Kidney diseases are classified into two types based on the duration of renal dysfunction, Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD). Renal dysfunction associated with structural or functional abnormalities of the kidneys lasting for more than three months is designated as chronic kidney disease. This is now the fifth leading cause of death in patients worldwide.
Causes of Chronic Kidney Disease
- Diabetes Mellitus : Both Type 1 and Type 2 diabetes mellitus are major risk factors. High blood sugar levels can damage the kidneys permanently over the years.
- High Blood Pressure (Hypertension) : Systemic hypertension can directly harm the small blood vessels in the kidneys, leading to decreased kidney function.
- Urinary Tract Obstruction and Infections : Conditions like kidney stones or an enlarged Prostate gland can obstruct the flow of urine, leading to kidney damage. This can also predispose to infections, which can in turn worsen kidney functions.
- Polycystic Kidney Disease (PKD) : An inherited disorder where cysts develop in the kidneys, thereby causing an impaired function.
- Glomerulonephritis : Inflammation of the glomeruli, which are crucial for filtering nitrogenous wastes from the blood. Many diseases like IgA nephropathy and Focal Segmental Glomerulosclerosis (FSGS) fall in this category.
- Autoimmune Disorders: Conditions like Systemic Lupus Erythematosus and Rheumatoid Arthritis can also cause significant damage to kidney tissue.
Symptoms of Chronic Kidney Disease
Symptoms often appear gradually and people may be totally asymptomatic in the early stages of chronic kidney disease. Common symptoms include Fatigue, nausea, vomiting, loss of appetite, Pruritis (Itching), Swelling (over the face and legs) and Nocturia (frequent urination at night)
Tests to detect Chronic Kidney Disease
Chronic kidney disease can be diagnosed with simple tests like Serum Creatinine, Urine routine and a Renal Ultrasound examination. A kidney biopsy may also be required in few patients to ascertain the cause of chronic kidney disease. This test would be useful only in the early stages of chronic kidney disease.
Treatment of Chronic Kidney Disease
Treatment of chronic kidney disease focuses on managing symptoms and slowing the progression of the disease involved. Medications are required to treat or control the cause of kidney dysfunction. It is important for us to understand that there are no medications to reduce serum creatinine values.
- Dietary changes : Restricting food rich in proteins, potassium, and maintaining an optimal salt and fluid intake.
- Lifestyle Modification : Maintaining an optimum body weight, regular exercises, avoiding smoking and alcohol consumption can help reduce the risk of developing chronic kidney disease.
- Medications : To treat conditions like diabetes mellitus, hypertension, and complications of chronic kidney disease like anemia, hypocalcemia and hyperphosphatemia.
- Dialysis : A treatment that filters nitrogenous wastes from the blood and maintains optimal solute and fluid balance in the blood.
- Kidney Transplantation : A surgical procedure to replace a completely damaged kidney with a healthy, functioning kidney from a donor.
Early detection and medical intervention are crucial in treating chronic kidney disease effectively. Regular monitoring and adherence to treatment plans can significantly improve outcomes for individuals with chronic kidney disease.
