Chronic kidney disease (CKD) is a condition where the functioning of the kidneys is gradually lost. The kidneys are the organs that filter impurities from the blood and a decrease in their functioning will allow impurities to collect in the bloodstream. Over time, the buildup can become so large that your health is seriously affected. Among the most common complications are:

• Anemia
• Low blood pressure
• Nerve damage
• Bone weakness
• Inadequate nutrition intake
• Heart disease
• Blood vessel disease

The speed at which the function reduces varies from patient to patient, but unless the condition is spotted early, complete kidney failure could result. This will mean that the patient will require either dialysis for the rest of his life or a kidney transplant.

Causes

Various medical conditions can result in the development of kidney disease. Among the most common are:

• Diabetes: The unregulated high blood sugar levels caused by this condition can cause damage to many organs including the kidneys, heart, nerves, eyes and blood vessels.
• High Blood Pressure: If your BP is too high, it places a great strain on the heart and other organs, including the kidneys. The reverse is also true – kidney disease can cause high blood pressure.
• Inherited Diseases: Kidney conditions can run in the family. Among the most common is polycystic kidney disease (PKD) where large cysts form in the kidneys, impairing their functioning.
• Abnormalities at Birth: If there are malformations in the development of the fetus as it grows in the womb, it could cause kidney disease. For example, any genetic restriction in the urine flow places pressure on the kidneys and could cause them to fail.
• Autoimmune Diseases: In autoimmune diseases, the immune mechanism of the body attacks its own cells, causing various medical ailments to arise. Lupus nephritis is a condition where the kidneys become inflamed or scarred which affects their ability to filter the blood.
• Glomerulonephritis: This is an umbrella term for a group of diseases that cause kidney inflammation and lasting damage. These are among the most common chronic kidney diseases.
• Other Causes: These include kidney stones, tumors, enlarged prostate glands in men and recurring urinary tract infections (UTIs).

Anyone can develop kidney disease at any age, but those with any of the above conditions are more prone to the disease.

Symptoms

The common symptoms of chronic kidney disease are:

• Tiredness and lack of energy
• Poor appetite
• Difficulty in sleeping
• Inability to concentrate
• Swollen feet and ankles
• Repeated muscle cramping while sleeping
• Puffiness around the eyes that may be more pronounced in the mornings
• More frequent urination
• Dry itchy skin

In many cases, the symptoms become noticeable only when the disease has reached an advanced stage.

Diagnosis

If your doctor suspects that you have CKD, they will order various examinations and tests to enable an accurate diagnosis to be formulated. These include:

• Blood Test for Creatinine: This will determine if creatinine, a waste product, is remaining in the blood.
• Urine Test: This will show abnormalities in the urine.
• Albumin to Creatine Ratio Urine Test: Low albumin levels are a sign of a kidney problem and this test helps to detect albumin level.
• Glomerular Filtration Rate (GFR): This will measure the efficiency of the kidneys’ functioning in filtering waste from the blood.
• CT Scan: The scan will be used to see if there are any structural problems with the kidneys or urinary tract. The size of the kidneys can also be measured and the presence of stones or tumors will be shown in the scan.
• Biopsy: In a few cases, a biopsy may be ordered. A small piece of the kidney is removed for laboratory examination to check for any diseases that do not show up in other tests.

Treatment 

Some types of CKD can be treated. Treatment modalities typically consist of controlling the symptoms and slowing the progression of the disease to reduce the possibilities of other complications. Among the most used treatment protocols are given below.

• CKD can cause high blood pressure or be caused by it. Medication to control BP may be prescribed if there is a BP issue.
• CKD can result in fluid accumulation in the body. This can cause swelling in the legs and contribute to high BP. Diuretic medication may be prescribed to increase the release of water.
• If the patient has anemia, hormone and iron supplements may be advised to increase red blood cell production and to reduce the symptoms of fatigue and weakness.
• Cholesterol lowering medication will be prescribed if you have high cholesterol levels. This is a common complication with CKD and can lead to cardiac problems. 
• Calcium and vitamin D supplements may be prescribed to strengthen the bones and reduce the possibility of fractures.

In order to minimize the amount of waste matter in the blood, a low protein diet may be advised.

Regular check-ups are essential to monitor the state of the kidneys and their functioning and modify the treatment protocols if required.

If the kidneys reach a stage of near complete or total failure, the condition is known as end-stage kidney disease. In such cases, there are 2 options available to avoid fatal consequences:

• Dialysis: A machine will be used to remove waste matter from the blood. This will have to be done regularly and the frequency will vary according to the patient’s health status.
• Kidney Transplant: A healthy kidney from a compatible donor, living or dead, is transplanted into the patient’s body. While this offers a permanent solution to CKD, the patient will need to remain on medication to prevent his body from rejecting the new organ.

CKD is a serious medical condition, and early detection, accurate diagnosis and specialized treatment at a multispecialty hospital with specialist doctors and cutting-edge medical equipment and technology is required to ensure that the best and most effective treatment is available to the patient.

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