Chronic kidney disease, also called chronic kidney failure, is a gradual loss of kidney function. Your kidneys filter waste and extra fluid from your blood, which is then excreted in your urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes, and waste in your body. In the early stages of chronic kidney disease, you may have few symptoms or signs.
You may not realize you have kidney disease until the condition improves. Treatment of chronic kidney disease usually focuses on slowing the progression of kidney damage by controlling the cause. But, even controlling the cause may not prevent kidney damage from progressing. Chronic kidney disease can progress to end-stage renal failure, which is fatal without artificial filtration (dialysis) or a kidney transplant.
Symptoms of Chronic kidney disease
Signs and symptoms of chronic kidney disease appear over time if kidney damage progresses slowly. Loss of kidney function can cause fluid or body waste or electrolyte problems. Depending on how severe it is, kidney failure can cause:
- Nausea
- vomit
- Loss of appetite
- Fatigue and weakness.
- Sleep problems
- Urinating less or more
- Decreased mental acuity
- Muscle aches
- Swelling of feet and ankles
- Dry, itchy skin
- Hypertension (hypertension) is difficult to control.
- Chest pain, if fluid builds up around the heart lining.
Symptoms and signs of kidney disease are often nonspecific. This means they can be caused by other diseases as well. Because your kidneys are able to make up for the lost function, you may not develop signs and symptoms until there is irreversible damage.
When to see a doctor
See your doctor if you have signs or symptoms of kidney disease. Early detection can help prevent kidney disease from progressing to kidney failure. If you have a medical condition that increases your risk of kidney disease, your doctor may monitor your blood pressure and kidney function through urine and blood tests during an office visit. Ask your doctor if these tests are necessary for you.
Diagnosis
As the first step toward diagnosing kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor may ask questions about whether you’ve been diagnosed with high blood pressure, or if you’ve taken any medications that can affect kidney function if you’ve changed your urine. Have you noticed changes in the habits of your family members? Those who have kidney disease. Next, your doctor does a physical exam, checks for signs of problems with your heart or blood vessels, and performs a neurological exam. To diagnose kidney disease, you may also need certain tests and procedures to determine how severe (stage) your kidney disease is. Tests may include:
- Blood tests. Kidney function tests look for levels of waste products, such as creatinine and urea, in your blood.
- Urine tests. Analyzing your urine sample can detect abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.
- Imaging test. Your doctor may use an ultrasound to assess the structure and size of your kidneys. Other imaging tests may be used in certain cases.
- Removing a sample of kidney tissue for testing. Your doctor may recommend a kidney biopsy, which involves removing a sample of kidney tissue. A kidney biopsy is often performed with local anesthesia through a long, thin needle that is inserted into your skin and into your kidney. A biopsy sample is sent to a laboratory for testing to help determine the cause of your kidney problem.
Treatment of Chronic kidney disease
Depending on the cause, some types of kidney disease are treatable. Treatment usually consists of measures to control signs and symptoms, minimize complications, and slow the progression of the disease. If your kidneys become severely damaged, you may need end-stage kidney disease treatment.
Treat the cause
Your doctor will work to slow or control the underlying cause of your kidney disease. Treatment options vary depending on the cause. But kidney damage can get worse even when an underlying condition, such as diabetes mellitus or high blood pressure, is controlled.
Complications of Chronic kidney disease
Kidney disease complications can be managed to make you more comfortable. Treatment may include:
- High blood pressure medications. People with kidney disease may develop high blood pressure. Your doctor may prescribe medications to lower your blood pressure—usually angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers—and to preserve kidney function.
- High blood pressure medications can initially reduce kidney function and alter electrolyte levels, so you may need frequent blood tests to monitor your condition. Your doctor may also recommend a water pill (a diuretic) and a low-salt diet.
- Medicines to relieve swelling. People with CKD often retain fluid. This can lead to leg swelling as well as high blood pressure. Medicines called diuretics can help maintain the balance of fluids in your body.
- Medicines to treat anemia Supplements of the hormone erythropoietin (uh-rith-roe-POI-uh-tin), sometimes with extra iron, help produce more red blood cells. It can relieve fatigue and weakness associated with anemia.
- Medicines to lower cholesterol levels. Your doctor may prescribe drugs called statins to lower your cholesterol. People with chronic kidney disease often have higher levels of bad cholesterol, which can increase the risk of heart disease.
- Medicines to protect your bones. Calcium and vitamin D supplements can help prevent weak bones and reduce your risk of fractures. You can also take a medicine called a phosphate binder to lower the amount of phosphate in your blood and protect your blood vessels from damage from calcium deposits (calcification).
- As your body processes protein from foods, it produces waste products that your kidneys must filter from your blood. To reduce the amount of work your kidneys have to do, your doctor may recommend eating less protein. A registered dietitian can recommend ways to reduce your protein intake while eating a healthy diet.
Your doctor may recommend regular follow-up tests to see if your kidney disease is stable or progressing.