Chronic kidney disease (CKD) is a long-term condition in which the kidneys get damaged and lose their function to filter the blood. This decline in function is usually gradual and is most often associated with getting older.
When untreated, CKD may lead to kidney failure or end-stage kidney disease (ESRD) characterized by complete loss of kidney function, requiring a person to undergo dialysis or a kidney transplant.
People with CKD or ESRD can live a long life but their quality of life can be affected.
Symptoms
Kidney disease at an early stage does not show any symptoms until it is diagnosed by a blood or urine test done for any other ailment. Signs and symptoms are experienced when CKD reaches the progressive stage. These include:
- Flank pain
- Tiredness
- Shortness of breath
- Blood in urine or cloudy urine
- Swelling in body parts, especially in peripheries (ankle, feet, hands)
- Anemia
- Muscle pain
- Skin dryness, itching, colour change or extreme pigmentation
Causes
Most of the prominent factors that can cause CKD are:
- Diabetes: Sugar in the blood damages the small filters of the kidneys
- High blood pressure can damage the blood vessels of the kidneys
- Family history of CKD
- Heart disease due to dysregulation of the blood supply to the kidneys
- Polycystic kidney disease (PKD) is a genetic disorder that forms many cysts in the kidneys
- Any ongoing infection
- Medicine that is toxic to the kidneys (NSAIDs, antibiotics)
- Environmental factors such as excessive alcohol consumption, illicit drug abuse
Diagnosis
The manner of diagnosing CKD can vary depending on whether one has diabetes, high blood pressure, heart disease or a family history of CKD. However, for an accurate diagnosis and severity, other methods are followed, including:
- A blood test to check the ability of kidneys to filter blood called Glomerular Filtration Rate (GFR)
- Urinalysis to check for albumin, a protein that can pass through the damaged kidneys
- An ultrasound, MRI, CT scan to check the size or any blockage in the kidneys
- A biopsy to examine the signs of damage to the kidney cells/tissue
Moreover, a doctor will perform a kidney function test regularly to evaluate what would be the right treatment.
| Stages of CKD | Severity of CKD | GFR* | % of kidney function |
| STAGE 1 | Normal kidney function | 90 or higher | 90 –100 |
| STAGE 2 | Mild loss of kidney function | 89 – 60 | 89 – 60 |
| STAGE 3 | Mild to moderate loss of kidney function | 59 – 30 | 59 – 30 |
| STAGE 4 | Severe loss of kidney function | 29 – 15 | 29 – 15 |
| STAGE 5 (ESRD) | Kidney failure | Less than 15 | Less than 15 |
GFR Graph: https://www.kidney.org/atoz/content/gfr; https://www.nhs.uk/conditions/kidney-disease/diagnosis/
Treatment
There is no cure for CKD but treatments can help reverse kidney function decline and reduce the symptoms. The treatment will be dependent on the stage of CKD. This includes:
- Lifestyle changes including reducing smoking and alcohol consumption, eating a balanced diet, restricting salt intake to <6gm/day, weight management, etc.
- Medicines to control underlying ailments such as diabetes, high blood pressure, heart conditions, etc.
- Dialysis often used in stage 5 or ESRD
- Kidney transplant is opted for when dialysis stops helping
