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Chronic Kidney Disease 101

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Chronic kidney disease, also known as CKD, is becoming an ever more frequent condition in contemporary society. The statistics regarding this particular disease are alarmingly high, as the National Kidney Foundation reports in a virtual chart that no less than 26,000,000 American adults suffer from chronic kidney disease, while many other millions are on the edge of developing this condition. Also according to the foundation, the types of individuals who have a high risk of developing CKD are African Americans, American Indians, Hispanics, Pacific Islanders and, of course, seniors. According to the ICD health care classification system, the condition formerly known as “chronic renal failure” is now being called “chronic kidney disease” (ICD9 codes as of 2005). You would also be surprised to find out that not only humans suffer from CKD, but also our canine and feline friends.

pulse measuring

Moreover, individuals suffering from hypertension, diabetes or those who come from a family with a history of kidney conditions are also prone to this disease. Both acute and chronic kidney problems are extremely dangerous and have proven to be fatal if not properly treated. In fact, according to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), the number of deaths from end-stage renal disease (also known as ESRD) has risen shockingly from 10,478 (1980) to 90,118 in 2009. The statistics regarding chronic kidney disease should be scary enough to make us want to inform ourselves more about this condition. But let’s not focus on the frightening statistics regarding kidney failure, but rather try to make an effort to lower these numbers altogether. In this article, we will be focusing upon the symptoms, stages, treatments, causes and prevention of chronic kidney disease, concluding with solutions for support.

Symptoms of chronic kidney disease

Although many symptoms and signs of chronic kidney disease are similar to those of other conditions, you should immediately contact your doctor if you begin experiencing any of the signs we are going to list. Some common symptoms include but are not limited to fatigue, muscle pains (cramps and / or twitching), nausea, insomnia or sleep problems, itching, decreased appetite, hiccups, pathophysiology-related issues like modifications in urine, high blood pressure, breath shortness, vomiting, swelling lower limbs (particularly ankles or feet), chest pain and a general state of weakness.

A series of patients have also described feeling an iron-like taste in their mouth. This also goes hand in hand with the decrease in interest for meat and a loss of appetite in general. Some patients have even claimed losing up to ten pounds before beginning dialysis. Moreover, many individuals who have gone through chronic kidney disease have mentioned getting chills and feeling really cold all the time, no matter the temperature inside the house or outside.

Another key symptom of kidney problems is a “decrease in mental sharpness” as specialists say, meaning that the patient will begin to experience troubles when attempting to concentrate. This particular symptom is due to the anemia that comes along with kidney failure, which cuts off the necessary amount of oxygen that your brain requires in order to function properly. Temporary dizzy feelings can develop into loss of memory if not treated in time.

Like we said before, changes in normal urine patterns can also be a sign of chronic kidney disease. If you find yourself urinating blood, or if your urine tests detect protein in the substance, then you should immediately take action as this is a frequent symptom for CKD. Likewise, urinating often, especially getting up at night to do so, might mean that you are developing or have already developed a kidney condition.

Stages

The Renal Association indicates 5 main stages of chronic kidney disease, based on the Glomerular Filtration Rate (GFR). For those who are unfamiliar with the concept, Glomerular Filtration Rate measures the functionality of the kidney in order to detect the staging of the chronic kidney disease. Doctors use a code or formula that takes into account the gender, age, race and serum creatinine level of a person, in order to obtain their GFR number. You can estimate your GFR by calculating it online with various tools, but it’s best to have a professional healthcare expert diagnose you.

Stage 1

The definition of Stage 1 chronic kidney disease involves 90+ GFR. The kidney tends to function normally, but factors such as urine modifications or a history of CKD in the family indicate the illness. In this stage, it is best for the patient to be kept under observation, while having his or her blood pressure controlled.

Stage 2

The second stage of CKD involves a GFR between 60 and 89. The stage presents the same factors as stage 1, with an added mildly decreased kidney functioning. Treatment coincides with stage 1, adding risk factors to the list.

Stage 3

Stage III is broken down into 3A (GFR 40-59) and 3B (GFR 30-44). The kidney function evolves from mildly decreased to moderately reduced, while treatment and management remain the same as that of stages 1 and 2.

Stage 4

Specialists define Stage 4 chronic kidney disease by severely reduced kidney function, with a Glomerular Filtration Rate of 15-29. In this state, the patient and the doctor must plan for end stage renal failure.

Stage 5

The fifth and final stage of CKD is defined by a GFR below 15 or on dialysis. The description is either extremely severe or even end stage kidney failure, also known as established renal failure. As GFR reduces, you can see that the disease either worsens or can ultimately lead to a reversible kidney illness.

Without wanting to scare you, but you should know that the prognosis of patients that suffer from CKD may not be bright: as the kidney function decrease more and more, the death rate of patients rises.

Treatment

Now that we have the symptoms and stages all covered, we will be focusing upon treating chronic kidney disease. Although CKD cannot be reversed or cured, there are various choices of treatment out there, and you will need to consult your physician in order to find out which treatment is best for your condition. Take into consideration that no form of nursing is permanent, so you can test out different solutions together with your doctor and see which one is right for you in the long run. A few of the common solutions for end stage renal disease are: kidney transplant, peritoneal dialysis, home hemodialysis, and in-center hemodialysis, all involving an iv. These options are all based on the general lifestyle of the patient and should be regarded accordingly. The most recommended solution by specialists is a kidney transplant, as it increases the life expectancy of patients. If you succeed in carrying out one, you will not be obligated to follow a strict diet or be restricted by dialysis and its implications. Another solution that will not affect your schedule that much is PD, also known as peritoneal dialysis.

