What is chronic kidney disease; how to deal with it
Chronic kidney disease (CKD) is a condition characterised by a gradual loss of kidney function over time. The term chronic is used to refer to a condition which is permanent and irreversible. In addition it progressively worsens even with treatment. This will eventually, over a period of time lead to need for dialysis or renal transplantation.
This is associated with complications such as high blood pressure, weak bones, low blood hemoglobin and cardiac and nerve and brain damages.
The two main causes of chronic kidney disease are diabetes mellitus and high blood pressure. Several other conditions such as congenital disorders, urinary obstruction, and renal stone diseases can cause chronic kidney disease.
Most people may not have any symptoms until their kidney disease is advanced. However, the following symptoms occur as the disease progresses.
Tiredness and feeling less energetic in day to day activities; have trouble concentrating have a poor appetite and have difficulty in sleeping. These are non-specific symptoms and occur very slowly and are difficult to recognize in the beginning.
In addition patient may also have certain specific symptoms like swelling in the feet, and puffiness of the face especially around the eyes more so in the morning. Decrease in urination sometimes associated with the need to urinate more often at night occurs.
In severe cases and advanced renal failure patients have breathing difficulty, headache, convulsions, visual disturbances, and loss of consciousness. This warrants emergency treatment. Earlier the disease is detected; better the chances of slowing or stopping its progression.
Blood Urea Nitrogen and Serum Creatinine: These are chemicals which form in the body during day to day activities. They are normally excreted by the kidney and it accumulates in the blood in patients in whom the kidney function is reduced.
A raised blood urea and creatinine levels generally indicate kidney failure; however the values need to be interpreted taking in to account several other variables. Generally both blood urea and serum creatinine levels are to be considered.
If these tests are abnormal then several other chemicals in the body need to be measured to decide on the severity of the disease and to guide the treatment. Ultra sound scan or CT scan of the kidneys will give information regarding the size of the kidneys and presence or absence of obstruction.
In patients with chronic kidney disease the kidney size is usually reduced to less than 9-centimetre, which is the normal size. In addition the appearance of the kidneys in the scan also is abnormal.
Additional tests like kidney biopsy may be necessary in some patients. Two simple tests can detect chronic kidney disease: blood pressure, urine albumin and serum creatinine.
Supportive treatment in the early stages include medication to control blood pressure, blood sugars in patients with diabetes, and some medications to alleviate the problems due to alterations in electrolytes, water content of the body and the bone minerals.
>Diet: Salt restriction and fluid restriction to control blood pressure and fluid accumulation in the body >Low protein: Protein in the diet acts as an additional burden on the already malfunctioning kidneys. Moderate reduction in dietary protein intake is known to reduce the progression of the kidney failure.
Renal replacement therapy when the disease is advanced.