Chronic Kidney Disease: Diagnosis, Stages and Management

Your kidneys are responsible for filtering excess fluid and waste from the bloodstream and eliminating them through the urine. Also referred to as chronic kidney failure or CKD, chronic kidney disease is a serious medical condition characterised by a gradual deterioration of your kidney function. In its later stages, this disease can result in a buildup of dangerous amounts of waste, electrolytes and fluid in the body, leading to a plethora of complications. As it progresses, chronic kidney disease can eventually cause kidney failure, which necessitates kidney transplant or dialysis to survive. Early detection and timely treatment are crucial for preventing its progression. Here’s all you need to know about chronic kidney disease.

Chronic Kidney Disease Stages

Chronic kidney disease progresses in five stages, which are based on your kidneys’ capability to filter out excess fluid and waste from the bloodstream. Your kidney function is determined by your glomerular filtration rate (GFR), which is a measure of the amount of a waste product called creatinine present in your blood. Here are the five chronic kidney failure stages:

• Stage 1: In stage 1 of chronic kidney disease, the minimum GFR of an individual is 90 ml/min per 173 m2. While this indicates normal kidney function, there is still some evidence of damage to the kidney. This damage can include physical damage or protein in the urine.
  
  
• Stage 2: In stage 2, GFR ranges from 60⁠-89 ml/min per 1.73 m2. This indicates additional signs of damage to kidneys, including physical damage and protein in the urine.
  
  
• Stage 3: In stage 3 of CKD, GFR ranges from 30⁠-59 ml/min per 1.73 m2. While there are often no symptoms in this stage of CKD, some people may experience back pain, swelling in the feet and hands, anaemia, more frequent urination, bone disease and/or high blood pressure.
  
  
• Stage 4: In stage 4, GFR is 15⁠-29 ml/min per 1.73 m2. At this point, kidneys have suffered moderate to severe damage. This is the last stage before you go into kidney failure. At this stage, you’re more likely to suffer from symptoms like back pain, swollen hands and feet, frequent urination, bone disease and anaemia.
  
  
• Stage 5: In stage 5 of chronic kidney disease, GFR is 15⁠ ml/min per 1.73 m2 or less. At this stage, kidneys have already failed or are very close to failing. Renal kidney failure symptoms include itching, nausea, muscle cramps, vomiting, back pain, swelling in the feet and hands, more frequent urination, difficulty breathing and trouble sleeping.

Chronic Kidney Disease: Diagnosis

When it comes to diagnosing chronic kidney disease, your doctor will first inquire about your family and personal medical history. Then, a neurological test and a physical exam will be performed to check for the signs of problems affecting your blood vessels or heart. The diagnosis of chronic kidney disease also requires a range of procedures and tests, which include:

• Blood Tests: They are done to determine the level of waste, like urea and creatinine, in the bloodstream.
• Urine Tests: Certain urine tests can help detect signs of chronic kidney disease and identify its cause.
• Imaging Tests: Your healthcare provider may order a CT scan or ultrasound to assess the condition of your kidneys and detect any physical damage.
• Kidney Biopsy: Your doctor may suggest a kidney biopsy, which involves the extraction of a sample of kidney tissue. This sample is then tested to identify the reason behind your kidney issues.

Chronic Kidney Disease: Treatment and Management

There is no cure for chronic kidney disease. The treatment can only help manage the symptoms and delay or prevent the disease’s progression. For CKD treatment, there are many different approaches for managing renal disorder symptoms and associated conditions, depending on the CKD stage. Here’s what the treatment of chronic kidney disease involves:

• Diet: A proper diet is crucial for treating chronic kidney disease. Limiting protein in your diet can help in slowing the progression of the disease as excess protein consumption can put strain on your kidneys. It’s advisable to consult with your doctor to figure out the suitable amount of protein intake. Moreover, it’s advisable to restrict your salt intake as this can help deal with hypertension. Limiting the consumption of phosphorus and potassium is also necessary for people with chronic kidney disease.
  
  
• Medications
  
  An angiotensin receptor blocker (ARB) or an angiotensin-converting enzyme (ACE) inhibitor for lowering blood pressure.
  Phosphate binder to help kidneys eliminate phosphate.
  Cholesterol-lowering medications.
  A diuretic to help kidneys eliminate excess fluid.
  Calcitriol and vitamin D to prevent bone loss.
  Erythropoietin to help anaemics develop red blood cells.

• Kidney Dialysis
  
  During the last stage of chronic kidney disease, kidneys are unable to perform the fluid and waste elimination process efficiently. This is where dialysis comes in. It is the method of mechanically removing excess waste and fluid from the bloodstream.
  
  
• Kidney Transplant
  
  When talking about the last stage of chronic kidney disease, kidney transplant is often a better option as compared to dialysis, particularly in individuals who are in good health except for kidney failure. Notably, kidney transplant involves the replacement of the damaged kidney with a healthy one. For kidney transplant, the donor is thoroughly screened to prevent any complications or transmissible diseases.

In a Nutshell

Chronic kidney disease is a prevalent condition that often doesn’t show any symptoms until the kidney function deteriorates to 15% of its original capacity. Early detection and prompt treatment are key to preventing this condition from progressing. People experiencing any concerning symptoms or at risk of this disease should consider getting tested. Getting a kidney profile test done by Pathkind Labs is a great way of assessing the overall function of your kidneys and ensuring they stay in top shape.

FAQs (Frequently Asked Questions)

1. What are the symptoms of chronic kidney disease?
   
   Answer:- There are usually no symptoms during the disease’s early stages. As the condition progresses, noticeable symptoms may include frequent urination, fatigue, loss of appetite, shortness of breath, swelling in feet, ankles and hands, puffy eyes, foamy or bubbly urine, itchy and dry skin, trouble concentrating, numbness, trouble sleeping, muscle cramps, nausea or vomiting, darkening of the skin and high blood pressure.
   
   
2. What causes chronic kidney disease?
   
   Answer:- Diabetes and hypertension are two of the most common causes of this disease. Other causes include glomerulonephritis, membranous neuropathy, polycystic kidney disease, vesicoureteral reflux, urinary tract obstructions, nephrotic syndrome, lupus, diabetic neuropathy and recurrent kidney infection.
   
   
3. Is chronic kidney disease genetic?
   
   Answer:- Yes, chronic kidney disease can be inherited from family members. Moreover, the disease’s risk factors, like diabetes, are often hereditary.
   
   
4. What are the complications of chronic kidney disease?
   
   Answer:- Chronic kidney disease can cause several complications, such as anaemia, gout, weak and brittle bones, hypertension, metabolic acidosis, heart diseases, nerve damage, high phosphorus, high potassium, high risk of infection and fluid buildup.
   
   
5. What can be done to prevent chronic kidney disease?
   
   Answer:- The best way to prevent chronic kidney disease is to keep in regular contact with your healthcare provider. Those at an increased risk of this disease should get frequent tests to ensure early detection of any damage to kidneys. Some other things you can do to prevent CKD include: