Kidney disease is a condition where the kidneys do not function normally. It is brought about by an infection, physiological problems like autoimmune disorders or physical damage to the kidney. The kidneys play an important role in filtering out toxins and maintaining blood pressure and acid-base levels in the body. They also regulate the urinary system, which is crucial in removing toxins from the body. Kidney disease was thought to be prevalent among older people, but now it is also common in young adults. In the case of kidney disease, depending on the severity, a doctor may advise medication, diet restrictions, dialysis or a kidney transplant. Doctors say that a kidney transplant is the best way to avoid further complications in a patient. Common symptoms of kidney failure are abdominal pain, back pain, nausea, loss of appetite, oedema, increased creatinine and protein content in a person’s urine and general malaise. Urinary retention is also another common indicator. Urinary retention leads to a build-up of toxins within the body and can lead to various other complications. If a person experiences the above-mentioned symptoms, it is prudent to visit a doctor immediately. In this section, you can find interesting articles like why the younger generation is more prone to kidney disease, some useful tips to prevent kidney disease and things that could be damaging your kidneys.
Types
Kidney disease is broadly classified as:
- Acute kidney disease or acute kidney failure (AKF): It occurs when the kidney function is reduced greatly or lost abruptly within a few hours or days.
- Chronic kidney disease (CKD): It is the gradual loss of kidney function over time. It is often symptomless in the initial stages.
Stages
Because loss of kidney function is gradual in CKD, there are different stages of CKD. These stages are determined by the eGFR test results, and they are as follows
- Stage 1: Mild kidney damage and an Estimated GFR (eGFR) of greater than 90 or 90, and other tests have shown mild kidney damage
- Stage 2: eGFR of 60 to 89ml/min and other signs of kidney damage.
- Stage 3: Divided into 3a and 3b. Symptoms start at this stage.
- Stage 3a: eGFR between 45 and 59ml/min
- Stage 3b: eGFR between 30 and 44ml/min.
- Stage 4: Last stage before kidney failure and eGFR between 15 and 30. Kidneys are damaged moderately or severely
- Stage 5: eGFR less than 15. Kidney failure has occurred.
Symptoms
Symptoms in acute kidney disease develop soon, but in CKD the symptoms may not be seen until the kidney function is reduced to a great extent. Here are some common symptoms of AKF:
- Reduced urine output
- Fatigue
- Nausea
Swelling in the feet, ankles and around the eyes. Symptoms may not be seen till the kidney damage is advanced. They are usually seen at stage 3 of CKD.
- Tiredness
- Poor sleep
- Poor appetite
- Unexplained itchiness
- Swelling of feet
- Puffiness of face and eyes
- Shortness of breath
Causes And Risk Factors
Causes
The cause of kidney disease depends on the type of kidney disease. Causes of acute kidney disease or AKF include:
- Renal ischemia: Reduced blood flow to kidneys due to blocked blood vessels.
- Drug-induced kidney disease: Certain drugs can cause inflammation of the kidney
- External Injury: Direct injury to the kidneys can damage the nephrons, thereby reducing kidney function
- Medical conditions: In some medical conditions or diseases like malaria can result in acute kidney failure
- Obstruction of urine flow: Conditions like enlarged prostate can obstruct the flow of urine, causing the wastes to accumulate in the kidneys, reducing their function
Causes of chronic kidney disease (CKD)
- Chronic diseases: CKD is mainly a secondary disease developed due to an underlying primary condition, and according to statistics, chronic diseases like diabetes, high blood pressure, and heart disease are the main causes of CKD
- Genetic factors: Certain genetic factors can cause kidney disease early in life. Polycystic kidney disease is a disorder in which several cysts arise in the kidneys. As the cysts grow, the kidney function reduces gradually and can also lead to kidney failure.
- Immunological diseases: Some conditions such as lupus that affect the immune system can trigger loss of kidney function.
- Congenital factors: Structural and functional abnormalities can even develop in the foetus, causing kidney disease in the baby.
- Recurring infections: Recurring kidney infections (pyelonephritis) and urinary tract infections can also lead to kidney disease.
Risk Factors
Risk factors for kidney disease are grouped under modifiable and non-modifiable categories. Although you cannot do anything about the non-modifiable risk factors, lifestyle-related factors can be controlled well in time to reduce the progression of kidney disease.
- Diabetes
- Hypertension or high blood pressure
- Family history of kidney disease
- Old age
- Heart disease
- Obesity
- Alcohol intake
- Drug abuse/drug overdose
- Race/Ethnicity
- Male sex
- Smoking
Prevention
Our kidneys are designed such that their filtration capacity naturally declines after the age of 30-40 years. So, every decade after your 30s, your kidney function will reduce by 10 per cent. But, if you’re going to increase the load on your kidneys right from the beginning, your risk of developing kidney disease later in life will be higher. Here’s why the youth is more affected by kidney diseases. Here are a few tips to follow to prevent kidney disease:
- Manage diseases such as high blood pressure, heart disease and blood sugar levels
- Reduce salt intake
- Exercise daily
- Drink lots of water every day
- Don’t resist the urge to urinate
- Eat a balanced diet
- Drink healthy beverages
- Avoid alcohol and smoking
- Avoid self-medicating
- Think before you take supplements and herbal medicine
Diagnosis
Generally, with acute kidney disease, you’ll develop symptoms based on which the doctor will recommend tests for assessing your kidney function. In chronic kidney disease, the symptoms are not seen in the early stages, but the same tests, if taken early, can help diagnose kidney disease.
