Chronic kidney disease is a long-term condition in which the kidneys gradually lose its function over time. The kidneys filter blood that passes through tiny filtering apparatus called glomerulus, thus removing waste and excess fluids from the body. When kidney function declines, harmful levels of waste and fluid can build up in the body, leading to a variety of health problems.

Chronic kidney disease is typically divided into five stages based on how well the kidneys are functioning. Blood levels of creatinine and estimated glomerular filtration rate (eGFR), are used to determine the level of CKD. Mild disease is stage 1, and stage 5 is end-stage kidney disease (ESKD).

Symptoms of CKD

In early stages, chronic kidney disease does not cause any noticeable symptoms. As CKD progresses over time, it may result in various manifestations. Usually, nephrologists can detect chronic kidney disease not through kidney failure symptoms but via blood or urine tests or from imaging scan of the kidneys.

Chronic kidney disease symptoms may vary depending on the severity of the condition. Some common symptoms of kidney conditions such as this may include:

Fatigue
Breathlessness
Swelling in the feet and ankles
Changes in urination (frequency, amount)
Muscle cramps
Dry, itchy skin
Loss of appetite
Nausea and vomiting
Difficulty concentrating
Trouble sleeping

Symptoms

It is important to note that these chronic kidney disease symptoms can also be caused by other health conditions and can easily be confused with symptoms of acute kidney injury. This is because both are forms of kidney problems and may have similar kidney failure symptoms. Hence, it is crucial to see a doctor for a proper diagnosis. If left untreated, chronic kidney disease can lead to kidney failure, which may require dialysis or a kidney transplant.

Diagnosis

CKD is diagnosed through:

1. Blood tests

Serum creatinine is used as a marker of kidney function. It is a waste product produced by the muscles, filtered by the kidneys and excreted in the urine. The unit of measurement can be either in micromol/L (µmol/L) or mg/dL. An elevated level indicates abnormal kidney function.
Estimated glomerular filtration rate or eGFR is a calculation used to estimate how well the kidneys are filtering waste from the blood. It takes in the age, gender, race and serum creatinine of the patient to determine the eGFR level. Currently, the formula used to calculate eGFR is the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula.

2. Urine tests

To check for blood and/or protein in the urine. This can be a spot urine test or a 24-hour urine collection test.

3. Imaging test

This can be an ultrasound scan, computed tomography scan (CT scan), or magnetic resonance imaging scan (MRI scan).
This is to determine any structural abnormality of the kidneys.

Causes and Risk Factors of Chronic Kidney Disease

There are several causes of chronic kidney disease, including:

Diabetes: Diabetes is a leading cause of CKD. High blood sugar levels may damage the blood vessels located in the kidneys.
High blood pressure: High blood pressure can damage the small blood vessels in the filtering system located in the kidneys.
Glomerulonephritis: Inflammation of the kidney’s filtering units. This is usually caused by auto-immune conditions.
Polycystic kidney disease: A generic condition where numerous cysts form in the kidneys, ultimately replacing all the filtering units causing CKD.
Other conditions: Excessive muscle breakdown (rhabdomyolysis), excessive and prolonged use of certain medications, and repeated kidney infections.

Risk Factors:

Family history: If you have a family history of CKD, you may be at an increased risk of developing the condition.
Age: The risk of CKD increases with age.
Obesity: Being obese or overweight increases the risk of CKD.
Smoking: Smoking can damage the blood vessels in the kidneys and increase the risk of CKD.
Cardiovascular disease: People with cardiovascular disease, such as heart disease or stroke, have an increased risk of CKD

Keep in mind that having one or more of the above risk factors does not mean you will develop chronic kidney disease or kidney failure. However, it is vital to be aware of these risk factors and to take steps to reduce your risk, such as maintaining a healthy lifestyle and getting regular check-ups.

Treatment Options for CKD

Chronic kidney disease treatments for people with kidney problems will depend on the severity of the condition and the underlying cause. In the early stages of CKD, treatment will focus on controlling the underlying cause of kidney damage and slowing the progression of the disease. This may involve lifestyle changes such as quitting smoking, eating a healthy diet, and exercising regularly. In some cases, medications may be prescribed to help control blood pressure, lower cholesterol levels, or improve blood sugar control.

Chronic kidney disease treatments usually require long-term commitment and compliance. If chronic kidney failure progresses to the point where the kidneys are severely damaged and unable to function properly, more advanced kidney failure treatment may be necessary.

This may include:

Dialysis: Dialysis is a treatment that employs a machine to remove waste from the blood when the kidneys are unable to do so. As far as dialysis treatments go, hemodialysis and peritoneal dialysis are the two most common.
Kidney transplant: When a person’s kidneys fail, a healthy kidney organ donor is surgically implanted into the body. The transplanted organ performs the job of the failing kidneys.

The kidney failure treatment above will help relieve kidney failure symptoms, such as nausea, lack of appetite, breathlessness, tiredness and lethargy. Consult a kidney specialist today and check on your kidney health!

What are the differences between AKI vs CKD?

CKD and AKI are both conditions that affect the kidneys. They may seem similar, but their causes, onset, and duration differ.

Onset and Duration:
- Chronic Kidney Disease: CKD is a prolonged condition that develops gradually. It may take months or years for symptoms to become noticeable. CKD is often the result of underlying health conditions such as diabetes or high blood pressure. Once kidneys are damaged, the condition is usually irreversible, and the aim of treatment is to slow the progression of the disease.
- Acute Kidney Injury: AKI, on the other hand, is a sudden and often reversible condition where the kidneys lose their function over a short period. It can develop rapidly, sometimes within hours or days, and is often triggered by severe infections, dehydration, or certain medications.

Causes:
- Chronic Kidney Disease: CKD is commonly caused by conditions that gradually damage the kidneys over an extended period. Causes are often diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease.
- Acute Kidney Injury: AKI is usually caused by a sudden drop in blood flow to the kidneys (prerenal), direct damage to the kidneys (intrinsic renal), or obstruction of urine flow (postrenal). Common causes include severe infections, dehydration, kidney infections, and certain medications.

Do you have a question about your kidney or medical condition?

Reach out to us for a consultation with Dr Alvin Ng.