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Chronic Kidney Disease

Chronic kidney disease is one of the common disorders in Unites States. Nearly 26 million American adults have CKD and millions of others are at increased risk. Patients with chronic kidney disease have decrease in kidney function and or protein loss in their urine. Over time, wastes will accumulate in your body and make you feel sick.

Depending to underlying kidney disease, the kidney may or may not progress to end stage renal disease (when patient will need dialysis). Further, progression to end stage renal disease depends on disease severity. If the disease is detected early, the kidney doctor (nephrologist) can prescribe kidney protective medications. It is crucial to have close follow up with a kidney doctor to slow the progression of kidney disease. As such, compliance with medications and doctor instructions are key.

Over time, patients with chronic kidney disease may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Combination of chronic kidney disease and high blood pressure is very common. Chronic kidney disease can cause high blood pressure and high blood pressure can cause chronic kidney disease. Unfortunately this is a vicious cycle. As such, it is very important to monitor your blood pressure frequently and review the results with you kidney doctor (nephrologist). If the high blood pressure remains uncontrolled, you need to notify your doctor as uncontrolled blood pressure can have devastating outcomes for your health (heart attack, stroke, and death).

What Causes Chronic Kidney Disease:
  • Uncontrolled diabetes
  • High blood pressure
  • Non-kidney friendly medications
  • Decreased heart function (also known as heart failure)
  • Protein loss in urine (also known as Proteinuria)
  • Genetic diseases like polycystic kidney disease
  • Kidney stone
  • Bladder obstruction
  • Smoking
  • and many more ...

Chronic Renal Failure Pathophysiology
Chronic kidney disease is when the kidneys stop working as well as they should. When they are working normally, the kidneys filter the blood and remove waste and excess salt and water. In people with chronic kidney disease, the kidneys slowly lose the ability to filter the blood. In time, the kidneys can stop working completely. That is why it is so important to keep chronic kidney disease from getting worse.

Chronic Kidney Failure Disease Symptoms:
At first, chronic kidney disease causes no symptoms. As the disease gets worse, it can:
  • Make your feet, ankles, or legs swell (doctors call this “edema”)
  • Give you high blood pressure
  • Make you very tired
  • Damage your bones

Chronic Kidney Failure Stages & Kidney Function
In 2002, K/DOQI published its classification of the stages of chronic kidney disease, as follows:
  • Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2)
  • Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m2)
  • Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m2)
  • Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m2)
  • Stage 5: Kidney failure (GFR < 15 mL/min/1.73 m2 or dialysis)

Slow Progression of Chronic Kidney Disease
  • Taking blood pressure and other medicines every day, if your doctor or nurse prescribes them to you
  • Keeping your blood sugar in a healthy range, if you have diabetes
  • Changing your diet, if your doctor or nurse says you should
  • Avoiding medicines known as “nonsteroidal antiinflammatory drugs,” or NSAIDs. These medicines include ibuprofen (sold as Advil® or Motrin®) andnaproxen (sold as Aleve®). Check with your doctor, nurse, or kidney specialist before starting any new medicines — even over-the-counter ones.

Chronic Kidney Failure Treatment
People in the early stages of chronic kidney disease can take medicines to keep the disease from getting worse. For example, many people with chronic kidney disease should take medicines known as “ACE inhibitors” or “angiotensin receptor blockers.” If your doctor or nurse prescribes these medicines, it is very important that you take them every day as directed. If they cause side effects or cost too much, speak to your doctor or nurse about it. He or she might have solutions to offer.
 If your kidneys stop working completely, you can choose between three different treatments to take over the job of your kidneys. Your choices are described below.
  • You can have kidney transplant surgery. That way, the new kidney can do the job of your own kidneys. If you have a kidney transplant, you will need to take medicines for the rest of your life to keep your body from reacting badly to the new kidney. (You only need one kidney to live.)
  • You can have your blood filtered by a machine. This treatment is called “hemodialysis,” but many people call it just “dialysis.” If you choose this approach, you will need to be hooked up to the machine at least 3 times a week for a few hours for the rest of your life. Before you start, you will also need to have surgery to prepare a blood vessel for attachment to the machine.
  • You can learn to use a special fluid that has to be piped in and out of your belly every day. This treatment is called “peritoneal dialysis.” If you choose this type of dialysis, you will need surgery to have a tube implanted in your belly. Then you will have to learn how to pipe the fluid in and out through that tube.

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