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Chronic Kidney Disease (CKD) Symptoms, Causes and Management

The kidneys are two bean-shaped organs. Each kidney is about the size of a fist. Your kidneys filter extra water and wastes out of your blood and make urine. Kidney disease means your kidneys are damaged and can’t filter blood the way they should.

Kidney Functions

  • Help remove waste and excess fluid
  • Filter the blood, keeping some compounds while removing others
  • Control the production of red blood cells
  • Make vitamins that control growth
  • Release hormones that help regulate blood pressure
  • Help regulate blood pressure, red blood cells, and the amount of certain nutrients in the body, such as calcium and potassium.

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed above. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

What causes CKD?

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. 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. High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.

Other conditions that affect the kidneys are:

  • Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units. These disorders are the third most common type of kidney disease.
  • Inherited diseases, such as polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue.
  • Malformations that occur as a baby develops in its mother’s womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
  • Lupus and other diseases that affect the body’s immune system.
  • Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men.
  • Repeated urinary infections.

What are the symptoms of CKD?

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:

  • Feel more tired and have less energy
  • Have trouble concentrating
  • Have a poor appetite
  • Have trouble sleeping
  • Have muscle cramping at night
  • Have swollen feet and ankles
  • Have puffiness around your eyes, especially in the morning
  • Have dry, itchy skin
  • Need to urinate more often, especially at night.

Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:

  • Have diabetes
  • Have high blood pressure
  • Have a family history of kidney failure
  • Are older
  • Belong to a population group that has a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians.

Diagnosing CKD

To check for kidney disease, health care providers use:

  • A blood test that checks how well your kidneys are filtering your blood, called GFR. GFR stands for glomerular filtration rate.
  • A urine test to check for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged.

If you have kidney disease, your health care provider will use the same two tests to help monitor your kidney disease and make sure your treatment plan is working.

What happens if my test results show I may have chronic kidney disease?

Your doctor will want to pinpoint your diagnosis and check your kidney function to help plan your treatment. The doctor may do the following:

  • Calculate your Glomerular Filtration Rate (GFR), which is the best way to tell how much kidney function you have. You do not need to have another test to know your GFR. Your doctor can calculate it from your blood creatinine, your age, race, gender and other factors. Your GFR tells your doctor your stage of kidney disease and helps the doctor plan your treatment.
  • Perform an ultrasound or CT scan to get a picture of your kidneys and urinary tract. This tells your doctor whether your kidneys are too large or too small, whether you have a problem like a kidney stone or tumor and whether there are any problems in the structure of your kidneys and urinary tract.
  • Perform a kidney biopsy, which is done in some cases to check for a specific type of kidney disease, see how much kidney damage has occurred and help plan treatment. To do a biopsy, the doctor removes small pieces of kidney tissue and looks at them under a microscope.

Your doctor may also ask you to see a Kidney specialist who will consult on your case and help manage your care.

Managing Chronic Kidney Disease

If you have chronic kidney disease (CKD), you can take steps to protect your kidneys from more damage.

The sooner you know you have kidney disease, the better. The steps you take to protect your kidneys from damage also may help prevent heart disease—and improve your health overall. Making these changes when you have no symptoms may be hard, but it’s worthwhile.

Ten ways to manage kidney disease

  1. Control your blood pressure
  2. Meet your blood glucose goal if you have diabetes
  3. Work with your health care team to monitor your kidney health
  4. Take medicines as prescribed
  5. Work with a dietitian to develop a meal plan
  6. Make physical activity part of your routine
  7. Aim for a healthy weight
  8. Get enough sleep
  9. Stop smoking
  10. Find healthy ways to cope with stress and depression

Eating Right for Chronic Kidney Disease

You may need to change what you eat to manage your chronic kidney disease (CKD). Work with a registered dietitian to develop a meal plan that includes foods that you enjoy eating while maintaining your kidney health.

The steps below will help you eat right as you manage your kidney disease. The first three steps (1-3) are important for all people with kidney disease. The last two steps (4-5) may become important as your kidney function goes down.

The first steps to eating right

Step 1: Choose and prepare foods with less salt and sodium

Why? To help control your blood pressure. Your diet should contain less than 2,300 milligrams of sodium each day.

  • Buy fresh food often. Sodium (a part of salt) is added to many prepared or packaged foods you buy at the supermarket or at restaurants.
  • Cook foods from scratch instead of eating prepared foods, “fast” foods, frozen dinners, and canned foods that are higher in sodium. When you prepare your own food, you control what goes into it.
  • Use spices, herbs, and sodium-free seasonings in place of salt.
  • Check for sodium on the Nutrition Facts label of food packages. A Daily Value of 20 percent or more means the food is high in sodium.
  • Try lower-sodium versions of frozen dinners and other convenience foods.
  • Rinse canned vegetables, beans, meats, and fish with water before eating.

Look for food labels with words like sodium free or salt free; or low, reduced, or no salt or sodium; or unsalted or lightly salted.

Step 2: Eat the right amount and the right types of protein

Why? To help protect your kidneys. When your body uses protein, it produces waste. Your kidneys remove this waste. Eating more protein than you need may make your kidneys work harder.

  • Eat small portions of protein foods.
  • Protein is found in foods from plants and animals. Most people eat both types of protein. Talk to your dietitian about how to choose the right combination of protein foods for you.

Animal-protein foods:

  • Chicken
  • Fish
  • Meat
  • Eggs
  • Dairy

A cooked portion of chicken, fish, or meat is about 2 to 3 ounces or about the size of a deck of cards. A portion of dairy foods is ½ cup of milk or yogurt, or one slice of cheese.

