Chronic Kidney Disease

Statistics indicate that 1 in 10 persons in the general population are estimated to have some form of chronic kidney disorder (CKD)

By 2030, India is expected to have the world’s largest population of patients with diabetes. 1.3 billion people are served by 1850 nephrologists who are unequally distributed. Even today, over 90% of patients requiring Renal Replacement Therapy in India die because of inability to afford care, and even in those who do start Renal Replacement Therapy, 60% stop for financial reasons. There are over 130,000 patients receiving dialysis, and the number is increasing by about 232 per million population, a reflection of increasing longevity in general. It has also been estimated that about 60% to 70% of CKD cases are offshoots of diabetes and hypertension



Source:

  • Indian Society of Nephrology to organize ISNCON 2017 in New Delhi, published in EtHealthworld December 13, 2017, 16:22 IST
  • Chronic Kidney Disease in India,A Clarion Call for Change,Santosh Varughese1, and Georgi Abraham


  • Kidneys:
    The main job of kidneys is to regulate the amount of water in the body and balance the concentration of mineral ions in the blood. They also get rid of waste products, especially a nitrogen-containing compound called urea. At the same time they hold on to useful substances such as glucose and protein so none is lost from the body.


    Understand your disease:
    Chronic kidney disease occurs when one suffers from gradual and usually permanent loss of kidney function over time.

    This happens gradually, usually over months to years. It includes conditions that damage kidneys and decrease their ability to keep doing the Functions. “CKD is defined as kidney damage or glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 for 3 months or more, irrespective of cause”.

    Symptoms


    • Anemia
    • Blood in urine
    • Dark urine
    • Decreased mental alertness
    • Decreased mental alertness
    • Edema- swollen feet, hands, and ankles (face if edema is severe)
    • Fatigue (tiredness)
    • Hypertension (high blood pressure)
    • Insomnia
    • Itchy skin, can become persistent
    • Loss of appetite
    • Male inability to get or maintain an erection (erectile dysfunction)
    • More frequent urination, especially at night
    • Muscle cramps
    • Muscle twitches
    • Nausea
    • Pain on the side or mid to lower back
    • Panting (shortness of breath)
    • Protein in urine
    • Sudden change in bodyweight
    • Unexplained headaches


    Causes


    • Diabetes
    • High blood pressure
    • A genetic disorder that causes many cysts to grow in the kidneys,polycystic kidney disease (PKD).
    • An infection
    • A drug that is toxic to the kidneys
    • Disorders in which the body’s immune system attacks its own cells and organs, such as Goodpasture syndrome
    • Heavy metal poisoning, such as lead poisoning
    • Rare genetic conditions, such as Alport syndrome
    • Hemolytic uremic syndrome in children
    • Henoch-Schönlein purpura
    • Renal artery stenosis


    Stages


    Slightly diminished function; kidney damage with normal or relatively high GFR (≥90 ml/min/1.73 m2) and persistent albuminuria. Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies. Below points are to be taken care of:


    Stage 1:


      Slightly diminished function; kidney damage with normal or relatively high GFR (≥90 ml/min/1.73 m2) and persistent albuminuria. Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies. Below points are to be taken care of:


    • Control blood sugar if you have diabetes
    • Keep a healthy blood pressure.
    • Eat a healthy diet.
    • Do not smoke or use tobacco.
    • Exercise 30 minutes a day, 5 days a week.
    • Keep a healthy weight.
    • Ask a doctor if there are medicines you can take to protect your kidneys.
    • Make an appointment to see a nephrologist, even if you already have a general doctor.

    Stage 2:


    Mild reduction in GFR (60–89 ml/min/1.73 m2) with kidney damage. Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies. Below are ways to slow kidney damage in Stage 2 kidney disease:


    • Control blood sugar in case of diabetes.
    • Eat a healthy diet.
    • Do not smoke or use tobacco.
    • Exercise 30 minutes a day, 5 days a week.
    • Keep a healthy weight.

    Stage 3:


    Mild reduction in GFR (60–89 ml/min/1.73 m2) with kidney damage. Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies. Below are ways to slow kidney damage in Stage 2 kidney disease:


    • Control blood sugar in case of diabetes.
    • Eat a healthy diet.
    • Do not smoke or use tobacco.
    • Exercise 30 minutes a day, 5 days a week.
    • Keep a healthy weight.

    Stage 4:


    Severe reduction in GFR (15–29 ml/min/1.73 m2).Preparation for renal replacement therapy


    • Swelling in the hands and feet
    • Back pain
    • Urinating more or less than normal
    • By Stage 4 kidney disease, there are other health complications as a result of waste building up in body. Common complications from kidney disease are high blood pressure, anemia, and bone disease.

    Stage 5:


    Established kidney failure (GFR less than 15 ml/min/1.73 m2), permanent renal replacement therapy, or end-stage kidney disease.


    • Itching
    • Muscle cramps
    • Nausea and vomiting
    • Not feeling hungry
    • Swelling in the hands and feet
    • Back pain
    • Urinating more or less than normal
    • Trouble breathing
    • Trouble sleeping
    • Once kidneys have failed, there is need to start dialysis or have a kidney transplant to live