ManipalHospitals • May 25, 20180 Comment

Our kidneys perform a variety of crucial bodily functions, including blood filtration, regulation of blood pressure and hemoglobin levels. Chronic Kidney Disease (CKD) implies damage of permanent nature to the kidneys, which is irreversible and happens over a period of time. This disease impairs all the functions of the kidneys. This results in an increased kidney damage and worsening of blood pressure, anemia and bone disease.


What are the stages of chronic kidney disease?
There are 5 stages of CKD, depending on the severity. Though the kidney function is relatively good, there might be some protein, blood or cysts in the urine. When the disease is in this stage, there is scope for preventing further progression of CKD. Stage 5 is where the maximum damage to the kidneys occur. At this stage, medical management alone is inadequate to treat the kidneys and other options such as dialysis or transplantion need to be considered to replace the kidney.


What are the risk factors for CKD?
 Diabetes: The foremost risk factor for CKD is diabetes, especially in India, which has the most number of diabetics in the world. In this case, due to a lack of awareness and proactive approach regarding regular health checks, diabetes is detected during the later stages, by which time other organs like the kidneys will have been affected.
 Hypertension: When uncontrolled, is a very high risk factor for CKD. On the other hand, when hypertension is under control, it is not much of a risk factor.
 Family History: A family history of renal dysfunction, i.e. if someone has renal failure or has succumbed to it, or required dialysis increases the risk of getting affected by CKD.
 Infections: A person suffering from recurrent urinary or kidney infection is also at a higher risk of getting affected by CKD.
 Over-the-counter medications: Taking medicines like painkillers unsupervised is also another risk factor.
 Glomerular disease: The presence of protein in the urine, if detected early, can prevent the progression of this disease.


Kidney disease usually doesn’t present any symptoms, unless there is a significant decline in the kidney function.
In the initial stages, the symptoms may include
• Unexplained anemia
• Feeling weak
• Tiredness
• Problems getting sleep
• Chest pain
• Shortness of breath
• Loss of appetite
• Changes in urine
Apart from these, when the kidney function declines beyond 90%, then the person may develop symptoms like
• swelling of feet and the face
• recurrent vomiting
• Nausea
• Unexplained weight loss
The symptoms associated with kidney disease are vague and there is no specific symptom associated with it. Usually, by the time the symptoms appear and the patient visits the doctor, the kidney is already significantly damaged. This is the reason one should not wait for the symptoms to appear to get his/her kidneys evaluated and checked.


Why is early diagnosis important in CKD?
Early diagnosis is very important in kidney disease because it helps in getting to the root of the problem and stop the further progression of this disease. The diagnostic techniques include:
• Blood Tests: To assess the presence and level of substances like urea and creatinine.
• Urine Tests: These are carried out to check the levels of albumin, creatinine and blood proteins in the urine to determine how well the kidneys are functioning.
• Imaging Tests: CT Scan, MRI scan and ultrasound can help give a picture of the kidneys and help look for any blockages or abnormailities.
• Biopsy: A small sample of the kidney is extracted and is analysed in a laboratory.


How is Chronic Kidney Disease treated?
The treatment for CKD depends on various stages. The first three stages are early stages where the underlying cause must be treated and no specific medicines for kidney disease are taken. For example, if a person has diabetes, the blood sugar levels must be kept under control. The same applies to high blood pressure as well. Quitting smoking is a very important step. The idea is to avoid things which are harmful to the kidneys, like painkillers. Any infections like kidney or urinary infection should be treated appropriately.
In the advanced stages, where there is a significant dysfunction and almost 60-70% of the kidneys is damaged, there should be more emphasis on controlling the blood pressure and things which are harmful to the kidneys.
There are certain medications such as Angiostein-Converting Enzyme (ACE) inhibitors and Angiostein Receptor Blockers which are proven to prevent further progression.
In stage 5, where the kidney damage exceeds 80-90%, medications do not have any effect and the only solutions are either dialysis, or, if the patient is fit enough, a kidney transplant.


Can patients with Chronic Kidney Disease benefit from exercise?
Exercise can indirectly help people affected by CKD as it helps control the blood pressure, sugar levels, keeps the weight under control, all of which help in preventing further progression of this disease. Moderate exercises like walking, cycling etc. for about 150 to 180 minutes a week is definitely beneficial in the early stages.


What happens if CKD gets worse?
As the kidney disease progresses, beyond stage 4, it needs to be managed with specific medications and certain dietary changes such as reducing salt and fluid intake and getting any heart problems treated. In stage 5, the only life-saving options are dialysis and kidney transplant.


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