Information about Kidney Disease Many people who have chronic kidney disease don't know it, because the early signs can be very subtle. It can take many years to go from chronic kidney disease (CKD) to kidney failure. Some people with CKD live out their lives without ever reaching kidney failure. However, for people at any stage of kidney disease, knowledge is power. Knowing the symptoms of kidney disease can help you get the treatment you need to feel your best. If you or someone you know has one or more of the symptoms of kidney disease or you are worried about kidney problems you should take the kidney disease test. Remember, many of the symptoms can be due to reasons other than kidney disease. The only way to know the cause of your symptoms is to see your doctor. Kidney Disease Usually kidney failure is a gradual process. Kidneys can carry out their normal functions even if only one is working, or if they are partially damaged. This means it can take a long time for any effects to be felt. When symptoms do appear, they are quite variable between people, and often it is hard to pinpoint the cause. - Changes in Urination
- Kidneys make urine, so when the kidneys are failing, the urine may change. How?
- You may have to get up at night to urinate.
- Urine may be foamy or bubbly. You may urinate more often, or in greater amounts than usual, with pale urine.
- You may urinate less often, or in smaller amounts than usual with dark coloured urine.
- Your urine may contain blood.
- You may feel pressure or have difficulty urinating.
Swelling
Failing kidneys don't remove extra fluid, which builds up in your body causing swelling in the legs, ankles, feet, face, and/or hands.
Fatigue
Healthy kidneys make a hormone called erythropoietin (a-rith'-ro-po'-uh-tin) that tells your body to make oxygen-carrying red blood cells. As the kidneys fail, they make less erythropoietin. With fewer red blood cells to carry oxygen, your muscles and brain become tired very quickly. This condition is called anaemia, and it can be treated.
Skin Rash/Itching
Kidneys remove wastes from the bloodstream. When the kidneys fail, the build-up of wastes in your blood can cause severe itching.
Metallic Taste in Mouth/Ammonia Breath
A build up of wastes in the blood (called uraemia) can make food taste different and cause bad breath. You may also notice that you stop liking to eat meat, or that you are losing weight because you just don't feel like eating. Nausea and Vomiting
A severe build up of wastes in the blood (uraemia) can also cause nausea and vomiting. Loss of appetite can lead to weight loss. Shortness of Breath
Trouble catching your breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anaemia (a shortage of oxygen-carrying red blood cells) can leave your body oxygen-starved and short of breath. Feeling Cold
Anaemia can make you feel cold all the time, even in a warm room.
Dizziness and Trouble Concentrating
Anaemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to memory problems, trouble with concentration, and dizziness. Leg/Flank Pain
Some people with kidney problems may have pain in the back or side related to the affected kidney. Polycystic kidney disease, which causes large, fluid-filled cysts on the kidneys and sometimes the liver, can cause pain. Diagnosis of kidney disease Tests
Tests performed on samples of your blood and urine are the first line of defence in detecting kidney problems and minimising damage. Tests of these types can show how well the kidneys are removing excess fluids and waste. When a structural problem is suspected, a variety of imaging tests can be used to evaluate the kidney. A sample of kidney tissue, a biopsy, is sometimes helpful in diagnosing the specific cause of the problem. Tests commonly used for screening and diagnosis - there are several tests commonly used to help your health care provider recognise if you have kidney or urinary disease. A blood sample can be analysed for creatinine (and estimated glomerular filtration rate (EGFR)) and urea. The level of these waste products in the blood increases as kidney filtration declines. Abnormal results are usually the first sign that kidney disease is present. A urine sample is typically also examined and analysed (urinalysis) as part of routine screening. This set of tests looks for indicators of kidney and urinary disease such as red blood cells, white blood cells (WBCs or leukocytes), and albumin in the urine. If you have diabetes or high blood pressure, the amount of albumin in your urine should be checked at least yearly to detect kidney disease in its early stages. Treatment of Kidney Disease Depending on the cause of kidney disease, the early stages may be slowed down or improved by treating the underlying cause. Changing your diet can ease the strain on the kidneys, for example reducing intake of protein and phosphate. Foods that are rich in protein include eggs, meat and milk. The body needs some proteins to keep healthy but a GP or nutritionist can advise on the amount that should be eaten. Foods such as muesli, and some seafood and cheeses, are rich in phosphate. It is extremely difficult to cut out all phosphates so medicines called phosphate binders may be prescribed to prevent this mineral from being absorbed into the blood. Certain drugs, such as ACE inhibitors, can also be prescribed to lower blood pressure and help the kidneys to function. In cases of full kidney failure (of both kidneys), two main options are open to the medical team.
Kidney transplant, in which a functioning kidney from a donor is surgically grafted into the patient, has a good rate of success. However, there is a shortage of suitable donors and a risk that the new organ will be rejected. This means that the patient is required to take a large number of anti-rejection drugs, and due to the effects of kidney failure and these drugs, diseases of the circulation are common to recipients of transplants. The anti-rejection drugs also increase the risk of getting certain types of cancer. Dialysis is the option for ongoing treatment, often used while waiting for a suitable transplant opportunity. It can take place at home or in hospital and involves using a machine to artificially filter the blood of waste products and excess water. It is not as efficient as a human kidney, so people with kidney failure usually need to restrict their intake of fluid and of certain foods. They also require additional medicines such as iron supplements, phosphate binders, and antihypertensive medicine (to reduce blood pressure). Causes of Kidney Disease The most common causes of kidney disease are diabetes and high blood pressure. Diabetes can cause kidney disease if a person does not manage their diabetes properly. If too much glucose is in the blood, it can attack tiny units inside the kidney called nephrons. It is these nephrons that carry out the filtering process, so if they do not work, the kidney will stop functioning. High blood pressure causes damage by putting strain on the small blood vessels in the kidneys. This prevents the filtering process from working properly. Other causes include: - A kidney inflammation called glomerulonephritis;
- Kidney infections such as pyelonephritis;
- Polycystic kidney disease, an inherited condition in which both kidneys are several times the normal size, due to the gradual growth of masses of cysts;
- Nephrosclerosis, in which hardening of the kidneys occurs as a result of disease of the arteries;
- Failure of normal kidney development in an unborn baby while developing in the womb;
- Systemic lupus erythematosus, a disease of the immune system where the body attacks the kidney as though it were foreign tissue;
- Malaria;
- Yellow fever and jaundice;
- Certain medicines;
- Blockages (for example, due to kidney stones); and
- A sharp blow or physical injury to the kidney.
Prevention of Kidney Disease A number of measures can be taken to help protect yourself from kidney disease: - Avoid severe dehydration, especially for those who are in a risk group (such as diabetics).
- Diabetics should also make sure their blood sugar levels are kept under control.
- Maintain a healthy blood pressure (neither too high nor too low). This means having a healthy diet (particularly avoiding added salt) and lifestyle (for example, taking gentle exercise and avoiding stress) and taking medication prescribed by your GP.
- Reduce the amount of cholesterol in diets - cholesterol increases blood pressure and thus impairs kidney function.
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