How Do I Know If I Have Chronic Kidney Disease? (CKD)
Chronic kidney disease is tricky because the symptoms are not overtly severe until the disease has lingered in the body. There are some symptoms you can look for that will indicate that something is wrong with your kidneys. These symptoms include:
▪ Noticeable changes in urination – This can include producing more or less urine than what is normal, increased pressure while urinating, changes in the color of urine, bubbly or foamy urine and having to get up in the middle of the night to urinate.
▪ Swelling of your bodily extremities – When kidneys are not processing the excess liquids and waste from your body, it may stay in the body’s tissues, causing your hands, feet, ankles, wrists and face to swell.
▪ Chronic fatigue or weakness – When wastes build up in your body, or your body isn’t producing any new red blood cells, it can make you feel tired and weak.
▪ Short or shallow breath – Because liquid can be stored in the body if your kidneys are failing, your lungs can often take it on, causing asthmatic symptoms or pneumonia-like symptoms.
▪ Metallic or ammonia breath or tastes in your mouth – As waste builds up in the body, it can cause bad breath, changes in tastes to food or even complete distaste for protein-heavy foods, like red meat.
▪ Lower back and side pain – This is the location of your kidneys in the body, so if they are tender or sore, it could be an indication of a problem.
▪ Itchy legs – Waste buildup causes itchiness, especially in the legs.
▪ No appetite
▪ Nausea and vomiting regularly
▪ Hypoglycemic episodes – if you are diabetic, this can be an indication that the kidneys are at risk.
Beyond these symptoms and indicators, the best bet is to undergo testing to achieve accurate medical results about your kidney health. There are various tests that you can request from your doctor:
▪ eGFR Test – this is the estimated Glomerular Filtration Rate test, which produces a number based on a blood test for creatinine. Creatinine is a waste that is produced by muscles. A normal eGFR level is 60 or above. If your number is below 60, it indicates kidney disease, if it is below 15, you have full on kidney failure.
▪ Dipstick urine test – this test detects if there is protein in your urine. Your doctor will either ask you to bring a urine sample from home, or have you produce one in office.
▪ UACR Test – this test shows how much albumin is in your urine. Your doctor will test for both albumin, which is a type of protein, and creatinine, the waste discussed in the eGFR test. These two samples will be compared to figure out the UACR number. If the number is less than 30 mg/g, you should be fine, anything more than 30 could indicate a problem with the kidneys.
Stages of CKD
There are 5 stages of CKD. Results from a blood test for creatinine (a waste product removed by healthy kidneys) is plugged into a formula for eGFR, or estimated glomerular filtration rate, which is a measure of how well your kidneys are working. Think of it as your percent kidney function with 100% being perfect function.
Stages 1 and 2 are treated by your primary care provider. While you can’t reverse damage, in these stages it is possible to prevent further damage and maintain kidney function. Changes in lifestyle and diet along with regular checkups can help keep the kidneys from further deterioration.
Stages 3 – 5 are treated by a nephrologist, a specialist in kidney disease.
Stage 1 – Onset CKD
Stage 2 – Mild CKD
Stage 3 – Moderate CKD
Stage 4 – Advanced CKD
Stage 5 – End Stage CKD
eGFR: less than 15
How Can I Treat Chronic Kidney Disease?
Treatment of CKD is extremely preventative. The goal is to slow down the disease as much as possible to extend your kidney health and function and avoid kidney failure. There are ways you can alter your lifestyle habits and diet to halt the progression of CKD. Here are some helpful tips to use if diagnosed with CKD:
▪ Manage you blood sugar closely, especially if you are diabetic.
▪ Keep close track of blood pressure and maintain a healthy blood pressure range.
▪ Control cholesterol intake.
▪ Follow a kidney friendly diet consisting of low fat, low sodium, high protein, high potassium, high phosphorous foods. Also, fluid intake needs to be monitored closely, as kidney disease prohibits the body form processing fluids effectively.
▪ Avoid certain medicines that are harsh on the kidneys.
▪ Avoid alcohol, tobacco and other drugs.
▪ Maintain a healthy body weight.
▪ Engage in an active lifestyle.
What Happens When CKD Progresses To Kidney Failure?
If you are diagnosed with CKD, kidney failure is inevitable. You can prolong the onset of kidney failure by following the recommended steps by your doctor that promote a healthy, kidney friendly lifestyle. However, kidney dialysis will be necessary. When facing kidney failure and dialysis treatments, it is extremely important to know your options for treatment and how they may affect your lifestyle. These are the main forms of kidney dialysis treatment and solutions:
▪ Peritoneal Dialysis (PD) – Otherwise known as “needle-less”, this kind of dialysis uses your abdomen to help promote removal of toxins. A catheter is surgically placed in the lower abdomen. Fluid is instilled into the abdomen and is removed automatically by the dialysis machine while you sleep. This dialysis is done at home and it is done nightly.
▪ Hemodialysis – This is the dialysis most people know about. It can be done at day or night. Patients attend dialysis sessions 3 times weekly for a minimum of 4 hours per treatment. The actual time at the dialysis unit is 5-6 hours with transportation times and post treatment monitoring. It is a passive treatment in which dialysis is performed via a “shunt.” Needles are placed in the shunt and blood is passed through a filter for cleaning. It is effective but often leaves patients tired. A strict diet must be adhered to in order for this treatment to be maximally effective.
▪ Home Hemodialysis – This type of dialysis is done similarly to in-center hemodialysis but it is done at home. The treatment time is 2.5 hours and you will be trained to do this on your own. It is gentler than in-center hemodialysis and allows you the flexibility of doing it on your schedule.
▪ Kidney Transplant – Kidney transplants are seen as the last solution in the dialysis treatment plan. Depending on age and medical health, your eligibility for transplant and risks associated with the surgery will vary. However, if you are need of a transplant, we will do everything we can to make sure you are able to receive the most compatible kidney for your body and that you are as out of risk as possible.
How Can We Help?
Kidney and Hypertension Specialists is committed to providing more personal and reliable care to our patients. If you are interested in learning more about kidney disease, the way it can have an impact on your life, treatment options, or how our care plans can help you, feel free to contact us at any time.