Chronic Kidney Disease
What is chronic kidney disease?
Chronic kidney disease (CKD) is a disease in which the kidneys progressively stop working over time. The kidneys' main job is to clear waste products, toxins, and excess fluids from your blood. The term for that is filtering. CKD occurs when your kidneys start losing their ability to do this work.
When kidney disease starts, small amounts of protein leak into your urine. As CKD gets worse, more of this protein accumulates in the urine. This is usually a sign the kidneys are losing their ability to filter your blood properly. It means that waste and excess water are not properly removed from the bloodstream.
The disease commonly affects people with diabetes and high blood pressure, but can affect others as well. More than 1 in 7 people in the United States have chronic kidney disease.
You may not experience any symptoms in the early stages of chronic kidney disease. As the disease progresses, you may experience such symptoms as fatigue, general feelings of illness, headaches, unexplained weight loss, and nausea. Middle stage symptoms include pain, confusion, muscle twitching, numbness and tingling, bad breath, bruising, bleeding, unusual thirst, sleep disorders, edema (swelling), and vomiting. The last stage of chronic kidney disease is known as end stage renal disease, or kidney failure.
Treatment for chronic kidney disease includes medications to lower blood pressure or control the level of phosphorus in the body. Supplements may be useful in boosting depleted vitamin levels and treating anemia. Once chronic kidney disease has progressed to its final stages, dialysis or even kidney transplant may be necessary.
While there is no cure, chronic kidney disease can be managed. If you have risk factors for chronic kidney disease, it is vitally important to see your doctor regularly. Early diagnosis requires simple blood and urine tests, and is critical for ensuring a good outcome. Changes in your lifestyle, such as eating a healthy diet, exercising regularly, and avoiding smoking, may also help prevent or control chronic kidney disease.
Seek prompt medical care if you have signs and symptoms of kidney disease.
Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms, such as confusion, easy bleeding or bruising, difficulty breathing, inability to urinate, or bloody stool.
What are the symptoms of chronic kidney disease?
Symptoms of chronic kidney disease are related to the body’s inability to eliminate waste and excess water. Symptoms are progressive, meaning that they get worse over time. Early stage chronic kidney disease may not manifest any symptoms because the kidneys adapt and try to make up for the loss of function. In fact, 9 in 10 adults with chronic kidney disease don’t know they have it. End stage chronic kidney disease, or end stage renal failure, involves symptoms that are very serious, even life-threatening.
Early symptoms of chronic kidney disease
You may experience chronic kidney disease symptoms daily or just once in a while. At times, any of these symptoms can be severe:
- Dry skin
- General ill feeling (malaise)
- Itchy skin
- Nausea with or without vomiting
Later symptoms of chronic kidney disease
As chronic kidney disease progresses, existing symptoms will worsen and new symptoms can appear. These symptoms include:
- Amenorrhea (loss of menstrual period)
- Bone pain
- Changes in skin pigmentation
- Changes in urination
- Edema (swelling) in your feet and ankles
- Excessive thirst
- Muscle twitching, spasms or cramps
- Skin discoloration such as bruising
- Sleep disturbances
Serious symptoms that might indicate a life-threatening condition
In some cases, chronic kidney disease can be life-threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
- Blood-streaked stools
- Bloody stool (blood may be red, black, or tarry in texture)
- Chest pain or pressure
- Confusion or loss of consciousness, even for a brief moment
- Difficulty breathing or shortness of breath
- Easy bleeding or bruising
- Inability to urinate
What causes chronic kidney disease?
Chronic kidney disease is caused by damage to the kidneys over time. Usually, damage to the kidneys results from high blood pressure or poorly controlled diabetes. Damage to the kidneys may also result from problems with the circulatory system; kidney disorders, such as kidney stones; certain medications; environmental toxins; injury; or autoimmune disorders. The damaged kidneys become increasingly inefficient at filtering waste and excess water from the body, which can cause the disease to worsen.
Common causes of chronic kidney disease
Chronic kidney disease results from damage to the kidneys over time from a variety of conditions including:
- Certain chemicals, toxins or medications
- High blood pressure
- Infection (recurring kidney or urinary tract infections)
- Kidney stones
- Scleroderma (connective tissue disease characterized by skin and blood vessel changes)
- Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)
Other causes of chronic kidney disease
Chronic kidney disease can also occur due to a variety of other conditions including:
- Arterial defects
- Birth defects
- Glomerulonephritis (kidney inflammation)
- Kidney damage from enlarged prostate
- Kidney disease (including any type of kidney problem, such as kidney stones, kidney failure, interstitial nephritis, and kidney anomalies)
- Polycystic kidney disease (condition characterized by multiple cysts within the kidneys)
- Reflux nephropathy (damage to the kidneys due to backward flow of urine)
What are the risk factors for chronic kidney disease?
A number of factors are known to increase your risk of developing chronic kidney disease. Not all people with these risk factors will develop chronic kidney disease. Risk factors for chronic kidney disease include:
- Family history of diabetes
- Family history of kidney problems
- High blood pressure
- Personal history of autoimmune disorders
- Recent injury
- Recurrent UTIs
Doctors can detect CKD by checking for certain conditions that affect the kidneys. CKD generally results from poorly controlled high blood pressure or diabetes. You may have blood tests done if you’re at risk for kidney disease because of these health problems or a family history of kidney disease. Diagnosing and treating kidney disease and chronic kidney disease early on can help protect your kidneys and prevent kidney failure.
You can take basic precautions to help maintain a healthy blood pressure, thus minimizing your risk of chronic kidney disease. You may be able to lower your risk of CKD by:
- Avoiding smoking
- Controlling high blood pressure
- Controlling your blood sugar if you have diabetes
- Eating a healthy diet low in fat, cholesterol and salt
- Exercising regularly
How is chronic kidney disease treated?
The goal of chronic kidney disease treatments is to slow and minimize damage to the kidneys. If CKD progresses to end stage renal disease, dialysis or kidney transplant may be necessary to properly remove waste and excess water from the bloodstream.
Medications for chronic kidney disease
CKD medications lower blood pressure and restore the proper balance of vitamins and minerals in the blood. Medications your healthcare provider may recommend include:
- Blood pressure regulators, such as angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs)
- Calcium supplements
- Iron supplements or erythropoietin to prevent anemia
- Phosphate binders, to maintain proper phosphate levels in the blood
- Vitamin D supplements
Other treatments for chronic kidney disease
In addition to medication, your doctor may recommend:
- Blood transfusions
- Dialysis (filtering of the blood through a machine to remove toxins)
- Kidney transplant
What you can do to improve your chronic kidney disease
In addition to medication and other treatments, lifestyle modifications may help slow the progression of your chronic kidney disease. These modifications include:
- Avoiding smoking
- Changing your diet to limit fluids, protein, salt, potassium, phosphorous and electrolytes
- Consuming enough calories to prevent excessive weight loss
- Controlling your blood pressure
- Controlling your blood sugar
- Exercising regularly
- Getting the appropriate vaccinations
- Participating in a support group to cope with the stress of chronic kidney disease
What are the potential complications of chronic kidney disease?
Chronic kidney disease is a serious illness. While you are unlikely to suffer complications with early stage chronic kidney disease, the risk of complications increases dramatically as the disease progresses. Complications of untreated or poorly controlled chronic kidney disease can be life-threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your doctor design specifically for you.
Complications of chronic kidney disease include:
- Anemia (low red blood cell count)
- Cardiovascular disease
- Damage to the brain and nerves
- Hyperparathyroidism (overproduction of parathyroid hormone)
- Increased risk of infection
- Increased risk of bone fractures