an evening with

CKD

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CKD ...

The kidney is Mother Nature’s filtering system. Its bean shaped in appearance, located in the back beneath the lower ribs. The kidney carries out a number of key functions in order to maintain a healthy body;

So what’s Chronic Kidney Disease?

 

‘Chronic’ refers to the persistent, progressive, long-lasting nature of a

health condition or disease.

 

Kidney Disease or Nephropathy (its medical name) is non-discriminatory and can occur at any age. When a person has CKD their kidney function is no longer working as it once did and is either damaged, diseased or ageing.

 

CKD has 5 stages of progression.  Most people are diagnosed with mild to moderate CKD (levels 1 to 3). But regardless of the severity, it is important to get an early diagnosis so every effort is made to slow down the development and reduce the risks of stroke and heart attack.

 

1 in every 10 people live with CKD totally unaware. It shows no obvious symptoms and can progress over months or years resulting in End-Stage Chronic Kidney Failure. At this stage, (levels 4 and 5) CKD becomes symptomatic and intervention is imminent and often cannot be reversed.

  • Removes waste and excess water producing urine

  • Balances the body's fluid and salt content

  • Produces hormones that control blood pressure

  • Produces the hormone Erythropoietin to help make red blood cells

  • Activates vitamin D to maintain healthy bones

What causes CKD?

 

There are various reasons why people contract CKD. The most common causes are;

Who is at risk?

 

CKD has a tendency to affect women more than men. But regardless of sex there are some key groups of people prone to developing CKD.

  • Type 1 or Type 2 Diabetes

  • High blood pressure

  • Ageing kidneys although research suggests a reduction in age-related CKD

  • Glomerulonephritis (gloe-mer-u-lo-nuh-fry-tis), an inflammation of the kidney's filtering units (glomeruli)

  • Interstitial nephritis, an inflammation of the kidney's tubules and surrounding structures

  • Polycystic kidney disease, a genetic disease characterized by a formation of cysts on the kidney.

  • Prolonged obstruction of the urinary tract from conditions such as enlarged prostate (in men), kidney stones and tumours.

  • Vesicoureteral (ves-ih-koe-yoo-ree-ter-ul) reflux, a condition that causes urine to travel  back up into the kidneys

  • Reoccurring kidney infections, such as pyelonephritis (pie-uh-lo-nuh-fry-tis)

  • Lupus and other diseases which compromise the immune system

  • People living with High blood pressure

  • People with Type 1 or Type 2 Diabetes

  • People from Black Caribbean, African and South Asian backgrounds

  • People who regularly take prescribed drugs (nephrotoxic drugs), and long-term overuse use of painkillers such as Ibuprofen.

  • People with CVD Cardiovascular Disease - conditions that affect the heart, arteries and veins, such as coronary heart disease or stroke victims.  

  • People with structural renal tract complaints, blockages such as kidney stones or prostate enlargement.

  • People with a family history of stage 5 CKD - ESKD (End Stage Kidney Disease) or inherited kidney disease.

  • People with health conditions that affect other parts of the body including the kidneys, like Lupus.  

  • People with Haematuria, blood in the urine. Or Protein in the urine, Proteinuria.

  • People aged over 75 years with ageing kidneys, although in recent times a change in trend indicates a reduction in ageing kidneys. No longer considered as an ‘elderly persons’ disease.

The 5 stages of CKD  

 

These stages are indicative of your eGFR results. The lower the result, the higher and further along the CKD stages you are.

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How do you check for CKD?

 

A diagnosis is usually made through a urine or blood test to check kidney function. Your GP will request a test that highlights your GFR (Glomerular Filtration Rate).

 

GFR is the rate at which the kidney filters the waste fluid from the blood per minute. A healthy kidney should filter more than 90ml/min, (measured in millimetres per minute).

 

Determining the exact amount is difficult so a formula is used to give an estimated Glomerular Filtration Rate or eGFR.  The calculation utilises a blood sample to measure the levels of a waste product called Creatine, as well as the age, gender and ethnicity of the individual. The result is comparable to the percentage of normal kidney function so in other words, if the kidney eGFR is 50ml/min the kidney is functioning at 50%.

 

What are the symptoms of CKD?

 

There are no obvious symptoms in the initial stages of CKD. But if the disease is undiagnosed or left untreated evidence of CKD tends to develop at 'stage 4.' As CKD progresses, severe tiredness, less than usual energy, general feeling of unwell manifests itself. In addition to that, more obvious symptoms begin to develop which cannot be ignored.

 

 -  DIFFICULTY THINKING AND CONFUSION

 -  WEIGHT LOSS,

 -  PUFFINESS AROUND EYES,

 -  FLUID RETENTION CAUSING SWOLLEN ANKLES AND FEET,

 -  A NEED TO PASS URINE MORE OFTEN THAN USUAL,

 -  FEELING SICK,

 -  PALENESS IN SKIN,

 -  DISCOLOURATION IN EYE

 

End-stage renal failure 'Stage 5' symptoms are all of the above and will require Dialysis or Transplantation.  After a period of time death is imminent if no medical intervention is sought.

 

If you experience these symptoms or feel you could be at risk of developing CKD please visit your GP as soon as possible.

1. 90 OR ABOVE - Normal GFR with some structural abnormalities, urine findings eg, protein in the urine or genetic CKD traits

2. 60 TO 89 - Mildly reduced kidney function, other findings relating to stage 1

3a. 45 to 59

3b. 30 to 44 Moderately reduced kidney function

4. 15-29 - Severely reduced kidney function

5. Less than 15 on Dialysis. Very severe kidney damage. End-Stage kidney failure (ESRF) or sometimes called established Renal failure.

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