Chronic Kidney Disease

Chronic Kidney Disease

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It is the slow loss of kidney function over time. The main job of these organs is to remove wastes and excess water from the body.

Causes
Chronic kidney disease (CKD) worsens slowly for months or years. You may not notice any symptoms for some time. Loss of function may be so slow that you will not have symptoms until the kidneys have nearly stopped working.

The final stage of CKD is called end-stage renal disease (ERT). At this stage, the kidneys no longer have the ability to remove enough waste and excess fluid from the body. At that time, you would need dialysis or a kidney transplant .

The diabetes and hypertension are the 2 most common causes and are responsible for most cases.

Many other diseases and conditions can damage the kidneys, for example:

Autoimmune disorders (such as systemic lupus erythematosus and scleroderma )
Birth defects (congenital anomalies) of the kidneys (such as polycystic kidney disease )
Certain Toxic Chemicals
Kidney Injury
Infection and  kidney stones
Problems with the arteries that irrigate the kidneys
Some medications such as pain relievers (analgesics) and drugs for cancer
Retrograde flow of urine to the kidneys ( reflux nephropathy )
Other kidney diseases
The CKD leads to an accumulation of liquid and waste products in the body. This condition affects most body functions and systems, including:

Arterial hypertension
Low hemograms
Vitamin D and bone health
symptom
The first symptoms of CKD are also the same as those of many other diseases. These symptoms may be the only sign of a problem in the initial stages.

Symptoms may include:

Inapetencia
Feeling of general discomfort and fatigue
Headaches
Itching ( itching ) and dryness of the skin
Sickness
Unintentional weight loss
Symptoms that may occur when kidney function has worsened include:

Abnormally dark or clear skin
Bone-ache
Drowsiness or trouble concentrating or thinking
Numbness or swelling in hands and feet
Muscle cramps or cramps
Bad breath
Susceptibility to hematomas or blood in the stool
Excessive thirst
Frequent hiccup
Problems with sexual activity
Arrest of menstrual periods (amenorrhea)
Difficulty breathing
Sleeping problems
Vomiting, often in the morning
Tests and exams
Most people will have high blood pressure during all stages of CKD. When you do a test, your health care provider may also hear abnormal heart or lung sounds in your chest. On a test of the nervous system, you may show signs of nerve damage.

A urinalysis may reveal protein or other changes. These changes can occur 6 to 10 months before the onset of symptoms.

Tests to see how well the kidneys are working include:

Creatinine clearance
Creatinine levels
Urea nitrogen in the blood ( BUN , for its acronym in English)
The CKD changes the results of many other tests. You should do the following studies even every 2 to 3 months when kidney disease worsens:

Albumin
Calcium
Cholesterol
Complete blood count (CSC)
Electrolytes
Magnesium
Match
Potassium
Sodium
Other tests that may be done to look for the cause or type of kidney disease include:

CT scan of the abdomen
MRI of the abdomen
Abdominal ultrasound
Kidney biopsy
Kidney scintigraphy
Kidney ultrasound
This disease may also change the results of the following tests:

Erythropoietin
Parathyroid Hormone ( PTH , for its acronym in English)
Examination of bone density
Vitamin D Level
Treatment
Controlling blood pressure will delay further damage to the kidney.

Angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are most commonly used.
The goal is to maintain blood pressure at or below 130/80 mm Hg.
Making lifestyle changes like the following may help protect the kidneys and prevent heart disease and stroke:

Do not smoke.
Eat foods that are low in fat and cholesterol.
Exercise regularly (talk to your doctor or nurse before starting).
Take cholesterol-lowering medicines, if needed.
Keep your blood sugar checked.
Avoid drinking too much salt or potassium.
Always talk to your kidney specialist before taking any over-the-counter medications. This includes vitamins, herbs and supplements. Make sure that all care providers you visit know that you have ERC.

Other treatments may include:

Medications called phosphate fixatives to help prevent high levels of phosphorus.
Extra iron in food, iron tablets, iron through a vein (intravenous iron) Special injections of a drug called erythropoietin and blood transfusions to treat anemia.
Calcium and extra vitamin D (always talk to the care provider before taking them).
Your care provider may ask you to follow a special ERC diet .

Limit liquids
Eat less protein
Restricting salt, potassium, phosphorus and other electrolytes
Get enough calories to prevent weight loss
All people with CKD should keep up-to-date the following vaccines:
Hepatitis A vaccine
Hepatitis B Vaccine
Flu shot
Pneumonia vaccine (PPV, for its acronym in English)
Support groups
Some people benefit from participating in a support group for kidney disease.

Expectations (prognosis)
Many people are not diagnosed with CKD until they have lost much of their kidney function.

There is no cure for this disease. If the disease worsens to an ERT (terminal kidney disease), and how quickly it will, they depend on:

The cause of kidney damage.
How well you take care of yourself.
Renal failure is the last stage of CKD. This is when your kidneys can no longer meet your body needs.

Your care provider will talk about dialysis with you before you need it. Dialysis removes waste from the blood when the kidneys can no longer function.

In most cases, you should have dialysis when you have only 10 to 15% of kidney function left.

Even people who are waiting for a kidney transplant may need dialysis while they wait.

Possible complications
Complications may include:

Anemia
Bleeding from the stomach or intestines
Bone, joint or muscle pain
Changes in blood sugar levels
Damage to the nerves of the legs and arms ( peripheral neuropathy )
Dementia
Accumulation of fluid around the lungs ( pleural effusion )
Cardiovascular complications
High levels of phosphorus
High levels of potassium
Hyperparathyroidism
Increased risk of infections
Liver damage or impairment
Malnutrition
Spontaneous abortion and infertility
Seizures
Swelling ( edema )
Weakening of bones and increased risk of fractures
Prevention
Treating the condition that is causing the problem can help prevent or delay CKD. People who have diabetes should monitor their blood sugar and blood pressure, as well as refrain from smoking.

Alternative Names
Kidney insufficiency - chronic; Chronic renal failure; Chronic renal failure; Chronic kidney failure; Chronic renal failure