Chronic Kidney Disease

What is kidney disease?

Kidney disease results from damage to the nephrons, which are the tiny structures inside your kidneys that filter blood.

Chronic Kidney Disease (CKD) develops when the kidneys lose most of their ability to remove waste and maintain fluid and chemical balances in the body. CKD can progress quickly or take many years to develop.

What are the risk factors for kidney disease? 

  • Diabetes
  • High Blood Pressure: High blood pressure, called hypertension, can damage the small blood vessels in the kidneys, preventing the kidneys from filtering wastes from the blood. Taking prescription drugs to control blood pressure helps protect the kidneys from damage.
  • An Immediate Family Member with Kidney Failure: Some kidney diseases result from hereditary factors, and can run in families.
  • A History of Glomerular Disease: The risk of chronic kidney disease increases for patients with Glomerular Disease. Glomerular Diseases damage the glomeruli, which are tiny bundles of blood vessels that filter blood in the kidneys. Learn more about glomerular disease. 

How is Kidney Disease Treated?

Many times, kidney disease cannot be cured; however, it can be managed. Taking certain steps during the early stages of the disease will help keep the kidneys healthy longer.

  • Those with diabetes need to monitor blood glucose closely to keep it under control, and should consult a doctor for the best treatment method.
  • Patients with reduced kidney function should control blood pressure and take an ACE inhibitor or an ARB. Many people will require two or more types of medication to keep the blood pressure below 130/80 mm Hg and will need a diuretic in addition to the ACE inhibitor or ARB.

Is There a Test for Kidney Disease?

Since kidney disease sometimes has no symptoms, doctors may first detect the condition through routine blood and urine tests. The National Kidney Foundation recommends three simple tests to screen for kidney disease: a blood pressure measurement, checking for extra protein in your blood or urine, and measuring how well your kidneys are filtering wastes from your blood (Glomerular Filtration Rate or GFR).

Blood Pressure Test

High blood pressure (HBP), also known as Hypertension, can lead to kidney disease. It can also be a sign that your kidneys are already impaired. The only way to check blood pressure is to have a health professional measure with a blood pressure cuff. The result is expressed as two numbers. The top number, (called the systolic pressure) represents the pressure as the heart beats. The bottom number, (called the diastolic pressure) shows the pressure when the heart is resting. Your blood pressure is considered normal if it stays below 120/80 (expressed as "120 over 80").

Checking for Extra Protein in the Blood or Urine

Healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate a blood protein called albumin from the wastes. At first, small amounts of albumin leak into the urine, a condition known as microalbuminuria. As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria. Doctors test for protein using a dipstick in a small sample of urine taken in the doctor's office. The color of the dipstick indicates whether or not there is protein the urine.

A more sensitive test for protein or albumin in the urine involves testing a blood sample for the amount of protein and a waste product called creatinine. Creatinine is a waste created every time you use your muscles. When the kidneys aren't working well, the level of creatinine in your blood goes up. This test is used to detect kidney disease in people at high risk, especially those with diabetes.

Measuring How Well Kidneys Filter Waste From the Blood

This test is also known as "measuring the Glomerular Filtration Rate (GFR)." The (GFR) is a measure of how well the kidneys filter wastes from the blood. GFR is been estimated from a routine measurement of creatinine in your blood. By comparing GFR tests done at different times, a doctor knows whether kidney function is getting better or worse.

How Do I Talk to My Doctor About Kidney Disease?

Here are some good questions to ask next time you see your healthcare professional:

  • Based on my medical and family history, am I at risk for kidney disease?
  • Would lowering my blood pressure help reduce my risk of developing kidney disease?
  • Do my blood and urine tests show signs of kidney disease?
  • How can I prevent or control kidney disease?

Tips for talking with your health worker:

  • Write down any questions or concerns you have BEFORE you go to the health department or doctor's office. That way, if you get nervous, you can still remember what you wanted to talk about and make sure you and your healthcare worker get to talk about all of your concerns.
  • Write down the answers you get and ask more questions if you need to.
  • Know as much as you can about your family's medical history.
  • Bring someone else with you for support and to help you remember what you learn.

Sources:
National Kidney Disease Education Program (NKDEP)
National Institutes for Diabetes & Digestive & Kidney Diseases

CKD Patient Education Center

General Information about CKD

Kidney Function & Labs

Medicines and Kidney Disease

Diet/Nutrition with Kidney Disease

Special Issues Related to Kidney Disease

Treatment Options: Dialysis & Transplantation


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