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Chronic kidney disease (CKD} happens when 85-90% of your kidney gets damaged and becomes functionally impaired.
Doctors have staged the progression of chronic kidney disease (CKD) from stage 1 to stage 5 in the increasing order of its severity. These stages are based on your glomerular filtration rate (GFR).
GFR is a test that is used to check the functioning of your kidneys. Its results are in the form of mL/min, which is the amount of blood that passes through each filtering unit (glomeruli) of the kidney in a minute.
The GFR is calculated from your serum creatinine levels, your body size, age, sex, and ethnicity.
Table 1. Stages of CKD with corresponding GFR and kidney function
Stages of CKD
GFR in mL/min
Status of kidney function
Stage 1
≥90
Normal kidney function
Stage 2
60-89
A mild decline in kidney function
Stage 3
30-59
A moderate decline in kidney function
Stage 4
15-29
A severe decline in kidney function
Stage 5
<15
Kidney failure or end-stage renal disease (ESRD) requiring dialysis
What causes chronic kidney disease?
CKD happens when 85-90% of your kidney gets damaged and becomes functionally impaired. CKD is caused by a variety of conditions that gradually affect the kidney’s functions over a few to several years.
The conditions that cause chronic kidney disease include
- Diabetes (common cause)
- Hypertension (high blood pressure)
- Inflammation of the kidney’s structural units
- Glomerulonephritis (inflammation of the glomeruli)
- Interstitial nephritis (an inflammation of the kidney's tubules and surrounding structures)
- Polycystic kidney disease (multiple cysts or fluid-containing sacs in the kidney that occur by birth)
- Prolonged obstruction of the urinary tract by conditions, such as
- Enlarged prostate
- Kidney stones
- Tumors
- Pyelonephritis (bacterial infection of the kidney)
- Painkiller consumption over a long time
What are the signs and symptoms of chronic kidney disease?
Patients with CKD stages 1-3 generally do not have symptoms. Typically, signs and symptoms start appearing during the last stages of 4-5 (GFR < 30). These include:
- Nausea
- Loss of appetite
- Weight loss
- Fatigue
- Weakness
- Headaches
- Trouble sleeping
- Drowsiness
- Changes in how much you urinate
- Muscle cramps
- Swelling of feet and ankles
- Itching
- Dry skin or darkened skin
- Shortness of breath
- Uncontrolled high blood pressure (hypertension)
- Difficulty concentrating
QUESTION
The only purpose of the kidneys is to filter blood.
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How is chronic kidney disease diagnosed?
The doctor will take your complete medical history along with your family history, such as if anyone in your family has or had diabetes, whether you are on any medications (that can cause kidney damage), and so on. They will perform a thorough physical examination to see if you have any signs or symptoms of CKD.
A few tests will help your doctor confirm the diagnosis of CKD. These are:
- Kidney function tests: This test will look at your creatinine levels to check if you have trouble with your kidney.
- Blood tests: Low hemoglobin levels are found in CKD.
- Urine test: This will be done particularly to check for the presence of protein or persistent protein (proteinuria) in the urine, which is a sign of kidney damage. Other things that the doctor will look for include red blood cells (RBCs) and white blood cells (WBCs).
- Ultrasonography: To check for any cysts or scarring or size of the kidney.
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What are the complications of CKD?
CKD can affect many systems of your body. Some of its complications are:
- High blood pressure
- High cholesterol levels
- Pulmonary edema (fluid in your lungs)
- Cardiac arrhythmia (abnormal heart rhythms due to a sudden rise in potassium levels)
- Heart diseases
- Osteopenia (weakening of bones)
- Anemia (low hemoglobin level/low blood count)
- Erectile dysfunction
Can chronic kidney disease be cured?
There is no cure for CKD. However, treatments and an appropriate diet (low-protein, low-salt) can help manage its signs and symptoms. They can help you halt the progression of CKD to a certain extent.
Medications given to treat the complications of CKD can help you make feel better.
There are two main treatments for kidney failure:
- Dialysis: Dialysis is a procedure in which a machine placed outside of your body takes the role of a kidney. This procedure needs to be performed at least three times a week.
- Kidney transplant: A damaged kidney is replaced with a healthy kidney taken from a donor.