Kidney disease is like a silent threat inside one’s body. In the early stages, no symptoms appear. Without having a blood or urine test, one may not find out they have kidney disease in good time. Therefore, to be on the safe side, we’re going to share with you some useful information about chronic kidney disease.
What is chronic kidney disease?
Our two kidneys are organs shaped like red beans. Located under both sides of the rib cage, they are responsible for maintaining metabolic balance in the body by removing waste products and filtering excess water from the blood. They also maintain balance of important minerals, help control blood pressure, and produce red blood cells and vitamin D. Chronic kidney disease is when the kidneys deteriorate and lose their ability to remove waste and excess water from the blood, causing accumulation of waste and toxins which make one feel unwell. In the early stages, sufferers are usually unaware of any symptoms. As chronic kidney disease is progressive, by the time one finds out, the condition may already be at an advanced stage.
It is important to note, that while we do have two kidneys, they are not back-ups for each other. Rather, they work in tandem, so when symptoms of chronic kidney disease occur, they’re both impaired simultaneously.
What causes kidney disease?
Kidney disease is mostly caused by abnormal conditions in the body that permanently affect how the kidneys work and by genetic factors such as having certain chronic diseases running in the family, including:
- Diabetes, a condition where the body has high blood sugar levels causing the capillaries in the kidneys to narrow, thereby reducing waste filtration efficiency.
- High blood pressure causing the capillaries in the kidneys to leak protein out in the urine, in turn causing inflammation in the kidneys.
- Kidney disease with cysts.
- Nephritis.
- Ischemic nephropathy from the blood vessels that supply stenosis, as found in patients with cardiovascular disease.
- Urinary tract disease causing urinary obstruction or repeated urinary tract infections.
- Autoimmune diseases.
- Cancers.
Other factors include:
- Eating too much very salty, sweet or spicy foods.
- Injuries causing sudden loss of kidney function.
- Being overweight.
- Being elderly.
- Heavy smoking.
Stages of chronic kidney disease
Chronic kidney disease progresses through five stages of diminishing blood filtering efficiency.
- Stage 1: A glomerular filtration rate above 90 means that the kidneys are damaged but still functioning almost normally. At this stage, patients don’t suffer from symptoms and can lead a normal life. They just need to see a doctor regularly as directed to monitor glomerular filtration and treat any other health problems that may feed in.
- Stage 2: A glomerular filtration rate of 60-89 indicates that the kidneys have lost a small amount of function. At this stage, it is still quite likely for no symptoms to be apparent. As with stage 1, patients should simply be regularly monitored by their doctor.
- Stage 3: A glomerular filtration rate of 30-59 is a tell-tale sign of moderate kidney loss. Symptoms start to appear, but they may still be so minor as to not be noticed. A doctor should be seen regularly to check for complications and get treatment guidelines in case kidney failure occurs.
- Stage 4: A glomerular filtration rate of 15-29 indicates that the kidneys have lost a lot of function. Patients definitely begin to notice some symptoms and should prepare for kidney failure in consultation with their doctor.
- Stage 5: A glomerular filtration rate of less than 15 indicates actual renal failure. The symptoms of the disease are now clear, and dialysis must be started. Patients should consult their doctor and closely follow the prescribed treatment.
Chronic kidney disease symptoms
- Frequent urination during the night in the early stages of kidney disease.
- Bloody or foamy urine.
- Swollen legs and denting of skin when pressed. This is caused by the presence of excessive salt and water in the body or a large amount of protein leaking out in the urine. If the legs are very swollen, breathlessness can result from congestion in the lungs. The condition can be life threatening.
- Swollen eyes, especially in the morning.
- High blood pressure.
- Nausea, loss of appetite, dry skin, itchiness, fatigue.
- Bitter mouth and being unable to perceive the taste of foods and drinks.
- Unable to sleep or think clearly.
- Muscle cramps at night.
- Some may lose weight while others may swell up and gain weight.
- Women may experience menstrual irregularities or be unable to get pregnant. Men may have lower sex drive and spermatogenesis.
In the last stage, patients have more systemic symptoms such as inability to eat to the point of malnutrition, anemia, pericarditis, hiccupping, swelling and breathlessness. If severe symptoms are untreated, the patient will be lethargic and may have convulsions.
