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Chronic Kidney Disease: Factors, Symptoms, Causes, Stages.

chronic kidney disease

Introduction

The major function of kidneys is to filter wastes and excess fluids from your blood, which are then excreted in your urine. Kidney diseases happen when your nephrons are damaged and cannot filter the blood. However, most damage occurs gradually.

Chronic kidney disease/ called chronic kidney failure describes the gradual loss of kidney function that can get worse over time. If the damage is that bad, your kidneys stop working. This is termed to be kidney failure, or end-stage renal disease (ESRD). If your kidneys fail to function, you will need dialysis or might even need a kidney transplant to live.

When chronic kidney disease reaches a matured stage, dangerous levels of fluid, electrolytes can build up in your body.

High blood pressure (hypertension) and diabetes are the 2 most important factors responsible for the progressive type of damage to the nephrons and the resulting kidney failure (chronic kidney disease or CKD). Around 30 million people in the United States are living with chronic kidney disease (CKD).

Factors that increase your risk for CKD include:

  • Being over 60 years old
  • a family member with kidney disease
  • Being African-American, Hispanic, Native American or Asian
  • Diabetes mellitus
  • High blood pressure
  • Heart diseases
  • hepatic diseases

Symptoms:

  • Muscle cramps
  • Nausea
  • vomiting
  • Not feeling hungry enough.
  • Swelling in your feet and ankles
  • Too much urine or not enough urine
  • Trouble in sleeping
  • Trouble catching your breath

And if the kidneys stop working suddenly (a sign of acute kidney failure), you might  notice one or more of the following symptoms:

  • Abdominal pain
  • Back pain
  • Rashes
  • Vomiting
  • Diarrhoea
  • Fever
  • Nosebleeds

There are different stages of CKD:

Early-stage

In this stage kidney disease does not tend to cause any symptoms when it’s at an early stage as the body is able to cope with a significant reduction in kidney function. Kidney disease is often diagnosed at this stage by a routine test for another condition, like a blood or urine test, detects a possible problem.

If it’s found at an early stage, medicine and regular tests are needed to monitor it.

Later stages of CKD

A number of symptoms start appearing if kidney disease is not found at an early stage.

Symptoms are as follows:

  • feeling sick
  • headaches
  • weight loss and poor appetite
  • swollen ankles, feet etc
  • shortness of breath
  • Tiredness
  • itchy skin
  • muscle cramps
  • erectile dysfunction in men
  • blood in your urine
  • an increased urge to urinate often at night
  • difficulty in sleeping

If you notice any of these above symptoms, you should contact your doctor immediately

Chronic kidney disease (CKD) refers to all five stages of kidney damage, from very mild damage in stage 1 to severe including Kidney failure in stage 5.

Nephrologist and doctors will measure how well your kidneys filter waste from your blood is by the estimated glomerular filtration rate or eGFR.

The stages of kidney disease  are recognized by EGFR no:

  • Stage 1 CKD: eGFR 90 or Greater
  • Stage 2 CKD: eGFR Between 60 and 89
  • Stage 3 CKD: eGFR Between 30 and 59
  • Stage 4 CKD: eGFR Between 15 and 29
  • Stage 5 CKD: eGFR Less than 15

Stage 1

Stage 1 CKD states that you have mild kidney damage and have an eGFR of 90 or greater.

an eGFR of 90 or more than 90 indicates that your kidneys are healthy and working well, but you have other signs of kidney damage. Signs could be protein in your urine or physical damage to your kidneys.

Here are some ways to help slow down to manage the issue in Stage 1 kidney disease:

  • Try to be active at least for  30 minutes a day, 5 days a week
  • Stay at a healthy weight
  • Control your blood sugar level if you are a diabetic.
  • Control your hypertension
  • Try eating a balanced healthy diet
  • Do not smoke 
  • Make an appointment to see a nephrologist (kidney doctor).

Stage 2 CKD

It means you have mild kidney damage and an eGFR between 60 and 89.

Generally, eGFR between 60 and 89 means your kidneys are healthy and working well. But remember if you have Stage 2 kidney disease, this means you have other signs of kidney damage even though your eGFR is normal. 

