Causes of Chronic Kidney Disease

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Chronic Kidney Disease

It 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.

Causes

Chronic kidney disease (CKD) slowly gets worse over months or years and may not notice any symptoms for some time. The loss of function may be so slow that you do not have symptoms until the kidneys have almost stopped working.

The final stage of chronic kidney disease is called end-stage renal disease (ESRD). At this stage, the kidneys no longer able to remove enough wastes and excess fluid from the body. At that point, you would need dialysis or a kidney transplant.

Diabetes and hypertension are the two most common causes and account for most cases.

Many other diseases and conditions can damage the kidneys, including:

Autoimmune disorders (such as systemic lupus erythematosus and scleroderma)

Congenital anomalies of the kidneys (such as polycystic kidney disease)

Certain toxic chemicals

Kidney injury

Kidney stones and infection

Problems with the arteries supplying the kidneys

Some medications such as painkillers and drugs for cancer

 Backflow of urine into the kidney (reflux nephropathy)

Other kidney disease

Chronic kidney disease leads to a buildup of fluid and waste products in the body. This condition affects most of the functions and body systems, including:

Arterial hypertension

Low blood counts

Vitamin D and bone health

SYMPTOMS

The first symptoms of chronic kidney disease are also the same as for many other diseases. These symptoms may be the only sign of a problem in the initial stages.

Symptoms may include:

Inappetence

Feeling of malaise and fatigue

Headaches

Generalized itching (pruritus) and dry skin

Sickness

Losing weight without trying

Symptoms that may occur when renal function has worsened include:

Abnormally dark or light skin

Bone pain

Drowsiness or trouble concentrating or thinking

Numbness or swelling in the hands and feet

Muscle twitching or cramping

Bad breath

Bruising, or blood in the stool

Excessive thirst

Frequent hiccups

Problems with sexual activity

Cessation of menstrual periods (amenorrhea)

Difficulty breathing

Sleep problems

Vomiting, often in the morning

Exams and Tests

High blood pressure is almost always present during all stages of chronic kidney disease. An examination of the nervous system may show signs of nerve damage. The doctor may hear abnormal heart or lung sounds when listening with the stethoscope.

A urinalysis may show protein or other changes. These changes can arise from 6 months to 10 years or more before symptoms appear.

Tests to check how well your kidneys are working include:

Creatinine clearance

Creatinine levels

BUN

Chronic kidney disease changes the results of some other tests. Each patient needs to take the following checked regularly, as often as every 2 to 3 months when kidney disease gets worse:

Albumin

Calcium

Cholesterol

Complete blood count (CBC)

Electrolytes

Magnesium

Match

Potassium

Sodium

The causes of chronic kidney disease may be seen in:

Abdominal CT scan

MRI of the abdomen

Abdominal ultrasound

Kidney biopsy

Kidney scan

Ultrasound kidney

This disease may also change the results of the following tests: 

Erythropoietin

PTH

Bone density test

Vitamin D

Treatment

Controlling blood pressure will slow further damage to the kidney.

Inhibitors of angiotensin converting enzyme (ACE) inhibitors or blockers receptor blockers (ARBs) are used most frequently.

The goal is to keep blood pressure at or below 130/80 mmHg.

The act of making lifestyle changes like these can help protect the kidneys and prevent heart disease and stroke:

No Smoking.

Eat foods low in fat and cholesterol.

Getting regular exercise (talks to your doctor or nurse before starting).

Taking drugs to lower cholesterol, if necessary.

Keep blood sugar under control.

Avoid eating too much salt or potassium.

Always talk to your nephrologist before taking any OTC medicine, vitamin or herbal supplement. Make sure all doctors you visit know you have chronic kidney disease.

Other treatments may include:

Special medicines called phosphate binders to help prevent high levels of phosphorus.

Treatment for anemia, such as extra iron in the diet, iron pills, iron through a vein (intravenous iron) Special injections of a drug called erythropoietin, and blood transfusions.

Extra calcium and vitamin D (always talk to your doctor before taking)

Your doctor may ask that you follow a special diet for chronic kidney disease.

Limiting fluids.

Eat less protein.

Restricting salt, potassium, phosphorus and other electrolytes.

Get enough calories to prevent weight loss.

All people with chronic kidney disease should keep updated the following vaccines:

Hepatitis A Vaccine

Hepatitis B vaccine

Influenza vaccine

Pneumonia vaccine (PPV, for its acronym in English)

Support Groups

Some people benefit from eligibility in a support group for kidney disease.

Expectations (prognosis)

Many people are not diagnosed with chronic kidney disease until they have lost much of their kidney function.

There is no cure for chronic kidney disease. If worsening end-stage renal disease and how fast it does depends on:

The cause of kidney damage

How well you take care of yourself

Kidney failure is the final stage of chronic kidney disease. This is when the kidneys can no longer support our bodily needs.

The doctor will discuss dialysis with you before you need it. Dialysis removes waste from the blood when the kidneys can no longer do its job.

Generally, you will need dialysis when you stay only 10 to 15% of kidney function.

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

Complications

Anemia

Bleeding from the stomach or intestines

Bone, joint or muscle pain

Changes in blood sugar

Nerve damage in the legs and arms (peripheral neuropathy)

Dementia

Fluid buildup around the lungs (pleural effusion)

Cardiovascular complications

congestive heart failure

coronary artery disease

arterial hypertension

pericarditis

cerebrovascular accident

High levels of phosphorus

High potassium

Hyperparathyroidism

Increased risk of infections

Damage or liver failure

Malnutrition

Spontaneous abortion and infertility

Seizures

Swelling (edema)

Weakened bones and increased risk of fractures

Prevention

Treating the condition that is causing the problem can help prevent or delay chronic kidney disease. Diabetics must control their levels of blood sugar and blood pressure, as well as refraining from smoking