Chronic Kidney Disease Stages – Symptoms And Treatment

A pair of kidneys are fist-sized and are located at the BACK OF YOUR trunk. Kidneys filter blood and remove toxins from your body; The process of filtration starts with the
Glomerular filtration, where the transfer of soluble components, such as water and waste, from the blood into glomerulus takes place. That is then followed by a second step called re-absorption; in this step, the absorption of small molecules and ions occurs to maintain the homeostasis of the body.

Secretion, the third and last step, is responsible for transporting specific molecules out of the blood and into the urine. Secretions include hydrogen ions, creatinine ions, and some xenobiotics. All three steps end up with the bi-product called urine and, in turn, means urine is a collection of substances that have not been reabsorbed during glomerular filtration or tubular reabsorbed.

Kidney Disease

Kidneys are essential organs in maintaining a healthy life. They are responsible for filtration. They filtrate waste, toxins, excess water, and other impurities. These impure substances are stored in the gall bladder, then excreted with urine. With filtration, your kidneys regulate the body PH, salt, and potassium levels in the body. They regulate blood pressure and also control the production of red blood cells. Kidneys also produce hormones and help in activating the form of Vitamin D, which helps the body in absorbing calcium.

Kidney disease is one of the most widespread diseases. It occurs when kidneys are unable to filtrate properly due to damage. Damage may be caused due to high blood pressure, diabetes, heart disease, and many other kidney diseases chronic (long-term) condition.

Kidney damage, if left untreated, will worsen over time and result in kidney loss as the very worst-case scenario. It means you will then be shifted to dialysis or kidney transplant, the two most common treatments.

Types And Causes of Kidney Disease.

Chronic Kidney Disease

That is the most common type of kidney disease found in the population, as the word ‘chronic’ indicates a long-term condition that does not improve with time and is caused by hypertension.

High blood pressure is dangerous for the kidney as with hypertension; the pressure on the walls of Glomeruli increases. Glomeruli are tiny vessels where blood is cleaned. The increased blood pressure can damage the vessels and cause kidney function to decline.

There’s a point where kidneys lose their ability to function, and patients shift to dialysis. Dialysis is the process in which the blood is filtered to remove toxins from the body, with the help of a specialist machine. Dialysis can help to treat kidneys, but it is not a cure. A kidney transplant is the last option in chronic kidney disease.

Hypertension and diabetes are the major causes of chronic kidney disease; diabetes elevates the sugar level in the body, which ultimately damages the blood vessels in the kidneys over time. That means the kidneys fail to clean blood and remove toxins. Kidney disease/kidney failure can occur when the body is overloaded with impurities and toxins.

Sign and Symptoms of Kidney disease

• Fatigue
• Difficulty concentrating
• Trouble sleeping
• Poor appetite
• Muscle cramping
• Inflamed feet/ankles
• Puffiness around the eyes in the morning
• Dry, scaly skin
• Frequent urination, especially late at night

Kidney Failure

Kidney failure / End-stage renal disease
It is a condition of kidney disease where the kidney stops working, fails to remove toxins and other impurities from the blood, and keeps the chemical balance in the body. It is included in stage 5 and is irreversible.
Where patients in ESRD need dialysis (the process of cleaning the blood by passing it through a membrane or filter) or a kidney transplant, also called renal failure.
Symptoms of kidney failure
Patients with kidney failure will observe minor symptoms or sometimes no symptoms at all
The most common symptoms have been reported are

• • Shortness of breath
  • Fatigue
  • Excessive drowsiness
  • Reduced amount of urine
  • Nausea, vomiting
  • Seizures

Diagnostic Test For Kidney Disease

Here is a list of tests used to diagnose kidney disease.

