Chronic kidney disease: What you need to know

Leading consultant nephrologist Dr Rhys Evans discusses everything you need to know about chronic kidney disease (CKD) in this informative article.

What is chronic kidney disease?

Chronic kidney disease (CKD) is a progressive condition characterised by a gradual loss of kidney function over time. The kidneys play a vital role in filtering waste products and excess fluids from the blood, which are then excreted in the urine. When kidney function declines, waste products and fluids can accumulate in the body, leading to various health complications.

What causes chronic kidney disease?

CKD can be caused by a variety of factors and underlying conditions. The most common causes include diabetes and hypertension, which can damage the blood vessels in the kidneys. Other causes include glomerulonephritis, an inflammation of the kidney's filtering units and polycystic kidney disease, a genetic disorder that leads to cysts in the kidneys. Long-term obstruction of the urinary tract, such as from kidney stones or an enlarged prostate, and recurrent kidney infections can also contribute to CKD.

What are the symptoms of chronic kidney disease?

In the early stages, CKD may not present noticeable symptoms. As the disease progresses, symptoms can develop and may include fatigue, swelling in the legs or ankles, shortness of breath, nausea, loss of appetite and changes in urination. Persistent itching and muscle cramps can also occur in advanced stages. It is important to recognise these symptoms early and seek medical advice for proper diagnosis and management.

How is chronic kidney disease diagnosed?

Diagnosing CKD involves a combination of blood and urine tests, along with imaging studies. Blood tests measure levels of waste products such as creatinine and urea, which the kidneys typically filter out. The glomerular filtration rate (GFR) is calculated from blood test results to estimate how well the kidneys are filtering. Urine tests check for the presence of protein or blood, indicating kidney damage. Imaging tests, such as ultrasounds or CT scans, assess the structure of the kidneys and identify any abnormalities.

What are the stages of chronic kidney disease?

CKD is classified into five stages based on the GFR:

• Stage 1: Normal or high GFR (90 or above) with kidney damage.
• Stage 2: Mildly reduced GFR (60-89) with kidney damage.
• Stage 3: Moderately reduced GFR (30-59).
• Stage 4: Severely reduced GFR (15-29).
• Stage 5: Kidney failure (GFR less than 15), often requiring dialysis or a kidney transplant.

How is chronic kidney disease treated?

The treatment of CKD focuses on managing symptoms, slowing the progression of the disease, and addressing the underlying causes.

Lifestyle modifications are crucial, including:

• adopting a healthy diet low in salt and protein;
• maintaining a healthy weight;
• engaging in regular physical activity, and;
• avoiding smoking and excessive alcohol consumption.

Medications may be prescribed to control blood pressure, manage diabetes and treat symptoms such as anaemia and fluid retention. Regular monitoring through check-ups and tests is essential to adjust treatments and manage the disease effectively.

Can chronic kidney disease be prevented?

Preventing CKD involves managing risk factors and leading a healthy lifestyle. Controlling blood pressure and blood sugar levels, maintaining a healthy weight and avoiding smoking can significantly reduce the risk of developing CKD. Regular check-ups and screenings for those at risk, such as individuals with diabetes or hypertension, can help detect early signs of kidney damage and allow for timely intervention.

When should I see a doctor?

If you experience symptoms such as persistent fatigue, swelling in the legs or ankles, changes in urination, or any other signs associated with CKD, it's important to consult a healthcare professional. Early diagnosis and management can significantly improve outcomes and slow the progression of the disease. Additionally, if you have risk factors such as diabetes, hypertension, or a family history of kidney disease, regular check-ups with a healthcare provider are recommended to monitor kidney function and overall health.

If you require expert chronic kidney disease treatment, arrange a consultation with Dr Evans via his Top Doctors profile.