Diseases & Conditions

 

Chronic Kidney Disease

Diseases & Conditions

 

What is chronic kidney disease?

Chronic kidney disease, also known as chronic kidney failure, is a slow and progressive loss of kidney function leading to a permanent kidney failure. The kidneys perform the essential function of removing waste products from the blood and regulating the water fluid levels. When chronic kidney disease reaches an advanced stage, toxic level of fluids and wastes will accumulate in the body.

Chronic kidney disease affects 10% of the population worldwide.1 There have been a marked rise in the prevalence and incidence of chronic kidney disease in Saudi Arabia over the last three decades.2 The prevalence of chronic kidney disease in the Saudi population is around 5.7%.3

 

What causes chronic kidney disease?

Some conditions can cause chronic kidney disease such as:4

  • Diabetes mellitus
  • Hypertension
  • Glomerulonephritis: This is an autoimmune disease characterized by an acute inflammation of the kidney.
  • Polycystic kidney disease: This inherited disease causes large cysts to form in the kidneys and damage the surrounding tissue.
  • Malformations such as a narrowing that prevents normal outflow of urine and causes urine to flow back up to the kidney.
  • Lupus: This chronic autoimmune disease can damage any part of the body causing inflammation.
  • Prolonged obstruction of the urinary tracts from certain conditions such as stones, tumors or enlarged prostate.
  • Recurring urinary infections

 

What are the risk factors for chronic kidney disease?

Risk factors for chronic kidney disease include:5

  • Family history of chronic kidney disease
  • Older age
  • Ethnicity: Blacks and Hispanics are at higher risk of developing chronic kidney disease than Whites.
  • Hypertension
  • Diabetes mellitus
  • Overweight or obese
  • Smoking
  • Having lupus
  • Born Prematurely

 

What are the symptoms of chronic kidney disease?

Signs and symptoms of chronic kidney disease include:6

  • Weakness
  • Decreased concentration
  • Loss of appetite
  • Sleep problems
  • Muscle cramps
  • Swollen feet and ankles
  • Dry and itchy skin
  • Frequent urination especially at night
  • Swelling around the eyes
  • Hiccups
  • Nausea
  • Vomiting

 

How is chronic kidney disease diagnosed?

Different tests are needed to diagnose chronic kidney disease:7

Blood tests:

  • Measuring the level of blood creatinine helps to estimate the glomerular filtration rate which reflects how well the kidneys are working.
  • Measuring blood urea nitrogen helps to quantify the level of nitrogen from the waste product urea in the blood.

 Urine test:

    • Urinalysis can reveal abnormalities that point to chronic kidney failure
    • Urine test for microalbumin helps to measure the level of proteins in the urine

 Renal ultrasound:

A renal ultrasound is a safe and painless test that uses sound waves to make images of the kidneys that may help find causes of chronic kidney disease.

 A duplex Doppler study:

 A duplex Doppler study or angiogram of the kidney may be done to check for problems caused by restricted blood flow.

 Biopsy:

Removing a sample of kidney tissue may be recommended for testing.

 

 How is chronic kidney disease treated?

Treatment for chronic kidney disease involves treating complications and it includes:8

  • Medications for hypertension
  • Medications to lower cholesterol levels
  • Medications to treat anemia
  • Medications to relieve swelling
  • Medications to protect the bones: Calcium and Vitamin D supplements prevent weak bones and lower the risks of fracture.
  • Diet poor in proteins to lower waste product in the blood
  • Treatment for end kidney disease includes:
    • Dialysis: When the kidneys are unable to function properly, dialysis is used to filter and purify the blood using a machine.
    • Kidney transplant: A kidney transplant is an operation in which a person with kidney failure receives a new kidney from a deceased donor.


 References

  1. The National Kidney Foundation https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease#_ENREF_1 (Accessed January 25, 2016)
  2. Al-Sayyari, Abdulla A., and Faissal A. Shaheen. "End stage chronic kidney disease in Saudi Arabia. A rapidly changing scene." Saudi medical journal 32.4 (2011): 339-346.
  3. Alsuwaida, Abdulkareem O., et al. "Epidemiology of chronic kidney disease in the Kingdom of Saudi Arabia (SEEK-Saudi investigators)-a pilot study." Saudi Journal of Kidney Diseases and Transplantation 21.6 (2010): 1066.
  4. The National Kidney Foundation https://www.kidney.org/kidneydisease/aboutckd#causes (Accessed January 26, 2016)
  5. Risk Factors for Chronic Kidney Disease (CKD) http://www.ultracare-dialysis.com/kidney-disease/chronic/ckd-risk-factors.aspx (Accessed January 26, 2016)
  6. The National Kidney Foundation https://www.kidney.org/kidneydisease/aboutckd#causes (Accessed January 26, 2016)
  7. WebMD http://www.webmd.com/a-to-z-guides/chronic-kidney-disease-exams-and-tests?page=2 (Accessed January 26, 2016)
  8. Treatments and drugs http://www.mayoclinic.org/diseases-conditions/kidney-disease/basics/treatment/con-20026778 (Accessed January 26, 2016)