1. Glomerular filtration rate (GFR)
   This test will measure how well your kidneys are working and determine the stage of renal disorder.
2. Ultrasound or computerized tomography (CT) Scan
   Ultrasounds and CT scans produce clear images of your kidneys and tract. The photographs allow your doctor to ascertain if your kidneys are too small or large. They will also show any tumors or structural problems that are present.
3. Kidney biopsy
   During a kidney biopsy, your doctor will remove a little piece of tissue from your kidney while you’re sedated. The tissue sample can help your doctor to determine the sort of renal disorder you’ve got and the in which the damage has occurred.
4. Urine test
   Your doctor may request a urine sample to check for albumin. Albumin is a protein that could be passed in your urine when your kidneys are damaged.
5. Blood creatinine test
   Creatinine may be a waste. It’s released into the blood when creatine (a molecule stored in muscle) is weakened. The amount of creatinine in your blood will increase if your kidneys aren’t working properly, which indicates kidney disease.

Kidney Failure Types

• Acute prerenal kidney failure

Insufficient blood flow to the kidneys can cause acute prerenal renal failure. This type of renal failure can usually be cured once your doctor determines the explanation for the decreased blood flow.

• Acute intrinsic kidney failure

Acute intrinsic renal failure may result from direct trauma to the kidneys, like physical impact or accident. Causes also include toxin overload and ischemia, which may be a lack of oxygen to the kidneys.

The following may cause ischemia:

• •Severe bleeding
• Shock
•  Renal blood vessel obstruction
•  Glomerulonephritis

Chronic prerenal kidney failure

When there isn’t enough blood flowing to the kidneys for an extended period of your time, the kidneys begin to shrink and lose the power to function.

• Chronic intrinsic kidney failure

That happens when there’s long-term damage to the kidneys owed to intrinsic renal disorder. The intrinsic renal disorder develops from an immediate trauma to the kidneys, like severe bleeding or a scarcity of oxygen.

• Chronic post-renal kidney failure

A long-term blockage of the tract prevents urination. That causes pressure and eventual kidney damage.

Kidney disease stages

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Kidney disease that leads to kidney failure is classified into five stages. These range from very mild (stage 1) to finish renal failure (stage 5). Symptoms and complications increase as the stages progress.

Stage 1 kidney disease

This stage is very mild. You may experience no symptoms and have no visible complications. Some damage is present.
It’s still possible to manage and slow progression by maintaining a healthy lifestyle. That includes eating healthily, regularly exercising, and not smoking. Maintaining a healthy weight is essential, too.
If you have diabetes, it’s essential to manage your blood sugar.

Stage 2 kidney disease

Stage 2 renal disorder remains considered a light form, but detectable issues like protein in the urine or physical damage to the kidneys could also be more obvious.
The same lifestyle approaches that helped in stage 1 are still relevant in stage 2. Also, consult your doctor about other risk factors that would make the disease progress sooner. These include heart disease, inflammation, and blood disorders.

Stage 3 kidney disease

At this stage, kidney disease is considered moderate. Your kidneys aren’t working as they should do.
Chronic kidney disease stage 3 renal disorder is usually divided into 3A and 3B. A blood test that measures the amount of waste products in your body differentiates between the two.
Symptoms may become more apparent at this stage. Inflammation in hands and feet, back pain, and changes to urination frequency are likely.

Stage 4 kidney disease

Stage 4 renal disorder is considered to be a moderate to severe stage. The kidneys aren’t working well, but you’re not in complete kidney failure yet. Symptoms can include complications like anemia, high vital signs, and bone disease.
A healthy lifestyle is still vital. Your doctor will likely have you on treatments designed to slow damage for the duration of your life.

Stage 5 kidney disease

In stage 5, your kidneys are nearing or are in complete failure. Symptoms of the loss of kidney function will be evident. These include vomiting and nausea, trouble breathing, itchy skin, and more.
At this stage, you’ll need regular dialysis or a kidney transplant.

Drugs and Medication.

