What Is Kidney Disease?
Chronic kidney disease (CKD) includes any condition that causes reduced kidney function for more than 3 months.3, 4
CKD is present when a patient’s glomerular filtration rate (GFR) remains below 60 milliliters per minute for more than 3 months or when a patient’s urine albumin‐to‐creatinine ratio is over 30 milligrams (mg) of albumin for each gram (g) of creatinine (30 mg/g).1
With early chronic kidney disease (CKD), people tend not to feel ill or notice any symptoms as kidney function deteriorates slowly over time. For this reason it has been referred to as the “silent killer.” Specific blood and urine tests are the only way to determine CKD.5
If kidney failure does occur, typical symptoms are weight loss and poor appetite, peripheral edema (swollen ankles, feet, or hands due to water retention), shortness of breath, blood or protein in urine, high blood pressure (hypertension), nausea, erectile dysfunction in men,6 vomiting, bone pain, headache, insomnia, itching, dry skin, malaise, fatigue with light activity, muscle cramps, high urine output or no urine output, recurrent urinary tract infections, urinary incontinence, pale skin, bad breath, hearing deficit, detectable abdominal mass, tissue swelling, irritability, poor muscle tone, change in mental alertness, and a metallic taste in the mouth.
Causes and Risk Factors
The two main causes of chronic kidney disease are diabetes mellitus and high blood pressure, which are responsible for up to two‐thirds of the cases. Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes. When the pressure of your blood against the walls of your blood vessels is too high, it results in high blood pressure, or hypertension. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of CKD, heart attacks, and strokes. Also, CKD can cause high blood pressure.13
Other conditions that may lead to chronic kidney disease include3:
- Diabetic nephropathy (diabetes can cause permanent changes, leading to kidney damage)
- Systemic lupus erythematosus (SLE), a chronic inflammatory/autoimmune disease that can injure the skin, joints, kidneys, and nervous system
- Prolonged urinary tract obstruction or blockage
- Alport syndrome (an inherited disorder that causes deafness, progressive kidney damage, and eye defects)
- Nephrotic syndrome (a condition that has several different causes, characterized by protein in the urine, low protein in the blood, high cholesterol levels, and tissue swelling)
- Polycystic kidney disease (a genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys)
- Cystinosis (an inherited disorder in which the amino acid cysteine accumulates within specific cellular bodies of the kidney, known as lysosomes)
- Interstitial nephritis or pyelonephritis (an inflammation to the small internal structures in the kidney)
- Renal artery stenosis
- Ascending (chronic) infections of the lower urinary tract
Other risk factors3:
- Heart problems or stroke
- Family history
- Tobacco use
- 60+ years old
Stages of Chronic Kidney Disease of All Types7
What happens if my test results show I may have chronic kidney disease?13
Your doctor will want to pinpoint your diagnosis and check your kidney function to help plan your treatment. The doctor may do the following:
- Calculate your Glomerular Filtration Rate (GFR). It is the best test to measure your level of kidney function and determine your stage of kidney disease. Your doctor can calculate it from the results of your blood creatinine test, your age, race, gender and other factors.
- Perform an ultrasound or CT scan to get a picture of your kidneys and urinary tract. This tells your doctor whether your kidneys are too large or too small, whether you have a problem like a kidney stone or tumor, and whether there are any problems in the structure of your kidneys and urinary tract.
- Perform a kidney biopsy under image guidance, typically ultrasound. This is done in some cases to check for a specific type of kidney disease, see how much kidney damage has occurred, and help plan treatment. To do a biopsy, the doctor takes a sample from the region of interest. The pathologist than performs the histological analysis.
In complex cases, your doctor may also ask you to see a kidney specialist who will consult on your case and help manage your care.
1. U.S. Department of Health and Human Services ‐ National Institute of Diabetes and Digestive and Kidney Disease: https://www.niddk.nih.gov/health‐information/kidneydisease
3. Johns Hopkins Medicine: http://www.hopkinsmedicine.org/healthlibrary/conditions/kidney_and_urinary_system_disorders/end_stage_renal_disease_esrd_85,P01474/
4. Chronic Kidney Disease: www.diseaseinfosearch.org/result/3996
5. U.S. Department of Health and Human Services – Centers of Disease Control and Prevention: http://www.cdc.gov/diabetes/pubs/pdf/kidney_factsheet.pdf
6. National Health Services UK: https://www.nhs.uk/conditions/kidney‐disease/symptoms/
7. Recreated from: http://guidelines.diabetes.ca/App_Themes/CDACPG/images/Ch29_Tbl4_Stages_of_CKD.jpg
13. National Kidney Foundation (U.S.) Republished with permission.: https://www.kidney.org/atoz/content/about‐chronic‐kidney‐disease
This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.