Kidney disease

Kidney disease occurs when your kidneys are not able to effectively remove waste or extra fluids from your blood, this includes a failure to maintain a healthy balance of sodium, potassium and calcium that assist in ensuring healthy blood pressure. As a result of failing kidneys, the waste and fluids build-up causing edema, swollen ankles, overall weakness, vomiting, shortness of breath and problems sleeping. Eventually, without proper treatment, the kidneys will lose total function, called ESRD, end stage renal disease, requiring either a kidney transplant or chronic dialysis, in order to sustain life. The difference between chronic and acute kidney disease, is that the former has no cure. Acute kidney disease, may require several dialysis treatments to shock the kidneys back into a functioning status, but the renal failure is temporary, less than 3-months in duration. Human kidney function can operate at a level as low as 60 percent of full function, without suffering consequences of complete kidney failure, without requiring dialysis or transplant. Acute kidney failure may be caused by trauma, or a direct shock to the kidney during an infection, called sepsis.

Kidney disease Symptoms

Early stages of chronic kidney disease often have no apparent symptoms. Learning about the occurrence, and progression of the disease, may be the result of an unrelated malady where medical testing reveals renal failure. Some of the early identifiable symptoms of kidney disease include the following:

  • anemia (fatigue and weakness)
  • high blood pressure
  • weakening of the bones
  • diabetes
  • fluid retention
  • Numbness in the limbs (peripheral neuropathy)
  • Encephalopathy as a result of waste products or uremic poisons
  • Bleeding due to poor blood clotting, easy bruising
  • Chest pains caused by pericarditis, inflammation surrounding the heart
  • Disturbed sleeping
  • Itching
  • Lightheadedness

Kidney disease Causes

Chronic kidney disease cannot be cured but in most instances, it can be managed. Diabetes and high blood pressure are the 2 most common causes of chronic kidney disease. Nearly 50 percent of patients with chronic renal disease suffer comorbid conditions of diabetes and high blood pressure. Other causes of chronic kidney disease include:

  • Polycystic kidney disease is congenital
  • Immune system issues such as HIV, Lupus and hepatitis B & C
  • Urinary tract infections (UTIs), pyelonephritis can result in scarring and with additional occurrences kidney damage
  • Inflammation in the glomeruli inside the kidney
  • Congenital defects at birth from malformation
  • Toxins and drugs over time including NSAIDS like ibuprofen and street IV drugs

Acute renal failure is usually caused by some sort of dramatic trauma with loss of blood, dehydration, pregnancy complications or an obstruction in urine flow, such as a swollen prostate. Due to damage to the kidneys, failed blood flow to the kidneys or blocked urine from the kidneys, this may result in acute kidney injury.

Kidney disease Diagnosis

There are 5 stages of kidney failure as defined by the National Kidney Foundation (NKF). A diagnosis of kidney disease, and the stage of kidney disease, can be measured and determined using glomerular filtration rate and by creatinine clearance, blood creatinine level. Creatinine is a normal waste product that is filtered through the kidneys and expelled in the urine. The creatinine clearance rate, the rate at which the kidneys clear the creatinine from the blood, is normally 125 mL per minute, for a healthy young person. Creatinine clearance is also an estimate of an individual’s GFR, glomerular filtration rate, how well the kidney’s filtering units, or glomeruli, are performing, more specifically, the rate of at which blood flows through the kidneys. Creatinine clearance deteriorates as renal function declines. It also declines, to some extent with age. Creatinine clearance is equal to the amount of creatinine in the urine, over a 24 hour period. GFR is estimated by measuring blood creatinine level. A lower blood creatinine level means a lower GFR and a low creatinine clearance. GFR is estimated from the blood creatinine level, age, gender, weight and other demographic characteristics. The estimate of GFR provides a diagnosis as to the stage of kidney disease, as follows: GFR Degree of Kidney Disease: 1 90 or higher Normal kidney function 2 60 to 90 Mild kidney decline 3 30 to 59 Moderate kidney decline 4 15 to 29 Severe kidney disease 5 15 Complete kidney failure A diagnosis of chronic kidney disease can be derived from the following, blood tests:

  • BUN – Urea nitrogen
  • Creatinine
  • GFR

A normal adult BUN ranges from 7 to 20 mg/dL. BUN rises as kidney function declines. Those on dialysis have BUN within the range, 40 – 60 mg/dL. Normal creatinine is between 0.7 and 1.3 mg/dL for men and 0.6 – 1.1 mg/dL mg/dL for women. When creatinine levels for an adult are 10 mg/dL or greater, dialysis is the next step. For children with creatinine of 2.0 mg/dL, dialysis is recommended. Kidney disease imaging tests include a CT scan and ultrasound, where both tests take a picture of the kidneys, the former uses a contrast dye whereas the ultrasound uses sound waves. Both are looking for abnormalities in the kidneys and possible blockage, tumors or stones. Kidney biopsy is a third method for diagnosing kidney disease. A small piece of kidney tissue is cut and then examined closely under a microscope. The biopsy can reveal the extent of damage to the kidney. A urinalysis can measure:

  • Excess protein in the urine, called proteinuria
  • Microalbuminuria is a more sensitive test, if the proteinuria result is negative
  • Creatinine clearance measures urine to creatinine in the blood

Kidney disease Treatment

Early stages of chronic kidney disease often have no apparent symptoms. Learning about the occurrence, and progression of the disease, may be the result of an unrelated malady where medical testing reveals renal failure. Some of the early identifiable symptoms of kidney disease include the following:

  • anemia (fatigue and weakness)
  • high blood pressure
  • weakening of the bones
  • diabetes
  • fluid retention
  • Numbness in the limbs (peripheral neuropathy)
  • Encephalopathy as a result of waste products or uremic poisons
  • Bleeding due to poor blood clotting, easy bruising
  • Chest pains caused by pericarditis, inflammation surrounding the heart
  • Disturbed sleeping
  • Itching
  • Lightheadedness