Doctor administring dialysis to a male patient

It is usually carried out while you sleep at home with the use of a machine that cleans your blood. The process goes on for around 8 to 10 hours. Home hemodialysis, also known as HHD, involves dialyzing more often in order to improve your condition. Time-wise, HHD will take up about 2-3 hours for 5-6 times per week. The final form of treatment, In-Center Hemodialysis involves carrying out the treatment in a dialysis center, where the patient has the chance to communicate more, like with other patients or members of the staff. The main advantage of this option of treatment is that you are under the supervision of professional healthcare specialists at all times. As technology advances, we hope that we will soon be able to offer you even more options for treatment without any unwanted complications. Like we said before, you can discuss these options with your doctor and even test them out with solution A vs solution B, until you find the one which works the best with your job, family situation and all-around daily schedule.

Causes

If you or a loved one are undergoing chronic kidney disease, you are probably interested in finding out the causes that lead to this condition in the first place. According to the Mayo Clinic, a patient ends up developing CKD when he or she is already suffering from an illness or a condition that affects the normal functioning of kidneys. The most common diseases that can cause chronic kidney disease are: high blood pressure, polycystic kidney disease, pyelonephritis (multiple kidney infections), kidney stones, enlarged prostate, diabetes (types 1 or 2), vesicoureteral reflux (when urine backs up into the kidneys of an individual), lupus (as well as other illnesses that have an impact on the immune system of the human body), glomerulonephritis (when the glomeruli, also known as the filtering units of kidneys, experience inflammation) and interstitial nephritis (when the tubules of kidney’s undergo inflammation). A study has also proven that certain types of medication, taken for a long period of time, can end up damaging your kidneys. A few of these medicines can be ibuprofen or celecoxib (both nonsteroidal anti-inflammatory drugs), as well as various antibiotics.

All in all, specialists have concluded that high blood pressure and diabetes are the leading causes of chronic kidney disease, being the reason for 2/3 of CKD cases. The case is also vice-versa, as CKD can end up causing high blood pressure.

Prevention

Sometimes chronic kidney disease is inevitable, especially if it runs in your family, you are hypertensive or suffer from diabetes. Still, there are quite a few steps that you can take in order to prevent the risk of developing chronic kidney disease. So what can you do? If you’re a smoker, then quit! This will not only help you prevent CKD, but it will also aid you in living out a much healthier life, while protecting other vital organs, such as your lungs. If you find difficulty in quitting, consult your doctor for strategies and solutions. Secondly, it would be best if you stopped drinking alcohol altogether, but if that is not possible, at least drink in a moderate manner. Moderation means that you should not consume more than one alcoholic beverage per day if you are a senior citizen (over the age of 65), and maximum two beverages per day if you are below this age. Maintaining a healthy, normal weight will help you avoid chronic kidney disease, as well as a disease-free heart. This is yet another piece of advice that will have a great impact on your entire lifestyle, by frequently exercising and maintaining a low-calorie diet based on healthy food. Try to be more active and take up a sport, as well as avoiding fatty foods and testing out healthy recipes for your own home cooked menu. Our third suggestion involves taking into consideration instructions on various kinds of nonprescription medications. If you are aching and end up consuming too many pain relievers (like Tylenol, Advil or Motrin IB), you could be triggering kidney injury without even knowing it. Finally, always seek the help of your doctor, while treating and attempting to maintain your condition under control. You can always take tests and openly communicate with a specialist regarding your health concerns, and it’s best to do them as soon as you feel you are experiencing any kind of the symptoms we listed above.

Support

If you are suffering from chronic kidney disease, you should know that you are not alone. Like we mentioned in the introduction, there are tens of millions of patients with this condition all across the United States, with even greater numbers around the world. There are countless support groups that you can attend and meet other patients like yourself. You will have the chance to communicate openly about your condition, ask about different guidelines for coping and even make some friendships that could last a lifetime. Organizations such as the National Kidney Foundation, the American Kidney Fund or the American Association of Kidney Patients offer resources for finding the closest support groups located in the area you live in, whereas Medscape offers many online resources for understanding and coping.

Secondly, having chronic kidney disease does not mean that you cannot live out a normal life while undergoing treatment. Go to work, take care of your family, be physically active and live out every moment to the fullest. The most important moment of the entire process is most likely when you receive the diagnosis; don’t allow yourself to fall into depression and cope with your condition by being as productive as you can!

Thirdly, one of the most significant ways to cope with chronic kidney disease is to maintain communication with a loved one. Whether it is a family member or a close friend, the right amount of warm, compassionate and empathic words can really work wonders for your general state of mind. Try to be as open as possible and really let off everything that seems to be on your chest. If you feel that finding the right person to confide is difficult for you, try openly speaking to your doctor or asking for recommendations regarding counseling. Be strong and have the will to carry out a beautiful and flourishing life!

Photo credits: Kidneybuzz.com, Mcscooby.blogspot.com.

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