Chronic Kidney Disease

Know Your Kidneys

Kidneys are two bean-shaped, fist-sized organs located below your rib cage, on either side of your spine. They are made up of units called nephrons, which consist of filters called glomerulus, and tubules.

Simply put, kidneys are the filters of your body. They filter blood, retain essential minerals, and remove waste and excess fluid in the form of urine. When a kidney begins to slow down, it loses its capacity to do all these functions.

The main functions of the kidney are:

to remove waste products and excess fluid from the body

regulate and maintain the balance of salt, potassium and water content in the body

produce hormones necessary for the function of other organs

produce erythropoietin which stimulates the synthesis of red blood cells

produce vitamin D that promotes bone strength

regulate blood pressure

What happens when kidney function is affected?

When the kidneys are affected, it means the filters of your body are not working properly. This results in the build-up of waste, and leads to chronic kidney disease (CKD). Progressively, when the damaged kidneys stop working, it is called kidney failure, or ESRD. Kidney failure has serious outcomes like:

  • waste and excess fluid builds up in the body
  • impacted functioning of the heart and lungs due to excess fluid, resulting in high blood pressure
  • a spike in waste products like Blood Urea Nitrogen and Creatinine in the blood
  • reduced filtration rate indicated by low GFR (see eGFR table)
  • change in urine output (too frequent urination, or too little urine output) and pain while passing urine
  • swollen hands, feet, and other parts of the body known as Edema
  • Anaemia, or low blood count, since the kidneys are unable to produce red blood cells
  • heart disease as a result of the buildup of sodium and potassium 
  • bone disease as a result of the inability to produce calcium and vitamin D essential for bone health
  • feeling of nausea due to toxins in blood, leading to poor appetite and low energy levels

What is Chronic Kidney Disease

Chronic kidney disease is a condition in which the kidneys are damaged in some way and thus are unable to carry on their functions properly. A progressing stage of CKD can lead to a build up of a high amount of waste products and excess fluids in the blood, making a person ill. This results in complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health, and nerve damage. In addition, kidney disease increases one’s risk of acquiring heart and blood vessel disease. Usually, these problems develop gradually over a long period of time.

Diabetes, high blood pressure, and other disorders are some of the causes of CKD. Early detection and treatment can often slow down the progress of chronic kidney disease. When kidney disease progresses, it may eventually lead to kidney failure, necessitating dialysis, or a kidney transplant to maintain life.

CKD in Children

Some of the main causes of kidney disease in children are:

  1. Birth defects, or malformations at the time of birth, which can be caused by genetic or environmental factors
  2. Your kid may be born with:
    1. One kidney instead of two (renal agenesis, or solitary kidney)
    2. Two kidneys, but one of them does not work (renal dysplasia)
    3. One kidney that may not be in the right location (ectopic kidney)
    4. One or both kidneys may be abnormally small (renal hypoplasia).
  3. Some issues may block the ureter:
    1. A blockage where the kidney attaches to the ureter
    2. The ureters may attach to the bladder in a way that allows urine to reflux or flow back into the  kidney
    3. A blockage where the ureter attaches to the bladder
    4. A blockage that causes urine to remain in the kidney leading to hydronephrosis

Through imaging, ultrasounds and CT scans early diagnosis is possible. Your child may need minor surgeries to overcome this problem before the kidneys get damaged.

Are You At Risk?

A question which seems irrelevant & yet is very important. As a family, an inquisitive friend, a donor, a casual browser, you need to be aware and avoid CKD afflicting you.  In the US, they say 1 in every 3 adults is at a risk for getting chronic kidney disease. Although clear figures for India are not available, it is good for every adult above 30 years to get their health regularly checked by their family doctor.

Diabetes
Designation

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High Blood Pressure
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Family History
of Kidney Disease
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Old Age
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Symptoms

Symptoms in kidney disease generally start showing only when the kidneys become severely damaged. You could be completely asymptomatic during the first 3 stages of CKD. It is hence best to keep monitoring your health at regular intervals. With progressed CKD, a combination of some of these symptoms may appear:

Nausea & Vomiting
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Tiredness
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Loss of Appetite
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Swelling around ankles
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Abnormal Urine Output
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Persistent Itching
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Breathlessness
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Insomnia
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Kidney Health

CAUSES & RISK FACTORS

Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes. Some of the leading causes are listed here.

TREATMENT

When the kidney function reduces, Estimated Glomerular Filtration Rate (eGFR) is used to determine the extent of the damage. With due care, patients can live long lives with these treatments.

PREVENTION

Once the kidneys get damaged, it becomes a challenge to check the progress of the disease. With certain precautionary measures, the onset of CKD can be prevented or delayed.