When you go for an annual screening of your kidney function, you will have to undergo some or all of the following tests:
- Blood tests: Several markers in the blood can help identify the actual kidney function. Urea and creatinine are the main parameters for checking kidney function.
- Urine tests: The ratio of values for blood and urine markers can give the actual rate of clearance of kidneys.
- Estimated GFR: eGFR is the estimate of the filtration rate of the kidneys based on a formula that includes serum creatinine values along with correction factors like age, gender and race.
- Imaging tests: Imaging tests like renal ultrasound uses ultrasonic waves to analyse the size and shape of the kidneys to identify renal injury and changes in the filtration capacity of the kidneys.
Treatment
Treatment for acute kidney disease
Acute kidney failure is an emergency that requires hospitalization. The goal of the treatment is to prevent further complications. Medications can help to control comorbidities like blood pressure, reduce fluid build-up and restorative calcium. Sometimes, dialysis may also be needed.
Treatment for chronic kidney disease
- Medicines: Chronic kidney disease, by definition, is a gradual and irreversible loss of kidney function. However, with a proper diet, certain medicines like angiotensin-converting enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs) can significantly slow down the progression of kidney disease when under proper guidance and monitoring. It is also important to avoid self-medication, even with over-the-counter medicines, whether allopathic or herbal, as they may worsen kidney function.
- Dialysis: Once the kidney function reduces to between 7-15 ml/min/1.73m2, depending on symptoms and other lab parameters, dialysis may be needed, and a transplant may have to be considered.
Lifestyle Management
Changes that can help slow down kidney failure include:
- Maintaining normal blood pressure
- Controlling diabetes
- No smoking or alcohol
- Changing your diet
- Exercise regularly and stay healthy
Prognosis And Complications
Prognosis
Early detection of kidney failure can help in slowing down or preventing complete kidney failure. Following the doctor’s instructions and keeping your diabetes, and blood pressure in check can help this cause.
Complications
Complications due to kidney diseases include:
- Anaemia
- Heart problems
- Nerve damage in hands and legs.
- Pain in joints
- Mental functioning reduces causing dementia and confusion
- Skin issues like itching.
- Greater risk of catching infections
Alternative Treatment
- Home Remedies: Kidneys play an important role in clearing out the toxins from our bodies. Dietary changes that can help include reducing salt intake, having low potassium, low protein-containing foods and reducing phosphorous in the diet. Food that can help in kidney disease includes:
- Cauliflower: Cauliflower helps destroy toxins as it is high in folate, vitamin C, and fibre. It also helps control various other factors like diabetes and heart disease, which can cause kidney disease.
- Carrots: Carrots are low in potassium content and help in reducing Hypertension.
- Hypertension: It is a huge contributor to kidney disease and kidney failure. People with chronic kidney disease should eat food that helps in controlling their blood pressure.
- Apples: Diabetes is a risk factor for kidney disease. Apples can reduce cholesterol and blood glucose levels.
- Onions: Onion has a high flavonoid content, which is an antioxidant that helps reduce heart disease, which is a risk factor for kidney disease.
- Garlic: Garlic contains antioxidants that help to control inflammation, lower cholesterol and reduce plaque.
References:
- Kidney Failure: Symptoms, Causes, Tests and Treatment Cleveland Clinic [Internet] Available at: https://my.clevelandclinic.org/health/diseases/17689-kidney-failure.
- Creatinine Test: MedlinePlus Medical Test [Internet] Available on: https://medlineplus.gov/kidneydiseases.html#summary.
- Acute Kidney Injury - Symptoms, causes, treatment | National Kidney Foundation [Internet] Available on: https://www.kidney.org/atoz/content/AcuteKidneyInjury.
- Chronic kidney disease (CKD) - Symptoms, causes, treatment | National Kidney Foundation[Internet] Available at: https://www.kidney.org/atoz/content/about-chronic-kidney-disease.
- Kidney Disease / Chronic Kidney Disease: Symptoms, Treatment & More Cleveland Clinic [Internet] Available at: https://my.clevelandclinic.org/health/diseases/15096-kidney-disease-chronic-kidney-disease.
- Stages of Chronic Kidney Disease (CKD) - American Kidney Fund (AKF) [Internet] Available on https://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/stages-of-chronic-kidney-disease/
- Renal Failure - Conditions We Treat - Patient Care - Nephrology Division - Department of Medicine - Rochester, NY [Internet] Available at https://www.urmc.rochester.edu/heart/conditions/kidney-failure.cfm.
- Chronic kidney disease - Prevention – NHS [Internet] Available at: https://www.nhs.uk/conditions/kidney-disease/prevention/
- Kidney Failure: Symptoms, Causes & Diagnosis - Urology Care Foundation[Internet] Available at: https://www.urologyhealth.org/urology-a-z/k/kidney-(renal)-failure.
- Lifestyle Changes to Manage Chronic Kidney Disease | Winchester Hospital [Internet] Available at: https://www.winchesterhospital.org/health-library/article?id=103158.
- Diabetes and Kidney Disease: What to Eat? | CDC Available at: https://www.cdc.gov/diabetes/managing/eat-well/what-to-eat.html.
- Kidney-Friendly Superfoods | National Kidney Foundation [Internet] Available at: https://www.kidney.org/content/7-kidney-friendly-superfoods.
- Foods to Eat or Avoid If You Have Kidney Disease - Durham Nephrology Associates, PA [Internet] Available on: https://www.durhamnephrology.com/10-foods-to-eat-or-avoid-if-you-have-kidney-disease/
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