Here are some ways to manage the condition in Stage 2 :

  • Eat a healthy and balanced diet 
  • Do not smoke 
  • Try to be active 30 minutes a day, 5 days a week
  • You should control your blood sugar if you have diabetes
  • You should try controlling  your hypertension too
  • Make an appointment to see a nephrologist (kidney doctor).

Stage 3

An eGFR between 30 and 59 indicates that there is some damage to your kidneys and are not working as well.

Stage 3  has  two stages: 

  • Stage 3a – have an eGFR between 45 and 59
  • Stage 3b – have an eGFR between 30 and 44

People sometimes with Stage 3 kidney disease have no such symptoms. But if there are symptoms, there may be:

  • Back pain
  • Urinating more or less than normal
  • Swelling in your hands and feet

In this stage, you are more likely to have health complications as waste  starts to build up in your body and your kidneys are not working well

Symptoms include

  • High blood pressure
  • Anaemia 
  • Bone disease

In order to  keep your Stage 3 kidney disease from getting worse,

  • Try to Control your blood sugar or pressure  if you have diabetes and  blood pressure 
  • Do not smoke.
  • Eat a healthy, balanced diet 
  • Try to be active 30 minutes a day, at least 5 days a week
  • Visit a nephrologist (kidney doctor) every month
  • Try to meet up with a dietitian, who will help you follow a healthy diet 
  • Please don’t forget to ask your doctor about blood pressure medicines called ACE inhibitors and ARBs if you have diabetes or high blood pressure.
  • Stage 4 CKD

 Stage 4 kidney disease should be noticed and taken seriously – it is the last stage before kidney failure. It means you have an eGFR between 15 and 29. An eGFR between 15 and 30 indicates that your kidneys are moderately or severely damaged.

At Stage 4 kidney disease,  people have symptoms such as:

  • Swelling in your hands and feet
  • Back pain
  • Urinating more or less than normal

At Stage 4, you will likely also have health complications as waste builds up in your body  like :

  • High blood pressure 
  • Anaemia 
  • Bone disease
  • Hence
  • Try and have regular appointments with a nephrologist, who will make a treatment plan that is right for you.
  • Try to visit a nutritionist or dietitian, who will help you follow a healthy diet 

Once your kidneys have failed, you will need to start dialysis or have a kidney transplant to live under doctor’s supervision.

  • Preparing for dialysis: Dialysis helps clean your blood when your kidneys have failed.
  • Preparing for a transplant: A kidney transplant is a surgery to give you a healthy kidney from someone else’s body.
  • Stage 5 CKD
Chronic kidney disease (CKD) concept. Vector illustration in flat style

An eGFR which is less than 15 means the kidneys are getting very close to failure or have completely failed.

Some of the symptoms of kidney failure are:

  • Not feeling hungry
  • Swelling in your hands and feet
  • Back pain
  • Feeling sick and throwing up
  • Itching
  • Muscle cramps
  • Urinating more or less than normal
  • Trouble in breathing and in sleeping

Once your kidneys stopped working, you will need to start dialysis or you may need a  kidney transplant to live if the situation worsens.

What do you think?

Written by Subarna Ghosal

Subarna Ghosal, a graduate and postgraduate in Food and Nutrition from the University Of Calcutta and also a Certified Diabetes Educator from. Dr Mohan's Academy (NDEP), worked as a nutritionist, lifestyle Counsellor and also has specialization in Sports Nutrition and Pediatric Nutrition from IAPEN (The Indian Association Of parenteral and Enteral Nutrition)believes in making and creating permanent lifestyle changes which are Specific, measurable, attributable and easily achievable. My main motto in the nutrition field is to spread awareness among people about the complications of the diseases and how we can manage or treat by homemade lifestyle changes.
I love some quotes which boost me up a lot.
"Self Discipline is the key to good health"
"10,000 steps a day make a man healthy fit and fine"
"Take deeper breaths any time of the day to calm our mind"
"Drink at least 8litres of water a day"
"Stay always focussed on the important things in life"
"Try to start your day with a positive mind"
"Keep on listening to motivational videos at least one in a day"

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