age 60 or older
    • Born at a low birth weight (less than 5 pounds, 8 ounces)
    • Lupus and other autoimmune disorders
    • History of kidney stones
    • Family history of polycystic kidneys
    • Smoking and excess alcohol consumption

    The more risk factors that apply to you, the greater your chance of developing CKD.
     

    Symptoms
    CKD is often considered a silent disease/silent killer because most people have no symptoms in the beginning. By the time symptoms are noticeable, the disease is usually in an advanced stage and requires medical care. If you have risk factors for developing chronic kidney disease, watch for the following symptoms:

    • Fatigue or weakness
    • Foamy urine
    • Increased need to urinate (especially at night)
    • Difficult or painful urination
    • Pink or dark-colored urine (blood in the urine)
    • Puffy eyes
    • Increased thirst
    • Swollen face, hands, abdomen, ankles, feet

     

    Testing and Diagnosis
    When you visit your doctor for regular checkups, your blood pressure is a key indicator of possible problems with your kidneys. High blood pressure can cause kidney damage because of increased pressure on the blood vessels in the kidneys. As the kidneys become damaged, they have more trouble regulating blood pressure, so it’s a vicious cycle. High blood sugar can also damage the blood vessels in your kidneys.

    For these reasons, if your blood pressure or blood sugar is elevated, your doctor may order some lab tests (urine/blood) to check your kidney function.
     
    Testing includes:

    • Checking for protein in the urine, as this is an early sign of CKD.
    • Quantifying the amount of creatinine in the blood, as healthy kidneys filter out creatinine.
    • Monitoring the glomerular filtration rate (an estimate of how much blood passes through the glomeruli each minute. Glomeruli are the tiny filters in the kidneys that filter waste from the blood.)

    Based on the results of all these tests, doctors can determine the patient’s stage of kidney disease and create a care plan.
     

    CKD also causes these health problems
    Chronic kidney disease (CKD) is characterized by gradual loss of kidney function over a period of time. It can also lead to:

    • Cardiovascular disease, including heart attack
    • Stroke
    • High blood pressure
    • Weakened bones
    • Peripheral vascular disease (PVD—a blood circulation disorder)
    • Neuropathy (nerve damage)
    • Anemia
    • Kidney failure requiring dialysis or transplant
    • Death



    Prevention
    Taking steps to avoid this and other chronic health conditions are pretty basic. I recommend the following actions for preventing kidney disease and improving overall health.

    • Exercise regularly
    • Follow a balanced diet
    • Drink alcohol only in moderation
    • Monitor cholesterol and blood pressure
    • Know your family medical history
    • Control your weight
    • Quit smoking
    • Don’t take recreational/street drugs—they’re poison to your kidneys.
    • Stay hydrated
    • Get an annual physical exam
    • Stay current on vaccinations, including a flu shot.

    Taking care of your kidneys is critical for good health and a long life. To learn more, I recommend the National Kidney Foundation site at www.kidney.org. The site includes extensive patient education and resources that can help anyone learn more about managing their CKD.

     

     

     

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