Chronic kidney disease

What is Chronic Kidney Disease (CKD)?

CKD is a general term for renal dysfunction lasting more than 3 months (regardless of cause). When CKD is advanced, the kidneys are no longer able to filter the blood of toxins and harmful metabolic products and to perform all other functions (kidney failure). The disease may start suddenly or develop latently for a long time. It is usually painless, so sometimes it is diagnosed late. Most people develop kidney failure after a few years of chronic kidney disease (acute kidney failure, i.e. sudden renal impairment, is much less common). The most common causes are other chronic diseases: diabetes and arterial hypertension. It is estimated that up to 600 million people worldwide suffer from CKD.

Symptoms of chronic kidney disease

The symptoms of CKD can vary greatly. Among the most common are: changes in the volume and quality of urine (foaming, haematuria), sometimes difficulties with urination, swelling of: feet, ankles, lower legs, fatigue or weakness, shortness of breath, smell of ammonia from the mouth or its taste, metallic taste in the mouth, pain in the lumbar region, itching of the skin, loss of appetite, nausea and vomiting, increased number of hypoglycemic episodes in people with diabetes.

Diagnosis of CKD

The disease is diagnosed by symptoms and laboratory tests. Particularly important are the changes in the general urine results – the level of proteins and in the urine sediment. In addition, the filtration function of the kidneys is assessed (GFR – glomerular filtration), which is calculated from the serum creatinine concentration, taking into account the age and sex of the patient. If you have symptoms of CKD you should do screening tests (urinalysis and serum creatinine) and show the results to a nephrologist with. The nephrologist will review the diagnosis and, if necessary, suggest further diagnostics and treatment. A kidney biopsy may be necessary—a basic examination to identify many possible glomerular diseases. These and other treatments are designed to slow the progression of the underlying kidney disease to prevent kidney failure.

Stages of chronic kidney disease

The disease has 5 stages. The glomerular filtration rate (GFR) shows how advanced it is. It represents the amount of plasma filtered per time unit through the glomeruli into the so-called primary urine.

Stage 1 (GFR > 90 ml/min) and stage 2 (GFR = 60-89 ml/min) 

There are few symptoms at these stages of the disease. These can be: high blood pressure, increased levels of creatinine or urea in the blood, the presence of blood or protein in the urine, kidney damage found in: magnetic resonance imaging, computed tomography, ultrasound or X-ray.

Stage 3 (GFR = 30-59 ml/min)

In stage 3 of CKD, anaemia (deficiency of red blood cells) and / or bone problems may occur. Treatment of these disorders is aimed at improving the patient's well-being and slowing the progression of the disease.

Stage 4 (GFR = 15-29 ml/min)

At this point, kidney function is seriously impaired. It can be troublesome to maintain the water balance (swelling increases) or control blood pressure (more antihypertensive drugs are needed). You should immediately see a nephrologist who will present options for further treatment.

Stage 5 (GFR <15 ml/min)

It is the end stage of the disease, which means the decline of kidney function to an extent that significantly disrupts the functioning of the body. When symptoms of this occur, renal replacement therapy should be started: dialysis or kidney transplant. These are life-saving treatments.

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