Chronic Kidney Disease

Chronic Kidney Disease (CKD) is a diagnosis given to a person who has a disease or disorder that affects the kidneys. It is divided into five stages and we provide care for patients with all stages of kidney disease.

The kidneys are a two bean-shaped organs located just behind the stomach. They filter various toxins and extra salt and water from the body. They also make hormones that keep your bones strong and blood healthy.

Causes

There are more than 100 disorders, diseases and conditions that can lead to progressive destruction of the kidneys.

People with diabetes, high blood pressure, and atherosclerosis (hardening of the arteries) are at risk for kidney disease, as well as people with a family history of kidney disease/failure. Disease and infection in other parts of the body can also trigger a kidney disorder.

Findings by the National Kidney Foundation show that African Americans are four times as likely to develop End Stage Renal Disease (a condition where patients need a transplant or dialysis to survive).

Other at-risk groups include American Indians, Hispanic/Latinos, Pacific Islander Americans, older people and overweight people. These at risk groups and people who have a family history of kidney disease should have their urine tested regularly.

Symptoms

Many times there are no symptoms of kidney disease until late in its course. You may have it, but not know because you don’t feel sick.

 Some common warning signs:

• Increased or decreased frequency of urination
• Blood in the urine
• Swollen hands and feet, puffiness around the eyes
• High blood pressure

Diagnosis

To detect the disease doctors can do several simple tests including a blood test, a urine sample, checking your blood pressure, kidney imaging such as a kidney ultrasound or CT scan, and possibly a kidney biopsy.

Disorders and diseases that may affect the kidney should be evaluated by a specialist early in its course because kidney impairment can be progressive and the progression can often be slowed or stopped by early interventions.

Several different laboratory values can be used to determine how well your kidneys are functioning.

1. Creatinine: Creatinine is a waste product of the body, produced every day. Creatinine (or Cr) is filtered by the kidneys into the urine. If the kidneys are filtering normally, the creatinine will stay in a range around 1.0 (depending on your age). If the kidneys are not filtering normally, the creatinine will build up in the blood. This often triggers a referral to the nephrologist.
2. Glomerular Filtration Rate (GFR): Using the creatinine, a physician or laboratory can determine the GFR of your kidneys. GFR represents the rate at which the kidneys are filtering the toxins in your body. GFR is used to determine your stage of Chronic Kidney Disease. For most people, a GFR > 60 is normal.

The five stages of CKD are:

• Stage 1: Kidney damage with normal kidney function (estimated GFR ≥90 mL/min per 1.73 m2) and persistent (≥3 months) proteinuria.
• Stage 2: Kidney damage with mild loss of kidney function (estimated GFR 60-89 mL/min per 1.73 m2) and persistent (≥3 months) proteinuria.
• Stage 3: Mild-to-severe loss of kidney function (estimated GFR 30-59 mL/min per 1.73 m2).
• Stage 4: Severe loss of kidney function (estimated GFR 15-29 mL/min per 1.73 m2).
• Stage 5: Kidney failure requiring dialysis or transplant for survival. Also known as ESRD (End Stage Kidney Disease, estimated GFR <15 mL/min per 1.73 m2).

Treatment

Kidney disease is treated by a combination of methods that include dietary adjustments, medications, and lifestyle modifications. If the kidneys stop working enough to keep you going, their functions can be replaced by dialysis or a kidney transplant.

Talk to your doctor about what options are best for you.

What happens if kidneys fail completely?

If your kidneys stop working completely, your body fills with extra water and waste products. Your hands or feet may swell. You will feel tired and weak because your body needs clean blood to function properly. At this point you may need dialysis or a kidney transplant to help you feel better.