Plant-protein foods:

  • Beans
  • Nuts
  • Grains

A portion of cooked beans is about ½ cup, and a portion of nuts is ¼ cup. A portion of bread is a single slice, and a portion of cooked rice or cooked noodles is ½ cup.

Step 3: Choose foods that are healthy for your heart

Why? To help keep fat from building up in your blood vessels, heart, and kidneys.

  • Grill, broil, bake, roast, or stir-fry foods, instead of deep frying.
  • Cook with nonstick cooking spray or a small amount of olive oil instead of butter.
  • Trim fat from meat and remove skin from poultry before eating.
  • Try to limit saturated and trans fats. Read the food label.

Heart-healthy foods:

  • Lean cuts of meat, such as loin or round
  • Poultry without the skin
  • Fish
  • Beans
  • Vegetables
  • Fruits
  • Low-fat or fat-free milk, yogurt, and cheese

Step 4: Choose foods and drinks with less phosphorus

Why? To help protect your bones and blood vessels. When you have CKD, phosphorus can build up in your blood. Too much phosphorus in your blood pulls calcium from your bones, making your bones thin, weak, and more likely to break. High levels of phosphorus in your blood can also cause itchy skin, and bone and joint pain.

  • Many packaged foods have added phosphorus. Look for phosphorus—or for words with “PHOS”—on ingredient labels.
  • Deli meats and some fresh meat and poultry can have added phosphorus. Ask the butcher to help you pick fresh meats without added phosphorus.

Step 5: Choose foods with the right amount of potassium

Why? To help your nerves and muscles work the right way. Problems can occur when blood potassium levels are too high or too low. Damaged kidneys allow potassium to build up in your blood, which can cause serious heart problems. Your food and drink choices can help you lower your potassium level, if needed.

  • Salt substitutes can be very high in potassium. Read the ingredient label. Check with your provider about using salt substitutes.
  • Drain canned fruits and vegetables before eating.

Preventing Chronic Kidney Disease

You can protect your kidneys by preventing or managing health conditions that cause kidney damage, such as diabetes and high blood pressure. The steps described below may help keep your whole body healthy, including your kidneys.

1. Make healthy food choices

Choose foods that are healthy for your heart and your entire body: fresh fruits, fresh or frozen vegetables, whole grains, and low-fat or fat-free dairy products. Eat healthy meals, and cut back on salt and added sugars. Aim for less than 2,300 milligrams of sodium each day. Try to have less than 10 percent of your daily calories come from added sugars.

Tips for making healthy food choices

  • Cook with a mix of spices instead of salt.
  • Choose veggie toppings such as spinach, broccoli, and peppers for your pizza.
  • Try baking or broiling meat, chicken, and fish instead of frying.
  • Serve foods without gravy or added fats.
  • Try to choose foods with little or no added sugar.
  • Gradually work your way down from whole milk to 2 percent milk until you’re drinking and cooking with fat-free (skim) or low-fat milk and milk products.
  • Eat foods made from whole grains—such as whole wheat, brown rice, oats, and whole-grain corn—every day. Use whole-grain bread for toast and sandwiches; substitute brown rice for white rice for home-cooked meals and when dining out.
  • Read food labels. Choose foods low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
  • Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a slice of cake. Peel and eat an orange instead of drinking orange juice.
  • Try keeping a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.

2. Make physical activity part of your routine

Be active for 30 minutes or more on most days. If you are not active now, ask your health care provider about the types and amounts of physical activity that are right for you. Add more activity to your life with these tips to help you get active.

3. Aim for a healthy weight

If you are overweight or have obesity, work with your health care provider or dietitian to create a realistic weight-loss plan. View more weight control and physical activity resources to help you get and stay motivated.

4. Get enough sleep

Aim for 7 to 8 hours of sleep each night. If you have trouble sleeping, take steps to improve your sleep habits 

5. Stop smoking

If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it alone.

6. Limit alcohol intake 

Drinking too much alcohol can increase your blood pressure and add extra calories, which can lead to weight gain. If you drink alcohol , limit yourself to one drink per day if you are a woman and two drinks per day if you are a man. One drink is:

  • 12 ounces of beer
  • 5 ounces of wine
  • 1.5 ounces of liquor

7. Explore stress-reducing activities

Learning how to manage stress , relax, and cope with problems can improve emotional and physical health. Physical activity can help reduce stress, as can mind and body practices such as meditation, yoga , or tai chi.

8. Manage diabetes, high blood pressure, and heart disease

If you have diabetes, high blood pressure, or heart disease, the best way to protect your kidneys from damage is to

Keep blood glucose numbers close to your goal. Checking your blood glucose, or blood sugar, level is an important way to manage your diabetes. Your health care team may want you to test your blood glucose one or more times a day.

Keep your blood pressure numbers close to your goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Take all your medicines as prescribed. To help prevent heart attacks and stroke, keep your cholesterol levels in the target range. There are two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels, which can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. A cholesterol test also may measure another type of blood fat called triglycerides.

Treatment of CKD

Some people live with kidney disease for years and are able to maintain kidney function. Others progress quickly to kidney failure.

Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. If your kidney function drops to this level, you may have symptoms from the buildup of waste products and extra water in your body.

To replace your lost kidney function, you may have one of three treatment options:

End-stage renal disease (ESRD) is kidney failure that is treated by dialysis or kidney transplant. Some people with kidney failure choose not to have dialysis or a transplant but continue to receive care from their health care team, take medicines, and monitor their diet and lifestyle choices.

Work with your health care professional, Dubai and family to consider your options and choose a treatment that is right for you.

Reference:

Disclaimer: All contents on this site are for general information and in no circumstances information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility of any damage done by the misuse or use of the information.

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