Is Chronic Kidney Disease (CKD)?
Chronic kidney disease (CKD) is the progressive and irreversible destruction
of the kidneys.
Your kidneys are essential parts of your body. They have several
- helping maintain the balance of minerals and
electrolytes in your body, such as calcium, sodium, and potassium
- playing an essential role in the production of
red blood cells
- maintaining the delicate acid-base balance of
- excreting water-soluble wastes from your body
Damaged kidneys lose their ability to perform these functions. The
Centers for Disease Control (CDC) estimates that at least 20 million
Americans have CKD.
Causes Chronic Kidney Disease?
The most common causes of CKD are high blood pressure and diabetes.
Each kidney contains about 1 million tiny filtering units called
nephrons. Any disease that injures or scars these filtering units can cause
kidney disease. Diabetes and high blood pressure can both damage your nephrons.
High blood pressure can also damage the blood vessels of your
kidneys, heart, and brain. This is key because blood vessel diseases are generally
dangerous to your kidneys. The kidneys are highly vascularized, meaning they
contain lots of blood vessels.
Autoimmune diseases such
as lupus can damage blood vessels and can make antibodies against kidney
There are various other causes of CKD. Polycystic kidney disease
is a hereditary cause of CKD. Glomerulonephritis can be due to lupus. It can
also appear after a streptococcal infection.
Is at Risk for Chronic Kidney Disease?
The risk of CKD increases for those over the age of 65. It runs
in families. It’s more likely to occur in African-Americans, Native Americans,
and Asian-Americans. Other risk factors for CKD include:
- cigarette smoking
- high cholesterol
- diabetes (types 1 and 2)
- autoimmune disease
- obstructive kidney disease, including bladder
obstruction caused by benign prostatic hyperplasia (BPH)
- cirrhosis and liver failure
- narrowing of the artery that supplies your
- kidney cancer
- bladder cancer
- kidney stones
- kidney infection
- systemic lupus erythematosus (SLE)
- vesicoureteral reflux, which occurs when urine
flows back into your kidney
Are the Symptoms of Chronic Kidney Disease?
CKD doesn’t cause any symptoms until most of your kidney is
destroyed. Once the kidney is severely damaged, the symptoms of CKD can
- swelling around your eyes, which is called
- swelling of your legs, which is called pedal
- shortness of breath
- vomiting, especially in the morning and after
- a urine-like odor to your breath
- bone pain
- abnormally dark or light skin
- an ashen cast to your skin, which is called
- mental cloudiness
- numbness in your hands and feet
- restless leg syndrome
- brittle hair and nails
- weight loss
- a loss of muscle mass
- muscle twitching and cramps
- easy bruising and bleeding
- blood in your stools
- excessive thirst
- low level of interest in sex, impotence
- sleep apnea
You may also have the symptoms of any diseases that are contributing
to your kidney problems.
Is Chronic Kidney Disease Diagnosed?
The diagnosis of CKD starts with a medical history. A family
history of kidney failure can raise suspicions, as can a history of high blood
pressure or diabetes. However, other tests are necessary to confirm that you
Complete Blood Count (CBC)
A complete blood count (CBC) can show anemia. Your kidneys make
erythropoietin, which is a hormone. This hormone stimulates your bone marrow to
make red blood cells. When your kidney is severely damaged, your ability to make
erythropoietin decreases. This causes a decline in red blood cells known as
CKD can affect your electrolyte levels. Potassium may be high and
bicarbonate levels may be low if you have CKD. There may also be an increase of
acid in the blood.
Blood Urea Nitrogen (BUN)
Blood urea nitrogen (BUN) can become elevated when your kidney
starts to fail. Normally, your kidney clears the products of protein breakdown
from your blood. However, after kidney damage, these byproducts build up. Urea
is one byproduct of protein breakdown. Urea is what gives urine its odor.
As kidney function declines, your creatinine increases. This
protein is also related to muscle mass.
Parathyroid Hormone (PTH)
The kidney and the parathyroid glands interact through the
regulation of calcium and phosphorus. A change in kidney function affects the
release of PTH. This affects calcium levels throughout your body.
When your kidney progresses to end-stage renal disease (ESRD), it
no longer excretes enough phosphorus and it impairs vitamin D synthesis. Your
bones may release calcium. This causes your bones to become weak over time.
Renal Flow and Scan
This is an imaging study of kidney function.
This noninvasive test provides images to help determine whether
there’s an obstruction.
Additional tests for CKD include:
- a kidney biopsy
- a bone density test
- an abdominal CT scan
- an abdominal MRI
Is the Treatment for Chronic Kidney Disease?
CKD is chronic and irreversible. Treatment focuses on improving
the underlying disease.
Treatment can also prevent and manage complications of CKD, such
- fluid overload
- congestive heart failure
- brittle bones
- weight loss
- electrolyte imbalance
Control of underlying problems, such as hypertension and
diabetes, can slow the progress of kidney damage.
Once your kidney function reduces to 10 percent or less, the symptoms
become obvious. At this point, you may need dialysis or a kidney transplant.
ESRD occurs when your kidneys clearly begin to shut down. The
treatment for CKD and ESRD includes:
- quitting smoking if you smoke
- restricting fat in your diet
- restricting salt in your diet to control blood
pressure and prevent fluid overload
- restricting protein in your diet (but still
getting adequate calories to maintain your weight)
- restricting potassium in your diet
- getting adequate exercise
- getting dialysis to purify your blood
- getting a kidney transplant
- restricting your fluids to prevent fluid
- restricting carbohydrates if you have diabetes
- controlling diabetes if you have it
- controlling your blood pressure
- taking iron and vitamin supplements to manage
- getting erythropoietin injections to stimulate the
production of red blood cells
- taking calcium and vitamin D supplements
- taking phosphate binders
- taking stool softeners for constipation
- taking antihistamines for itching
You may be more susceptible to infection if you have CKD or ESRD.
Doctors recommend that you get the following vaccinations:
- pneumococcal vaccine
- hepatitis B vaccine
- influenza vaccine
- H1N1 (swine flu) vaccine
Can I Prevent Chronic Kidney Disease?
You can’t always prevent CKD. However, controlling conditions
like high blood pressure and diabetes can help. You should get regular screenings
for CKD if you’re at high risk. Getting an early diagnosis of CKD can help slow