Overview
What Is Chronic Kidney Disease (CKD)?
Healthy kidneys remove waste from your blood. The waste then leaves your body in your urine. The kidneys also help control blood pressure and make red blood cells.
Normal Kidneys And Their Function
The kidneys are a pair of bean-shaped organs that lie on either side of the spine in the lower middle of the back. Each kidney weighs about ¼ pound and contains approximately one million filtering units called nephrons. Each nephron is made of a glomerulus and a tubule. The glomerulus is a miniature filtering or sieving device while the tubule is a tiny tube like structure attached to the glomerulus.
The kidneys are connected to the urinary bladder by tubes called ureters. Urine is stored in the urinary bladder until the bladder is emptied by urinating. The bladder is connected to the outside of the body by another tube like structure called the urethra.
The main function of the kidneys is to remove waste products and excess water from the blood. The kidneys process about 200 liters of blood every day and produce about two liters of urine. The waste products are generated from normal metabolic processes including the breakdown of active tissues, ingested foods, and other substances. The kidneys allow consumption of a variety of foods, drugs, vitamins and supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels. The kidney also plays a major role in regulating levels of various minerals such as calcium, sodium, and potassium in the blood.
- As the first step in filtration, blood is delivered into the glomeruli by microscopic leaky blood vessels called capillaries. Here, blood is filtered of waste products and fluid while red blood cells, proteins, and large molecules are retained in the capillaries. In addition to wastes, some useful substances are also filtered out. The filtrate collects in a sac called Bowman's capsule and drains into the tubule.
- The tubules are the next step in the filtration process. The tubules are lined with highly functional cells which process the filtrate, reabsorbing water and chemicals useful to the body while secreting some additional waste products into the tubule.
The kidneys also produce certain hormones that have important functions in the body, including the following:
- Activate form of vitamin D (calcitriol or 1,25 dihydroxy-vitamin D), which regulates absorption of calcium and phosphorus from foods, promoting formation of strong bone.
- Erythropoietin (EPO), which stimulates the bone marrow to produce red blood cells.
- Renin, which regulates blood volume and blood pressure.
Who is at risk ? Risk factors are conditions that make you more likely to develop a disease.
The leading risk factors for CKD are
- Diabetes
- High blood pressure
- Family history of kidney failure
Having diabetes increases your risk of developing CKD. In fact, diabetes is the leading cause of kidney failure. High blood pressure is the second leading cause. CKD runs in families, so you may have an increased risk if your mother, father, sister, or brother has kidney failure.
Some racial groups are also at increased risk for CKD:
- African Americans are nearly four times as likely to develop kidney failure as white Americans.
- American Indians have nearly three times the risk compared to whites.
- Hispanic Americans have nearly twice the risk of non-Hispanic whites.
What are the symptoms of CKD ?
Most people don't have any symptoms early in the disease. Once the disease progresses, the
symptoms can include the following:
- Feeling tired
- Feeling weak
- Loss of appetite
- Not sleeping
- Not thinking clearly
- Swelling of the feet and ankles
How can I find out if I have CKD ?
Since early CKD has no symptoms, the only way to find out if you have it is through simple medical tests.
- Blood pressure : High blood pressure can lead to kidney damage, and it can also be a sign that kidney damage has already occurred. If your blood pressure is high, you'll want to get it under control to make sure your kidneys remain healthy.
- Blood : The glomerular filtration rate (GFR) measures how efficiently the kidneys are filtering waste from the blood. The new method of calculating GFR requires only a measurement of the creatinine (kree-AT-ih-nin) in a blood sample. Creatinine is a waste product in the blood created by the normal breakdown of muscle cells during activity. When kidneys are not working well, creatinine builds up in the blood.
- Urine : Measuring the amount of a protein called albumin in the urine can show a kidney problem. A large amount of protein in the urine is known as proteinuria and is a sign of kidney damage. Your doctor may test for protein using a dipstick in a sample of your urine taken in the doctor's office. The color of the dipstick indicates the level of protein.
A test that can show smaller amounts of protein or albumin in the urine is called a microalbumin test and also uses a dipstick in the urine.
Your doctor may also do a calculation of the protein-to-creatinine or albumin-to-creatinine ratio. Healthy kidneys move creatinine from the blood into the urine. A ratio greater than 30 milligrams of albumin per 1 gram of creatinine indicates that the kidneys are leaking helpful substances from the blood and failing to filter out harmful substances. This test should be used in people at high risk, especially those with diabetes.
If your first laboratory test shows high levels of protein, another test should be done 1 to 2 weeks later. If the second test also shows high levels of protein, you have persistent protein in the urine (proteinuria) and should have additional tests to test your kidney function.
How else is CKD treated ?
Chronic kidney disease can cause other problems. Talk with your doctor about how you can treat these other problems.
He or she may have you take medicine to treat:
- High Triglyceride :- (say: try-gliss-er-eyed) and cholesterol levels. Triglycerides are a type of fat. Triglyceride levels often are higher in people who have kidney disease.
- Anemia :- Anemia occurs when your blood doesn't have enough hemoglobin (a protein that carries oxygen from the lungs to the rest of the body).Symptoms of anemia include feeling tired and weak.
- Weak bones :- CKD can also change the way your body uses minerals such as calcium and phosphorus that are used to make bone. Your doctor may have you avoid certain foods to help your body use these minerals better.
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