Chronic Kidney Disease

Kidneys act as filter in our body, removing excess fluid, wastes & toxins from the body to keep us healthy. Functioning unit of kidney is called Nephron . There are one million nephrons in each kidney. If one kidney is damaged for any reason, other kidney enlarges in size to compensate for the work of two kidneys.  In addition to filtering function, kidneys also regulate blood pressure, make red blood cells & help promote strong bones.

Chronic Kidney Disease ::
Is defined as gradual loss of filtering function over time, usually months & years. 
26 million American adults have CKD & many more are at risk of developing kidney disease.
 
Causes of CKD :: 
Two main causes of  chronic kidney disease are Diabetes & High blood pressure. These two diseases are responsible for two-thirds of the cases. As kidney disease progresses, it causes further elevation of blood pressure. High blood pressure also causes heart disease & stroke.
 
Other conditions that affect the kidneys are ::
 
Inherited diseases, such as Polycystic Kidney disease
Congenital malformation of urinary tract.
Autoimmune diseases such as Lupus & glomerulonephritis.
Obstructive diseases caused by stones, tumors &  enlarged prostate in men.
Repeated urinary tract infections with scarring of kidney tissue.
Vascular disease blocking kidney blood vessels leading to small shrunken kidneys.
Obesity
 
Symptoms of CKD ::
 
Many people may not know that they have kidney disease & may not experience any symptoms until kidney function is less than 30% of normal.
However you may notice ::
Decreased appetite, decreased stamina, energy, swollen feet & ankles, puffiness around your eyes, muscle cramping at night, decreased urine output & anemia.
 
Some types of kidney disease such as Nephritis may cause tea color urine, flank pain, nausea/ vomiting, weakness, decreased urine output & sometimes fever.
 
You may have increased risk for developing kidney disease if you have ::
Diabetes mellitus
High blood pressure
Old age
family hx of kidney disease
Certain ethnic background :::  native Americans, African Americans, Hispanic Americans, Asian, pacific islanders. These groups have high rate of diabetes & high blood pressure thereby increasing their risk of kidney disease.
 
Diagnosis of CKD :::
Physical exam will give your doctor few clues such as elevated blood pressure, swelling of legs & feet.  
Blood tests, urine test, U/S kidneys, kidney biopsy, help in diagnosis of CKD. Sometimes you  may also need MRI to assess blood flow to kidneys.
Presence of protein & blood  in urine is the foremost finding towards kidney disease.
 
Prevention of CKD :::It is impossible to prevent kidney disease but one needs to avoid following ::
 
Excessive drinking, smoking, illicit drugs, over the counter pain medications other than Tylenol.
 If you have diabetes & /or high blood pressure, tight controll of both diseases will help prevent faster decline of kidney function & CKD
Kidney disease also  increases your risk of heart disease & high lipids.
 
Treatment of CKD :
Treatment of underlying disease causing CKD
 
If you progress to total kidney failure called End stage kidney disease, then you will need Kidney replacement therapy ie Dialysis &  transplantation