Treatment of chronic kidney disease
Treatment of chronic kidney disease must be determined according to the cause and stage and any other medical conditions the patient has. There are two categories of treatment as follows:
Treatments to slow deterioration of the kidneys
- Those with underlying diseases such as diabetes or high blood pressure need to keep them under control. Medications such as antihypertensive drugs and certain diabetes medications can help slow deterioration of the kidneys.
- Mind your eating habits. Minimize intake of foods with strong flavors such as salty, sweet, or spicy. Eat sufficient protein to give your body enough energy and ensure appropriate levels of potassium and phosphorus. Check with your doctor that your diet is appropriate to your condition.
- Prescription of drugs that help slow deterioration of the kidneys such as diuretics and those that reduce phosphate absorption and medications for anemia, blood pressure, blood lipids, and acid-base balancing.
- Lifestyle changes such as losing weight, quitting smoking, exercising, and avoiding substances that can harm the kidneys, including immunosuppressants such as Methotrexate and Sulfonamides.
Kidney replacement therapy
Kidney replacement therapy is for patients with stage 5 chronic kidney disease whose kidneys no longer function normally on their own. The therapy does the kidneys’ job of ridding the body of waste residues. There are two methods of doing this:
- Hemodialysis – Connecting the blood stream to a hemodialysis machine through a vein in the arm or neck so the blood passes through the machine which filters out waste and excess water accumulated in the body and returns the treated blood to the body. Each hemodialysis session takes 4-5 hours and patients need 2-3 sessions weekly. Patients have surgery to prepare the blood vessel for the process. This treatment is popular because patients can undertake light activities such as reading, listening to music, and using their mobile phone during it. However, treatment can only be done in a medical setting under specialist supervision.
- Peritoneal dialysis – Dialysis fluid is inserted into the abdominal cavity where the peritoneum extracts waste and excess water from the dialysis fluid. After a specified time, the dialysis fluid filled with waste and excess water is discharged and a new bag of liquid is fitted to the patient. The treatment requires four rounds every day. There is also an automated solution to changing the liquid. Intraperitoneal tube insertion surgery is required before the treatment can begin. This method is convenient for patients as they can do it themselves at home and lead a relatively normal life.
There is no cure for chronic kidney disease. Once the kidneys have deteriorated to a certain point, they never recover their functionality. Medication and renal replacement therapy are the only treatments that can slow the deterioration.
Preparing for dialysis
Patients must be physically prepared for treatment and have to wait for the surgical wound to heal before starting dialysis. They must learn how to perform dialysis properly and safely. During dialysis they should wear comfortable clothing and strictly follow medical personnel’s instructions to avoid complications or side effects.
Post-dialysis care
After dialysis, the patient can lead a normal life until they have to return for the next session or can continue at home, as directed by their doctor. They should see their doctor regularly to closely monitor symptoms. During treatment, patients are required to maintain their health by strictly limiting food and fluid intake. Patients with kidney disease should avoid foods with strong flavors such as very salty, very sweet and very spicy. Patients should not consume more than one teaspoon of salt and six teaspoons of sugar daily and should avoid processed meats such as sausages, canned foods, pickles, and salty snacks. They should eat healthy foods, including vegetables, fruits, and whole grains as well as foods high in omega-3 fatty acid such as nuts and high-fat fish.
Chronic kidney disease develops gradually, at first without our knowledge. The disease only shows strong symptoms when it is already severe. To avoid it, we should mind how we live, including choosing healthy food, watching out for abnormal symptoms, and having an annual health check-up. This will help us keep our kidneys in good working order for as long as we need them.
If you’re a Krungthai-AXA Life Insurance customer and you start having kidney disease or any chronic disease symptoms and want to find a specialist doctor or hospital, you can contact our Care Cordination service. For more information, please visit https://www.krungthai-axa.co.th/th/care-coordination.
References
· Siriraj Piyamaharajkarun Hospital
https://www.siphhospital.com/th/news/article/share/461
· Bumrungrad Hospital
https://www.bumrungrad.com/th/conditions/ckd-chronic-kidney-disease
· Ramkhamhaeng Hospital
https://www.ram-hosp.co.th/news_detail/1712
· Pobpad website
https://bit.ly/3qTKol9
· My Kidney Journey
https://th.mykidneyjourney.com/th/find-answers-you-need