Chronic Kidney Disease


A progressive decrease in kidney function is a feature of chronic kidney disease, commonly known as chronic kidney failure. Wastes and extra fluid are removed from your blood by your kidneys and then passed through your urine. Your body may accumulate hazardous amounts of fluid, electrolytes, and wastes if you have advanced chronic renal disease.

You may not have many signs or symptoms when the chronic kidney disease is first developing. You might not notice that you have kidney disease until the situation is advanced.

The goal of chronic renal disease treatment is to slow the development of kidney damage, generally by addressing the underlying cause. Nevertheless, even addressing the cause could not protect kidney disease from worsening. Without mechanical filtration (dialysis) or a kidney transplant, end-stage renal failure from chronic kidney disease is deadly.

Chronic Kidney Disease: Causes

When kidney function is compromised by a disease or condition, chronic kidney disease develops. Over the course of several months or years, the kidney damage gets worse.

The following illnesses and diseases can lead to chronic kidney disease −

  • Diabetes, type1 or type2

  • Elevated blood pressure

  • An inflammation of the kidney's filtration organs is known as glomerulonephritis (glomeruli)

  • An inflammation of the kidney's tubules and surrounding tissues is known as interstitial nephritis.

  • Other hereditary kidney illnesses, such as polycystic kidney disease

  • persistent blockage of the urinary system caused by diseases including an enlarged prostate, kidney stones, or certain malignancies

  • The disorder is known as vesicoureteral reflux, which causes urine to back up into the kidneys.

  • Pyelonephritis, another name for recurrent kidney infection

Chronic Kidney Disease: Symptoms

As kidney damage advances gradually, signs and symptoms of the chronic renal disease appear over time. An accumulation of fluid, a buildup of bodily waste, or electrolyte issues can all be brought on by kidney failure.

Loss of kidney function can lead to any of the following depending on its severity −

  • Nausea

  • Vomiting

  • Reduced appetite

  • Weakness and weary

  • Issues with sleep

  • More or less frequent urination Diminished mental clarity

  • Muscle cramps

  • Swelling in the ankles and feet

  • Itchy, dry skin

  • Hard to regulate high blood pressure (hypertension)

  • Breathlessness if pulmonary fluid accumulates

  • If fluid accumulates around the heart's lining, chest discomfort may result.

Kidney disease symptoms and signs are frequently vague. They can thus also be brought on by other diseases. You might not experience symptoms until permanent damage has taken place since your kidneys can compensate for reduced function.

Acute renal failure can have an impact on virtually every organ in your body. Complications that might arise include −

  • Fluid retention, which can cause edema in the arms and legs, hypertension, or fluid in the lungs (pulmonary edema)

  • Hyperkalemia, a rapid increase in potassium levels in the blood that might endanger your life by affecting how well your heart functions

  • Anemia

  • Heart condition

  • Bone fracture risk is enhanced by weak bones.

  • Low fertility, erectile problems, or decreased sex desire

  • A central nervous system injury may result in personality changes, difficulties focusing, or convulsions.

  • Reduced immunological response, which increases your susceptibility to infection

  • An inflammation of the sac-like membrane that surrounds your heart is called pericarditis (pericardium)

  • Problems in pregnancy that put both the mother and the fetus in danger.

Chronic Kidney Disease: Risk Factors

The major risk factors include −

  • Diabetes

  • Elevated blood pressure

  • Illness of the heart and blood vessels

  • Smoking

  • Obesity

  • Having a kidney disease-related family history and being Black, Native American, or Asian American

  • Unusual kidney structure advancing age

  • Frequent use of drugs that can harm the kidneys

Chronic Kidney Disease: Diagnosis

Your doctor will initially talk with you about your personal and family history to help diagnose renal disease. Your doctor may inquire about your family history of kidney illness if you have been diagnosed with high blood pressure, whether you have taken any medications that may have an impact on kidney function, whether you have seen changes in your urination patterns, and more.

Your doctor will then do a physical examination, looking for any indications that your heart or blood vessels are having issues, as well as a neurological examination.

You might also require certain tests and treatments to diagnose kidney illness and assess the severity of your kidney disease (stage). Tests might consist of −

  • A blood test. Kidney function tests measure the number of waste products in your blood, including urea and creatinine.

  • Testing urine. A urine sample analysis can show irregularities that suggest chronic kidney failure and assist in determining the underlying cause of chronic kidney disease.

  • Image-based exams. To evaluate the shape and size of your kidneys, your doctor could utilize ultrasonography. In some situations, other imaging tests could be employed.

  • Taking a kidney tissue sample for analysis. A kidney biopsy, which includes taking a sample of kidney tissue, may be advised by your doctor. A long, thin needle is pushed through your skin and into your kidney during a kidney biopsy procedure under local anesthetic.

Chronic Kidney Disease: Treatment

Certain kidney diseases can be treated, depending on the underlying reason. Yet, chronic renal disease is frequently incurable.

Therapy often comprises steps to lessen consequences, regulate symptoms, and delay the disease's course. You may need therapy for end-stage renal disease if your kidneys suffer substantial damage.

Dialysis

When your kidneys are unable to filter out waste and excess fluid from your blood, dialysis can do it for you. A machine separates waste and extra fluid from your blood during hemodialysis.

An Organ Transplant

A healthy kidney from a donor is surgically implanted into your body during a kidney transplant. Both live and deceased donors can provide kidneys for transplant.

You will require lifelong medication after a transplant to prevent your body from rejecting the new organ. A kidney transplant is not required for those who are not on dialysis.

Chronic Kidney Disease: Prevention

One can take the following preventive measures to avoid getting a chronic kidney disease −

  • Take prescription and over-the-counter drugs as directed. Follow the directions on the label while taking over-the-counter painkillers including aspirin, ibuprofen, and acetaminophen. Kidney damage can result from using too many painkillers over an extended period.

  • Keep a healthy weight. Maintain your healthy weight by engaging in physical activity on the majority of your weekdays. If you need to reduce weight, discuss appropriate weight-loss techniques with your doctor.

  • Avoid smoking. Smoking cigarettes can harm your kidneys and exacerbate whatever renal problems you already have. Ask your doctor for advice on how to stop smoking if you do. Support groups, therapy, and drugs can all assist you to stop.

  • Control your medical issues with the assistance of your doctor. Work with your doctor to control any illnesses or conditions that put you at risk for renal disease. To find out about tests to check for kidney damage, consult your doctor.

Conclusion

A considerable portion of individuals with chronic kidney disease never have a particular cause identified, and the illness progresses slowly. It has several multi-system consequences that greatly reduce sufferers' quality of life and lengthen their mortality.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 30-Mar-2023

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