Chronic Kidney Disease - Causes, Symptoms, Diagnosis and Prevention

Chronic Kidney Disease (CKD)

Dr.Sree Bhushan Raju profile Authored by Dr.Sree Bhushan Raju on 20 Nov 2014 - 12:45.

Kidney Disease

Chronic kidney disease (CKD) or chronic kidney failure is a progressive damage caused to the kidney altering its functions, over time. The kidneys play an important role of purifying the blood by removing waste and excess fluids from the blood. Due to the altered functioning in advanced CKD, they cause accumulation of waste and excess fluid in the body, further complicating the normal physiology. However, CKD often remains silent during its initial phase and begins to develop symptoms as the disease progresses when the kidney is damaged enough to impair its functions.

Various diseases and clinical conditions may affect the kidneys and alter its functions progressively. Some common conditions responsible for CKD may include:

  • Diabetes Mellitus (insulin dependent and non-insulin dependent)
  • Hypertension
  • Various kidney diseases like glomerulonephritis (inflammation of the glomeruli), interstitial nephritis, etc.
  • Birth defects in the kidney Ex. Polycystic kidney disease.
  • Blockage in the urinary tract
  • Kidney stones
  • Cancer of different organs
  • Vesicoureteral reflux
  • Various infections, including pyelonephritis
  • Various autoimmune disorders
  • Harmful chemicals
  • Trauma or injury to the kidney
  • Some medicines like anti-cancer drugs

In advanced stages of CKD, following signs and symptoms can be experienced, but these are often non-specific:

  • Nausea and vomiting
  • Reduced appetite
  • Fatigue
  • Difficulty in breathing
  • Chest pain
  • Disturbed or lack of sleep and concentration
  • Decreased urine output
  • Muscle cramps
  • Hiccups
  • Swelling, especially in the feet and ankles
  • Itching sensations
  • Hypertension, which is often tricky to manage
  • Sudden weight loss
  • Headache
  • Skin discoloration
  • Numbness
  • Blood in the stool
  • Excessive thirst

When to see a doctor?

Consult your doctor right away in case of the following:

  • If you are experiencing the above signs and symptoms
  • If you have any other chronic disease that might increase your risk of kidney damage like diabetes and hypertension

Usually, it is routine practice to look out for the signs and symptoms of CKD in high - risk groups, especially those who have heart disease and diabetes. Following tests and procedures may be used to confirm the diagnosis.

Kidney function tests: To look for the presence of blood urea and/ or creatinine which indicates the altered kidney function.

Urine analysis: Urine examination to identify the CKD.

Ultrasound or other imaging studies: To examine abnormality in the kidneys.

Kidney Biopsy: Kidney tissue sample is examined to find the extent of damage and underlying cause. 

Following factors may increase the risk of developing CKD:

  • Diabetes mellitus
  • Hypertension or other heart diseases
  • Elevated blood cholesterol
  • Smoking tobacco
  • Obesity
  • Family history of kidney diseases.
  • Increasing age, especially above 60

Complications

Progressively, CKD affects almost every organ and system in the body causing various severe complications like:

  • Swelling in the arms and legs (pulmonary oedema)
  • High blood pressure
  • Heart diseases
  • Weakening of bones
  • Elevated potassium levels in the blood
  • Reduced blood cells
  • Impotency or decreased sex desire
  • Lack of concentration
  • Epileptic attacks
  • Decreased overall immunity
  • End-stage renal disease (ESRD)
  • May complicate the pregnancy

The ideal and effective approach to treat CKD is to find out the exact cause of the CKD and slow down the progression of the kidney damage by treating the cause. If the progression of the damage is not controlled on time and effectively, it may lead to end stage kidney disease which is life threatening.

Drugs and medications: Different causes and complications of the CKD can be controlled with the help of various medications. Conditions including hypertension, elevated blood cholesterol, swelling, anaemia, weakened bones, etc. can be effectively treated with medicines.

Approaches to reduce kidney workload:To reduce the workload by preferring diet low in protein reduces the waste products in the blood. The dietitian will suggest a plan to meet the dietary requirements by keeping the protein intake low.

Treating end-stage renal disease:Treatment of ESRD often demands dialysis, certain conservative measures and kidney transplant.

Alternative treatments:

Probiotics: Probiotic microorganisms act as cleansing agents and remove the waste material from the blood, thereby reducing the workload on the kidneys. An oral supplement of Probiotics keeps the kidneys healthy by metabolizing and consuming the nitrogenous waste.

Traditional Chinese herbal medications (TCHMs): These often work effectively against CKD when considered with other pharmacotherapies.

Ayurvedic approach: According to Ayurvedic belief, kidneys are made up of dhatus called “Rakta" and "Meda" and therefore focuses on, treating these dhatus. By doing this most of the kidney damage can be reversed either partially or completely, thereby preventing the life threatening events.

Yogasana and Pranayama: Regular practice of various yoga postures and pranayama’s helps to treat various conditions including hypertension, heart rate problems, respiratory diseases, stress (including oxidative as well as emotional stress), diabetes, heart diseases and diverse range of inflammatory diseases. Thus, Yoga can be considered as a potential approach to manage CKD as an adjuvant and postures must be correctly learnt from the experts.

Diet plays an important role in managing CKD:

  • Minimize protein rich foods from your diet Ex. Eggs, milk, lean meats, and cheese.
  • Consume lots of calories
  • Prefer foods containing polyunsaturated fats
  • Restrict the fluid intake
  • Eat low salt diet
  • Avoid foods rich in potassium Ex. Potatoes, bananas, beans, nuts, milk, oranges, and so on.
  • Avoid foods containing phosphorous Ex. Chocolate, nuts, cheese, etc.
  • Eat fresh apples, carrots, grapes, strawberries, cabbage, bread, cereals etc. 

Following measures can be implemented to reduce the risk of CKD:

  • Reduce alcohol intake (less than one drink for women and not more than two drinks for men)
  • Avoid taking too many over-the-counter pain killer medicines without consulting your doctor
  • Exercise daily
  • Maintain a healthy weight
  • Avoid smoking
  • Keep your blood pressure and blood sugar level under control
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.