What is it?
The kidneys are highly complex organs that control blood chemistry, blood pressure, and the amount of fluid in the body. They also keep the blood clean and chemically balanced.
Acting as very efficient and specialised filters, they work to rid the body of waste and toxic substances and return vitamins, amino acids, glucose, hormones and other vital substances into the bloodstream. But sometimes things can go wrong.
The term “chronic kidney disease” (CKD) is used world-wide to mean any form of kidney disease that goes on for more than a few months. The word “chronic” doesn’t necessarily mean “serious” and “disease” includes any abnormality of kidney structure or function, whether or not it is likely to cause a person to feel unwell or to develop complications.
It is a common condition that can affect anyone at any age, but the older you are the more likely you are to have some level of CKD. In fact, it is estimated that around 3 million people in the UK are at risk of developing CKD.
There are several stages of chronic kidney disease, ranging from mild loss of kidney function to kidney failure, but not all CKD conditions progress to the most serious stage. Most people fall into the mild to moderate categories.
What are the causes
CKD is often caused by a combination of other conditions that put a strain on the kidneys. For example:
- Poorly controlled blood pressure
- Diabetes
And you are at greater risk of developing CKD if you:
- have cardiovascular disease (conditions affecting the heart or blood vessels)
- have a family history of kidney disease
- are black, Asian or from a minority ethnic background
- smoke
- are overweight
Symptoms
Mild to moderate chronic kidney disease can often develop without any noticeable symptoms. That’s why it is often found by accident when GPs carry out routine health checks or tests to investigate other issues.
But you should visit your GP if you:
- see blood in your urine
- have a frequent need to pass urine, especially if this causes pain or a burning sensation and your urine has an offensive smell
- have any swelling (oedema) in your legs, hands and face
- feel tired or generally unwell without any apparent cause.
Diagnosis
Doctors can use simple tests, for example a blood test called eGFR (estimated glomerular filtration rate), to see how well your kidneys are working to filter out waste (e.g. creatinine) from your blood. They will also look for the presence of blood and protein in your urine – which are signs of kidney damage.
The earlier potential kidney problems are detected the greater the chance that disease progression can be slowed down and possibly even halted. And taking care of your kidneys can also help to reduce your risk of stroke and heart attack.
Treatment
If you have been told that you have mild to moderate CKD you’ll probably be:
- monitored regularly (through blood and urine tests) to check your kidney function and try to protect you from further illness which could increase your risk of getting acute kidney injury (AKI)
- given advice about staying as healthy as possible (e.g. by doing regular exercise, eating a healthy diet) and controlling blood pressure and protein loss with medications such as “ACE inhibitors” and Angiotensin Receptor Blockers (ARBs)
- given help to manage medicines safely – for example avoiding some over-the-counter medicines such as ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) which can reduce blood flow to the kidneys. And always checking with your doctor or pharmacist before using herbal and other alternative therapies
- offered medications and treatments if you develop anaemia or bone disease.
Disease progression
If your kidney disease looks like it’s getting worse you may be advised to start thinking about possible treatments should your kidneys eventually fail. These treatments (e.g. peritoneal dialysis, haemodialysis and kidney transplantation) are known as renal replacement therapies because they do some of the work of the kidneys.
You may also be advised to follow a special diet, where some types of foods and drinks are restricted, especially if you are on dialysis. A renal dietitian will work with you to create a plan that is tailor-made to your particular needs and lifestyle.
Help for you
If you have been diagnosed with chronic kidney disease and have any questions or concerns about your illness don’t hesitate to speak to your GP or your kidney specialist or your nurse specialist at the kidney unit.
You can also find further information, advice and helpful tips in our Just diagnosed and How can I help myself? sections.
- Watch Dr Kathryn Griffith talk about chronic kidney disease.
- Visit the Think Kidneys website
- Visit NHS Choices
The need for more research
Kidney Research UK is supporting a three-year study to look at the effects of giving intravenous iron supplementation to people with stages 3-4 CKD who are iron deficient (but not yet anaemic or on dialysis) to see if it helps improve their exercise and physical ability, as well as muscle functioning.
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