Your doctor will either prescribe angiotensin-converting enzyme (ACE) inhibitors, like lisinopril and ramipril, or angiotensin receptor blockers (ARBs) irbesartan and Olmesartan. These are vital sign medications that will slow the progression of renal disorder.

You may even be treated with cholesterol drugs (such as simvastatin). These medications can reduce blood cholesterol levels and help maintain kidney health. Depending on your symptoms, your doctor can also prescribe drugs to alleviate swelling and treat anemia (decrease in the number of red blood cells in your blood).

Medicines for kidney patients

You might need anti-hypertensive tablets to lower your blood pressure.

• Diuretics (water tablets)
• Hepatitis B vaccination.
• Iron supplements.
• Phosphate binders.
• Sodium Bicarbonate.
• Erythropoietin (EPO).

Dietary and lifestyle changes

Making changes to your diet is as important as taking medication. Adopting a healthy lifestyle can help prevent many of the underlying causes of renal disorder:

• • Control diabetes through insulin injections
  • Cut back on foods high in cholesterol
  • Cut back on salt
  • Start a heart-healthy diet that has fresh fruits, veggies, whole grains, and low-fat Dairy products
  • Limit alcohol consumption
  • Quit smoking
  • Increase physical activity
  • Lose weight

Dialysis

Dialysis is a human-made method of filtering the blood. It’s used when someone’s kidneys have failed or are close to failing. Many people with late-stage renal disorder must continue dialysis permanently or until a donor’s kidney is found.

There are two sorts of dialysis: hemodialysis and peritoneal dialysis.

• Haemodialysis

In hemodialysis, the blood is pumped through a particular machine that filters out waste products and fluid. Haemodialysis is done at your home, in a hospital, or dialysis center. Most people have three sessions per week, with each session lasting three to five hours. However, hemodialysis can also be done in shorter, more frequent sessions.

Several weeks before hemodialysis, most people will have surgery to create an arteriovenous (AV) fistula. An AV fistula is created by connecting an artery and a vein just below the skin, typically in the forearm. The larger blood vessel allows an increased amount of blood to flow continuously through the body during hemodialysis treatment. That means the blood can be filtered and purified more often. An arteriovenous graft (a looped, plastic tube) may be implanted and used for the same purpose if an artery and vein can’t be joined together.

The most common side effects of hemodialysis are low blood pressure, muscle cramping, and itching.

• Peritoneal Dialysis

In peritoneal dialysis, the peritoneum (a membrane that lines the abdominal wall) stands in for the kidneys. A tube is implanted and used to fill the abdomen with a fluid called dialysate. Waste products within the blood are due to the peritoneum into the dialysate. The dialysate is then drained from the abdomen.

There are two sorts of peritoneal dialysis: continuous ambulatory peritoneal dialysis, where the abdomen is filled and drained several times during the day, and continuous cycler-assisted peritoneal dialysis uses a machine for cycling the fluid in and out of the abdomen at night while the person sleeps.

The most common side effects of peritoneal dialysis are infections in the abdominal cavity or in the area where the tube was implanted. Other side effects may include weight gain and hernias. A hernia is when the intestine pushes through a weak part or tear within the lower wall.

Kidney Transplant

A kidney transplant is often the first choice of treatment in patients with chronic kidney disease and end renal failure disease.
People with failed kidneys moved to dialysis, which filters the blood and excretes toxins with an external source (machine).
Note: dialysis is not the treatment, but it can cure the kidney disease, and patient with kidney failure goes with a kidney transplant.
A kidney transplant is a surgical process where the damaged kidney is replaced with a healthy kidney to maintain homeostasis of the body.

Bonus video: Chronic kidney disease – causes, symptoms, diagnosis, treatment, pathology

References

1. http://www.nejm.org/doi/full/10.1056/NEJMoa041031
2. http://annals.org/article.aspx?articleid=716575
3. http://ndt.oxfordjournals.org/content/20/6/1048.short
4. http://qjmed.oxfordjournals.org/content/53/4/511.short

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