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Chronic Kidney Disease (CKD)


Symptoms, Causes and Treatment
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We offer Chronic Kidney Disease treatment at initial stage as well as at final stage with state-of-the-art facilities

We all have two kidneys in our body. Each kidney is the size of a fist and is bean shaped. They are located near middle of the back one on each side of the spine below the rib cage. Kidneys do many important jobs which are essential for our body like
  • Remove waste product from the body
  • Remove extra water from the body
  • Controls blood pressure
  • Help in making red blood cells
  • Help in keeping bones healthy
Each kidney has approximately one million functional units called nephrons. Nephrons remove waste products and extra water from body and form urine which we pass daily. Urine which is formed passes through tubes called ureters which connect kidneys from bladder which stores urine. The urine which is stored in bladder is passed out intermittently. 

What is chronic kidney disease (CKD)?

Chronic kidney disease (CKD) is also called kidney failure or renal failure. It means kidneys are damaged and loose some of their ability to remove waste products and excess water in the body. Because of this defect in kidney function waste products build up in body and are harmful to the body. Kidney disease can be acute or chronic. Chronic kidney disease is defined as structural and functional abnormalities of kidney which are present for more than 3 months duration. CKD is a major health problem worldwide and is one of the leading causes of death.

There are five (5) stages in the kidney disease. Stage of kidney disease is determined by the glomerular filtration rate (GFR) and the presence of kidney disease. Glomerular filtration rate is the measure of kidney function. As Chronic kidney disease progresses GFR decreases. Treatment of chronic kidney disease patients is based on stage of the disease.
Stage Description Glomerular filtration rate (GFR)
1 Kidney damage (e.g., protein in urine) with normal GFR 90 or above
2 Kidney damage with mild decrease in GFR 60 to 89
3 Moderate decrease in GFR 30 to 59
4 Severe reduction in GFR 15 to 29
5 Kidney failure Less than 15

Symptoms

Presentation of chronic kidney disease may be late. In the initial stage’s sometimes patient may feel normal without any complaints. Symptoms related to CKD are :

High blood pressure

Decreased urine output

Frothing in urine

Weakness or Fatigue (tiredness)

Unable to concentrate

Decreased appetite

Lack of sleep

Dry itchy skin

Cramping in legs

Swelling around eyes and legs

Anemia and insomnia

Blood in urine or dark urine

Itchy skin, can become persistent

Erectile dysfunction

Frequent urination

Muscle cramps or twitches

Pain on the side

Shortness of breath

Sudden change in body weight

Unexplained headaches

Causes


Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years. Diseases and conditions that cause chronic kidney disease include:

High blood pressure

Type 1 or type 2 diabetes

Glomerulonephritis 
(an inflammation of the kidney's filtering units (glomeruli))

Interstitial nephritis
(an inflammation of the kidney's tubules and surrounding structures)

Polycystic kidney disease

(inherited familial disease)

Obstructions of kidneys
(from conditions such as enlarged prostate, kidney stones and some cancers)

Pyelonephritis
(Recurrent kidney infection)

Vesicoureteral reflux
(a condition that causes urine to back up into your kidneys)

Who are at increased risk of chronic kidney disease?


Any person can get chronic kidney disease at any age. Some people are at increased risk of chronic kidney disease like people with Hypertension, Diabetes, Family history of CKD, Overweight and obesity, Very low birth weight, Previous history of acute kidney injury, Recurrent kidney stones, Older age, Use of medicines for prolonged duration which damage kidneys (e.g., pain killers)

What are the tests to identify kidney disease?


Following tests are used to identify the kidney disease in combination as assessed by the treating doctor.

Complete urine examination


Urine will be tested for the presence of protein or blood in urine. Urine will also be checked microscopically to look for any abnormal elements. Normally urine has very small amount of protein. Any increase in protein in urine will suggest presence of kidney disease in the appropriate clinical context. Presence of red blood cells in urine also point towards the presence of kidney disease requiring further tests to confirm.

Blood test


Blood will be checked for levels of urea and creatinine which are elevated in the presence of kidney disease. Creatinine values are used to calculate GFR in the clinic.

Ultrasound


Ultrasound examination of kidneys will help us to identify the location, number, size and appearance of kidneys. Ureters and bladder are also examined by ultrasound examination. Patients with chronic kidney disease may have small kidneys, abnormal kidneys or obstructed kidneys that can be identified by ultrasound.

Sometimes a renal biopsy is required to identify the etiology of kidney disease in which a small piece of kidney is examined microscopically, and diagnosis is made. 

What are the complications of chronic kidney disease?


CKD can lead to high blood pressure (high blood pressure can cause CKD and CKD can also cause high blood pressure), low haemoglobin levels (anaemia), bone weakness, heart ailments, vitamin D deficiency, weight loss, abnormal calcium and phosphate levels, increased infection risk

What is the treatment of chronic kidney disease?


Treatment of chronic kidney disease depends on stage and results of blood tests and other ailments associated. It includes:

  • Treatment of high blood pressure (take medicines, restrict salt, lose weight and regular exercise)
  • Controlling blood sugars in patients with diabetes (diet, regular exercise, diabetic medications)
  • Treatment of anaemia (iron supplements and erythropoietin stimulation agents)
  • Treatment of mineral and bone disorder (to correct calcium, phosphorus and parathyroid hormone levels with diet restrictions and medications)
  • Control cholesterol levels with diet and medications
  • Regular exercise
  • Follow a diet programme 
  • If the patient has kidney failure (GFR less than 15), he may require initiation of dialysis based on his symptoms and GFR

How to prevent chronic kidney disease?


People at high risk of chronic kidney disease should do the following to prevent the development of chronic kidney disease
  • Control diabetes and high blood pressure
  • Regular exercise
  • Avoid carbonated soft drinks
  • Stop smoking
  • Avoiding weight gain
  • Healthy diet
  • Regular blood and urine tests
  • Management of other conditions like renal stone disease, autoimmune disease, repeated urine infection etc.

Comprehensive Nephrology services under one roof


Successfully Treating -
  • Acute and Chronic renal diseases
  • Renal damage due to high blood pressure, diabetes, infections, tubulo-interstitial disorders, glomerular diseases
  • Blood in urine (hematuria)
  • Protein loss in urine (proteinuria)
  • Electrolyte or acid-base imbalance
  • Chronic and recurrent urinary tract infection
  • Hereditary renal disorders
  • Renovascular Diseases

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