Chronic Kidney Disease
Chronic Kidney Disease (CKD) means that your kidneys may not be working as well as they should. Many conditions can cause CKD which can range from a mild problem to kidney failure.
Most cases are mild or moderate, occur in older people, do not cause symptoms and do not progress to severe kidney failure.
It is important to detect even mild CKD as treatment may slow down the progression of the disease.
People with any stage of CKD have a higher risk of developing heart disease.
How is CKD Diagnosed?
The estimated glomerular filtration rate (eGFR) is a routine blood test. It measures the amount of blood your kidneys filter in a minute. A normal eGFR is 90ml/min/1.73m or more. If the kidney is damaged and can’t filter as much blood then the eGFR will be lower.
CKD is diagnosed by this blood test and other factors and is divided into five stages.
- Stage 1— eGFR shows normal kidney function but you are already known to have some kidney damage or disease, for example you may have some protein or blood in your urine, an abnormality of your kidney, kidney inflammation etc.
- Stage 2—Mildly reduced kidney function AND you are already known to have some kidney damage or disease. People with eGFR of 60-89 without kidney damage or disease are not considered to have CKD
- Stage 3 – Moderately reduced kidney function
- Stage 4 – Severely reduced kidney function
- Stage 5 – Very severely reduced kidney function. This is sometimes called end-stage kidney failure or established renal failure
What is CKD?
Chronic Kidney Disease (CKD) means that your kidneys may not be working as well as they should. Kidneys are important for regulating your blood pressure, filtering waste products, producing hormones and fine-tuning the amount of certain salts in your blood. It is hard for your body to keep things like blood pressure in check if your kidneys are damaged.
How common is CKD?
About 1 in 10 people have CKD. It can develop at any age but becomes more common with increasing age. About half of people aged 75 or more have some degree of CKD. Most cases of CKD are mild or moderate.
What causes CKD?
Many conditions can cause permanent damage to the kidneys or affect how the kidneys work and lead to CKD. The most common causes in the UK are:
- High Blood Pressure
- Ageing Kidneys
Other conditions that can cause CKD include renal artery stenosis (narrowing), haemolytic-uremic syndrome: polycyctsic kidney disease; blockages to the flow of urine; drug and toxin-induced kidney damage; repeated kidney infections and many other uncommon causes.
What should I do if I am unwell?
If you are unwell and unable to drink properly, particularly if you are losing excess fluid through vomiting or diarrhoea, or you have a high temperature and sweats, then it is important that you discuss your condition with a medical professional. This may be your GP or a specialist nurse, e.g. a heart failure or kidney nurse if you have one.
You may be advised to discontinue taking medications which lower your blood pressure or make you lose water for a short time and a blood test will be arranged to check your kidney function.
If you are admitted to hospital for a specialist x-ray or operation, you should make your health care team aware if you have chronic kidney disease.
If you are only passing small amounts of urine you may need admission to hospital and you should alert your GP to this.
What are the symptoms of CKD?
It is unusual to feel unwell or have symptoms with mild to moderate CKD. CKD is usually diagnosed by the eGFR test before any symptoms develop.
Symptoms tend to develop when CKD becomes severe. The symptoms at first tend to be vague and non-specific such as feeling tired, having less energy than usual and just not feeling well.
What about the future?
Your surgery will help you monitor your condition, offer advice and guidance and prescribe medication where necessary. More advanced cases may be referred to a specialist at the hospital. Only about 1 in 10 people with CKD progress to severe kidney failure (stage 5 CKD) that requires kidney dialysis or kidney transplant.
For many people with CKD there is a much higher risk of developing serious cardiovascular (heart and stroke) disease. Attention to blood pressure and to a healthy lifestyle can reduce your risk of developing cardiovascular diseased and make a big difference to your outlook.
How can I keep my kidneys healthy?
- Keep hydrated
- Don’t smoke
- Keep your weight down
- Exercise regularly
- Eat a healthy diet including fresh vegetables and fish
- Reduce your intake of salt, processed food and high sugar drinks
- Monitor your blood pressure regularly
- Be alert to symptoms of infection and dehydration and seek advice
What can I expect at my annual health review?
It is really important to attend these appointments to help you monitor your condition.
- Before the appointment – Pick up a specimen pot and bring a urine sample with you
- First appointment – blood test / blood pressure / weight / height
- Second appointment – discuss results, lifestyle and medications changes that may be recommended