A comprehensive guide to chronic kidney disease

Chronic kidney disease (CKD) is a progressive condition where the kidneys lose their ability to function effectively over time. The kidneys are vital organs responsible for filtering waste products from the blood, balancing electrolytes, and managing blood pressure. CKD can lead to severe health issues if not managed properly, making it essential for affected individuals to understand the condition and its implications. Established consultant Dr Rhys Evans provides a guide to the condition, including causes, diagnosis and measures which can be taken to prevent the disease.

What is chronic kidney disease?

Chronic kidney disease (CKD) is characterised by a gradual decline in kidney function over months or years. It is often identified through blood tests that measure the levels of a protein called creatinine, which is filtered by the kidneys and can be used to calculate the glomerular filtration rate (GFR). The GFR indicates how well the kidneys are filtering blood and a GFR of below 60 for three months or more is diagnostic of CKD. Measurement of protein in the urine and abnormalities on imaging of the kidneys may also detect kidney damage.

What are the main causes of CKD?

Several factors can contribute to the development of CKD. The most common causes include:

• Diabetes: Elevated blood sugar levels can harm the blood vessels in the kidneys.
• High blood pressure: Hypertension can harm the kidneys' blood vessels, reducing their ability to function properly.
• Glomerulonephritis: This condition involves inflammation of the kidneys.
• Polycystic kidney disease: A genetic disorder where cysts form in the kidneys, impairing their function.
• Prolonged use of certain medications: Some pain relievers and other medications can affect kidney health, especially if used excessively.

What are the key signs and symptoms of CKD?

In the early stages, CKD might not present any noticeable symptoms. As the disease progresses, symptoms are relatively non-specific but can include:

• Fatigue and weakness.
• Swelling in the ankles, feet, or hands (oedema).
• Shortness of breath.
• Nausea and vomiting.
• Alterations in urination patterns, such as more frequent urination, particularly during the night.
• Persistent itching.
• Muscle cramps.

These symptoms can often be mistaken for other conditions, making regular check-ups and blood tests crucial for those at risk.

Diagnosis and monitoring

Diagnosing CKD typically involves blood and urine tests. The blood test measures the level of creatinine to estimate the GFR. Urine tests check for protein or blood, which can indicate kidney damage. Imaging tests like ultrasounds or CT scans may also be used to get a detailed look at the kidneys.

Once diagnosed, regular monitoring is essential to track the progression of the disease. This includes routine blood and urine tests and blood pressure measurements.

What are the treatment options?

While CKD cannot be cured in most patients, its progression can be slowed with appropriate management. Treatment options include:

• Lifestyle changes: Adopting a healthy diet, stopping smoking, and engaging in regular physical activity.
• Medications: These can control blood pressure, manage blood sugar levels, and treat symptoms like swelling.
• Dialysis: In advanced stages, dialysis may be necessary to perform the kidneys' functions.
• Transplant: A kidney transplant may be considered for some patients with end-stage renal disease.

In all patients with CKD, the underlying cause should be identified and treated, alongside the above measures.

What are some preventive measures that I can take?

Preventing CKD involves managing risk factors effectively. This includes controlling diabetes and hypertension, maintaining a healthy weight, and avoiding excessive use of medications that can harm the kidneys. Regular check-ups are crucial, especially for individuals with a family history of kidney disease or other risk factors for its development.

Understanding CKD and its management can significantly impact the quality of life for those affected. Early detection and proactive management are key to slowing the progression of this chronic condition and maintaining overall health.

If you would like to learn more about chronic kidney disease, book a consultation with Dr Evans via his Top Doctors profile today.