Chronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body.
Kidney failure – chronic; Renal failure – chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure
Chronic kidney disease (CKD) slowly gets worse over months or years. you may not notice any symptoms for some time. The loss of function may be so slow that you do not have symptoms until your kidneys have almost stopped working.
The final stage of chronic kidney disease is called
Many other diseases and conditions can damage the kidneys, including:
- Autoimmune disorders (such as
systemic lupus erythematosusand scleroderma)
- Birth defects of the kidneys (such as
polycystic kidney disease)
- Some toxic chemicals
- Injury to the kidney
Kidney stonesand infection
- Problems with the arteries feeding the kidneys
- Some medicines, such as pain and cancer drugs
Backward flow of urine into the kidneys (
Other kidney diseases
Chronic kidney disease leads to a buildup of fluid and waste products in the body. This condition affects most body systems and functions, including:
High blood pressure
Low blood cell count
Vitamin D and bone health
The early symptoms of chronic kidney disease are the same as for many other illnesses. These symptoms may be the only sign of a problem in the early stages.
Symptoms may include:
General ill feelingand fatigue Headaches
- Itching (
pruritus)and dry skin Nausea Weight losswithout trying to lose weight
Symptoms that may occur when kidney function has gotten worse include:
Abnormally dark or light skin
- Bone pain
Drowsinessor problems concentrating or thinking Numbnessor swelling in the hands and feet Muscle twitchingor cramps Breath odor
bruising, or blood in the stool Excessive thirst
- Frequent hiccups
- Problems with sexual function
- Menstrual periods stop (amenorrhea)
- Shortness of breath
- Sleep problems
- Vomiting, often in the morning
Exams and Tests
Most people will have high blood pressure at all stages of chronic kidney disease. During an exam, your health care provider may also hear abnormal heart or lung sounds in your chest. You may have signs of nerve damage during a nervous system exam.
Tests that check how well the kidneys are working include:
Creatinine clearance Creatininelevels BUN
Chronic kidney disease changes the results of several other tests. You will need to have the following tests as often as every 2 – 3 months when kidney disease gets worse:
Complete blood count(CBC) Electrolytes Magnesium Phosphorous 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 Ultrasound of the abdomen Kidney biopsy Kidney scan
- Kidney ultrasound
This disease may also change the results of the following tests:
Erythropoietin PTH Bone density test Vitamin Dlevel
Controlling blood pressure will slow further kidney damage.
- Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are used most often.
- The goal is to keep blood pressure at or below 130/80 mmHg.
Making lifestyle changes can help protect the kidneys, and prevent heart disease and stroke, such as:
- Do not smoke.
- Eat meals that are low in fat and cholesterol.
- Get regular exercise (talk to your doctor or nurse before starting to exercise).
- Take drugs to lower your cholesterol, if needed.
- Keep your blood sugar under control.
- Avoid eating too much salt or potassium.
Always talk to your kidney doctor before taking any over-the-counter medicine. This includes vitamins, herbs and supplements. Make sure all of the doctors you visit know you have chronic kidney disease.
Other treatments may include:
- Medicines called phosphate binders, to help prevent high phosphorous levels
- Extra iron in the diet, iron pills, iron given through a vein (intravenous iron) special shots of a medicine called erythropoietin, and blood transfusions to treat anemia
- Extra calcium and vitamin D (always talk to your doctor before taking)
Your doctor may have you follow a special
- Limiting fluids
- Eating less protein
- Restricting salt, potassium, phosphorous, and other electrolytes
- Getting enough calories to prevent weight loss
All people with chronic kidney disease should be up-to-date on the following vaccinations:
Hepatitis A vaccine Hepatitis B vaccine Flu vaccine Pneumonia vaccine (PPV)
Some people benefit from taking part in a
Many people are not diagnosed with chronic kidney disease until they have lost most of their kidney function.
There is no cure for chronic kidney disease. If it worsens to
- The cause of kidney damage
- How well you take care of yourself
Kidney failure is the last stage of chronic kidney disease. This is when your kidneys can no longer support our body’s needs.
Your health care provider will discuss
Usually, you will go to dialysis when you have only 10 – 15 % of your kidney function left.
Even people who are waiting for a kidney transplant may need dialysis while waiting.
- Bleeding from the stomach or intestines
- Bone, joint, and muscle pain
- Changes in blood sugar
- Damage to nerves of the legs and arms (
peripheral neuropathy) Dementia
- Fluid buildup around the lungs (
- Heart and blood vessel complications
- High phosphorous levels
High potassium levels Hyperparathyroidism
- Increased risk of infections
- Liver damage or failure
Malnutrition Miscarriagesand infertility Seizures
- Swelling (
- Weakening of the bones and increased risk of fractures
Treating the condition that is causing the problem may help prevent or delay chronic kidney disease. People who have diabetes should control their blood sugar and blood pressure levels and should not smoke.