Chronic Kidney Disease "CKD" is a state of progressive loss of kidney functions which ultimately leads to the requirement of renal replacement therapy. The true measure as to what percent of the total population suffer from CKD is difficult to estimate as most patients are asymptomatic until kidney functions have been significantly impaired. The CDC estimates about 15% of American adults to be suffering from CKD.
Chronic kidney diseases are kidney damages that last for at least 3 months and are characterized by structural or functional damages to the kidney. These abnormalities may or may not present with decreased glomerular filtration rate (GFR). GFR is the measure of how much blood is filtered by the kidney in a minute.
Causes of CKD
CKD is usually multifactorial in its development; multiple factors that damage the kidney combine leading to impaired kidney function. Various conditions implicated include:- Hereditary: You are at a higher risk of developing CKD if your family members suffer from it. Diabetes: Diabetes is the leading cause of chronic kidney disease in the United States. An increase in levels of blood glucose causes damage to the blood vessels in the kidney compromising the functions of the kidney.
- Hypertension: Increased pressure in the vessels of your kidney over a considerable period causes it to weaken and narrow leading to impaired kidney functions.
- Pathologies of kidney tissue: Damage to intrinsic tissues of the kidney can lead to impaired functions
- Obstructive nephropathies: Conditions causing blockage of urine passage lead to a backflow of urine into the nephrons (functional unit of the kidney) and ultimately disrupts function.
- Cystic Diseases: Cystic disease of kidneys has also been shown to lead to functional impairment.
- Nephrotoxic drugs: Chronic use of painkillers and Lithium has been shown to increase the risk of CKD.
Signs and Symptoms of Chronic Kidney Disease
Symptoms are multi-systemic and may include:- Fatigue and weakness
- Nausea and vomiting
- Fluid retention leading to swelling in different parts of the body
- Easy skin bruising
- Difficulty breathing
- Loss of appetite
- Irritability and lack of concentration
- Bone and joint pain
- Increased predisposition to fractures
- Exercise intolerance
- Leg cramps, numbness, and restlessness
- Decreased libido
Diagnosis of Chronic Kidney Disease
The diagnosis of CKD is done based on:Medical History and physical examination: This helps identify the presence of different causative factors leading to Chronic Kidney Disease.
Imaging Studies: USG or CT scan of your abdomen and kidneys helps identify kidney pathologies.
Blood tests: Blood tests to estimate the level of waste products like creatinine. It also helps identify abnormalities in the acid-base balance of the body
Urine test: This helps estimate GFR and check for the presence of excess proteins or blood in the urine.
Management of Chronic Kidney Disease
There is no definite cure for chronic kidney disease as of now. Treatment measures are directed at symptomatic relief, prevention of disease progression, and reducing complications, and restoring quality of life. Main treatment strategies include:Lifestyle modification: Altering certain habits can help reduce disease progression and prevent complications. Quitting smoking, exercising, and having a balanced diet are few important lifestyle interventions. Salt intake should be consumed in moderation and painkillers should be avoided unless prescribed.