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Chronic Kidney Disease

According to the Centers for Disease Control, one in nine American adults – 26 million – have some level of CKD and 20 million more, 1 in 9, are at risk and they may not know it.

There are many types of kidney disease. Following are general definitions. Your physician can help you better understand these types of kidney disease and what they mean to you.
   ● Chronic Kidney Disease (CKD)
   ● Acute Kidney Failure, Kidney Failure: Loss of kidney’s ability to remove waste and help balance fluids in the body
   ● Renal Disease: Another name for kidney disease, or damage to kidney function
   ● End Stage Renal Disease (ESRD): Most advanced, stage 5, chronic kidney disease requiring renal replacement treatment.

Kidneys sort out and remove waste from your blood stream, so it doesn’t build up in your body and become toxic. Each kidney is made up of nephrons, or filtering units. Inside each nephron is a glomerulus, or a blood vessel, that allows waste and extra fluid to flow out while keeping in blood cells and protein. The wastes and extra fluid leave the kidneys and become urine.

Kidneys regulate the level of water and amount of important chemicals in your body, like sodium, potassium and acids.

Chemicals from your kidneys help control blood pressure, salt levels, red cell production to prevent anemia, and vitamin D for strong bones.

To measure kidney function, your doctor will test your blood for the eGFR (estimated glomerular filtration rate). To rule out kidney damage, a urine sample will be used to measure for albumin, a type of protein.

Your nephrologist – or kidney specialist – is your best resource for information about your individual condition. They can answer any questions you may have and can offer recommendations for next steps.

Dialysis Options

When a person’s chronic kidney disease (CKD) becomes advanced, he or she will discuss treatment with the nephrologist. There are different types of dialysis that may be chosen according to lifestyle, support at home, quality of overall health and access to necessary facilities. The most common form of dialysis is in-center hemodialysis. In some centers, dialysis can also be done overnight. Home dialysis is an option for some patients and might take the form of overnight or peritoneal dialysis. There are a lot of things to consider when it’s time to prepare for dialysis, but it is important to ask questions and be prepared for the future.

Preparing for Transplant

For those who have ESRD, or kidney failure, kidney transplant may be an alternative to dialysis.

After you have a kidney transplanted, you may live longer, feel better and have energy to be more active than if you continued dialysis treatment.

Anti-rejection medications are necessary after a kidney transplant and must be taken as long as that kidney is working. The medications can have side effects. There are risks in any surgery, including infection. Even successful kidney transplants do not often last a lifetime. The amount of time a transplanted kidney will work in your body is hard to predict, but you may need more than one transplant in your lifetime.

To qualify for a transplant, patients need to have a thorough evaluation to determine if they are healthy enough for the surgery and recovery. If you are not as healthy as doctors would like, you may be able to improve your chances to be approved as a transplant recipient by making a change, like losing weight, for example.

As you are looking into transplant, discuss the costs of the evaluation, surgery, post-op care and anti-rejection medications with your doctor or dialysis social worker. Also, ask about joining the deceased donor transplant list as soon as you are approved for the surgery, and explore living donor options from family members and friends. It can take years to get approved and for a donated kidney to be made available to you, so start educating yourself about this treatment option early.

High Blood Pressure

Have your blood pressure checked regularly. High blood pressure can damage the kidneys, so learn what range is healthy for you and work with your physician to keep your blood pressure numbers in range.

Kidney damage can also cause high blood pressure. If you have been taking medications for hypertension (high blood pressure), have made the right lifestyle changes, and your doctor is still concerned about your numbers, this is called resistant hypertension.

There are many diseases that cause resistant hypertension. The most common cause is worsening kidney disease. Another common disease is renal artery stenosis, which happens when plaque builds up in the blood vessels and arteries that lead to the kidneys.

If you are at risk, you should work closely with your doctor to stay healthy. Those most at risk for resistant hypertension are people with diabetes, kidney disease, smoking and old age.

Diabetic Kidney Disease

Diabetic Kidney Disease, also called Diabetic Nephropathy, is a condition in people with Diabetes that causes the kidneys to lose function.

Kidney disease is a serious condition. Your kidneys filter waste and extra water out of your body to clean your blood and make urine. They also perform important functions like controlling blood pressure and producing hormones. If your kidneys are not functioning properly, wastes will build up in your body and imbalances of some important chemicals will occur. Diabetes is the number one cause of kidney disease in the world. A hallmark of diabetic kidney disease is spilling of protein in the urine. This makes the urine bubbly or frothy. If the protein in the urine continues to worsen, diabetics can lose 5-10 % of their kidney function per year.

Kidney Stones

Kidney stones are quite common but should still be taken seriously. They are deposits of minerals and salts that form inside the kidneys or anywhere along the urinary tract.

Typically, if you know you have a small kidney stone, you can take pain medication and drink a lot of water to pass it at home. If stones are recognized quickly, they often do not cause permanent damage. However, sometimes kidney stones may become lodged in the urinary tract or cause other complications like infections or even septic shock. In these cases, surgery to remove them would have to be done.

Imbalances in the kidney can cause stone formation. These can be studied by performing a stone risk study on a 24-hour urine collection. Medications may be prescribed and dietary changes can be made to prevent recurrent stone formation. Patients may work with their doctor to try to prevent stones in the future.

Genetic & Rare Kidney Diseases

Some kidney diseases are genetic and may be inherited from family members, including Polycystic Kidney Disease (PKD) and Fabry Disease. Other diseases my have developed over time but are rare and difficult to diagnose, including Glomerulopathy and related conditions like FSGS. The kidney doctors of IKS have expertise in many of these conditions and partner with their patients to identify and treat them.

To learn more about your health, go to Understanding Kidney Disease.