Chronic kidney disease (CKD) is a medical condition characterized by a steady decline in kidney function. It can be caused by a number of things, and depending on the cause, the progress may be rapid, or very slow. Chronic kidney disease can be treated in a variety of ways, depending on the cause of the patient, and the prognosis is also quite varied.
Older people, people of color, and men are at increased risk of developing chronic kidney disease. The condition also arises more in people with a family history of kidney problems, and in people with high blood pressure or diabetes. The use of certain medications and some medical conditions can also cause chronic kidney disease. Many people at risk for the condition are routinely screened, allowing medical staff to catch it early.
Two methods can be used to test for chronic kidney disease. The first is a blood test for creatinine. If the creatinine level is high, it indicates that the kidneys are having difficulty. Urine samples can also be used to check for signs of protein and blood, which also indicate kidney problems. If a case of chronic kidney disease is suspected, a biopsy of the kidney may be taken in an attempt to uncover the cause, and a doctor will also take the patient's medical history to look for risk factors and potential causes.
Some patients experience no symptoms. Others have an increased blood pressure, caused by a buildup of fluids in the body, along with edema. Heart problems, muscle cramping, and poor appetite may develop as well. Many people also feel thirsty commonly and urinate a lot, indicating that their kidneys are trying to flush themselves out and failing. By the time symptoms emerge, the problem may be very advanced.
When someone is diagnosed with chronic kidney disease, it is classed as stage one through five. Stage one is the mildest, and five is the most serious. In the early stages, chronic kidney disease may be treatable through diet and lifestyle changes, and sometimes with the use of medication. In later stages, dialysis or kidney transplant may be required for treatment, as the kidneys are simply too damaged to function on their own.
People can reduce the risk of chronic kidney disease by eating well, keeping an eye on their blood pressure, and being careful about which medications they take, and for how long. People at increased risk should receive regular screenings so that if chronic kidney disease does appear, it can be caught early and managed.
Although chronic kidney disease sometimes results from primary diseases of the kidneys themselves, the major causes are diabetes and high blood pressure.
Type 1 and type 2 diabetes mellitus cause a condition called diabetic nephropathy, which is the leading cause of kidney disease in the United States.
High blood pressure (hypertension), if not controlled, can damage the kidneys over time.
Glomerulonephritis is the inflammation and damage of the filtration system of the kidneys, which can cause kidney failure. Postinfectious conditions and lupus are among the many causes of glomerulonephritis.
Polycystic kidney disease is an example of a hereditary cause of chronic kidney disease wherein both kidneys have multiple cysts.
Use of analgesics such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) regularly over long durations of time can cause analgesic nephropathy, another cause of kidney disease. Certain other medications can also damage the kidneys.
Clogging and hardening of the arteries (atherosclerosis) leading to the kidneys causes a condition called ischemic nephropathy, which is another cause of progressive kidney damage.
Obstruction of the flow of urine by stones, an enlarged prostate, strictures (narrowings), or cancers may also cause kidney disease.
Other causes of chronic kidney disease include HIV infection, sickle cell disease, heroin abuse, amyloidosis, kidney stones, chronic kidney infections, and certain cancers.
If you have any of the following conditions, you are at higher-than-normal risk of developing chronic kidney disease. Your kidney functions may need to be monitored regularly.
Diabetes mellitus type 1 or 2
High blood pressure
High cholesterol
Heart disease
Liver disease
Amyloidosis
Sickle cell disease
Systemic Lupus erythematosus
Vascular diseases such as arteritis, vasculitis, or fibromuscular dysplasia
Vesicoureteral reflux (a urinary tract problem in which urine travels the wrong way back toward the kidney)
Require regular use of anti-inflammatory medications
A family history of kidney disease
Most people with CKD have no symptoms because the body can tolerate even a large reduction in kidney function. In other words, we are born with a lot more kidney function than is necessary for survival. Kidney function is often sufficient if only one kidney is working.
A change in kidney function is usually discovered through a routine blood or urine test. If you are diagnosed with kidney disease, your kidney function will be monitored with regular blood tests, and treatment aims to keep any symptoms to a minimum.
If the kidneys continue to lose function and there is progression towards kidney failure (established renal failure or ERF), this will usually be tracked by blood tests and monitoring. If kidney failure does occur, the symptoms may include:
tiredness
swollen ankles, feet or hands (due to water retention)
shortness of breath
blood or protein in your urine (protein in your urine is not something that you will notice as it can only be detected during a urine test)
an increased need to urinate, particularly at night
itchy skin
nausea
erectile dysfunction in men (an inability to get or maintain an erection)
These are general symptoms and can be caused by many less serious conditions. Many of the symptoms above can be avoided if treatment begins at an early stage, before any symptoms appear.