Symptoms Treatment & Prevention of Kidney Disease

 Symptoms of Kidney

Early detection is the first step in treating chronic kidney disease. The symptoms of kidney disease may include:

• Nausea and vomiting
• Passing only small amounts of urine
• Swelling, particularly of the ankles, and puffiness around the eyes
• Unpleasant taste in the mouth and urine-like odor to the breath
• Persistent fatigue or shortness of breath
• Loss of appetite
• Increasingly higher blood pressure
• Muscle cramps, especially in the legs
• Pale skin
• Excessively dry, itchy skin
• In children: increased fatigue and sleepiness, decrease in appetite, and poor growth

See Your Doctor About Kidney Disease If:

You experience any of these symptoms, which could be a warning sign of kidney disease. Unfortunately, some people have no symptoms of chronic kidney disease until the majority of kidney function is lost; that is why prevention -- through diet, exercise, and medication -- is key.

Treatment

Blood and urine tests can help uncover signs of early kidney disease and monitor the condition.

• Blood pressure. Your health care provider will devise a plan, which may include diet changes and medications, to keep your blood pressure as close to normal as possible. Target blood pressure is defined as less than 130/80.
• Blood electrolytes. When the kidneys are not working correctly, you can develop high potassium and low calcium, phosphorus, bicarbonate, which can affect your heart’s conduction system and cause muscle aches and other complications.
• Urine protein or albumin in the urine. Albumin is the main protein in the blood. When the kidneys become damaged, the holes in the filtering system of your kidneys become enlarged, allowing protein to leak into the urine. In the early stages of kidney damage, only small amounts of albumin (microalbuminuria) are found. This test is very important for people with diabetes because at this early stage of kidney damage, further deterioration can often be prevented by diet, exercise, and medications.
• GFR (glomerular filtration rate). This is a measure of how well the kidneys are filtering blood. An estimate of your "filtering rate" is determined by a blood test called a blood creatinine test, which measures the amount of creatinine -- a waste product -- in your blood. This test, along with your age, body size, and gender, provides an estimate of your GFR. The GFR, or "filtering rate," helps confirm normal or low kidney function. A score of 90 or above is normal; a score below 15 indicates kidney damage that will require dialysis or a kidney transplant. Another commonly used test to estimate GFR is a creatinine clearance. This test measures the creatinine in the blood and urine to determine kidney function.

Your health care provider may also refer you to a kidney specialist, called a nephrologist, for more specialized testing. A kidney biopsy may also be performed. During a kidney biopsy a small amount of kidney tissue is removed for microscopic exam to pinpoint the cause of kidney damage and plan treatment.

How Can You Prevent Kidney Disease?

The key to prevention or delay of severe kidney disease is early detection and aggressive intervention -- while there's still time to slow down the progression to kidney failure. Medical care with early intervention can change the course of chronic kidney disease and help prevent the need for dialysis or a kidney transplant.
Diabetes and high blood pressure account for two thirds of all cases of chronic kidney disease. By aggressively managing diabetes and high blood pressure with diet, exercise, and medications, you may be able to prevent kidney failure and help keep as much kidney function as possible.
Know Your Risks for Kidney Disease
Since diabetes and high blood pressure put you at risk of kidney disease, know where you stand with these risks. Do you have diabetes or high blood pressure? If so, are they under control?
If you can, find out if diabetes, hypertension, or kidney disease runs in your family. Certain ethnic groups, such as African-Americans, Hispanics, Pacific Islanders, and Native Americans are at higher risk of chronic kidney disease, as are senior citizens.
Get Tested Regularly
At your next checkup, and at least within the next year if you haven't had these tests done:

• Ask for a urine test to see if you have excess protein, glucose, or blood in the urine.
• Ask for a blood pressure reading, to see if your blood pressure is elevated.
• Ask for a fasting blood glucose test, to see if you have too much glucose (sugar) in your blood. Another blood test that can be used to determine diabetes is a hemoglobin A1C which will indicate your average blood glucose level over the past two to three months.
• Ask for a creatinine test. This blood test measures the amount of waste from muscle activity. When the kidneys are not working properly, the creatinine rises.

If any of these tests are abnormal, your health care provider will need to do other tests to more clearly define the problem.
Control Diabetes
If you have diabetes, work with your health care provider to keep your blood sugar levels under the best possible control. A program of diet, regular exercise, glucose monitoring, and medications to control blood sugars and protect kidney function can help.

 

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Understanding Kidney Disease -- the Basics

What Is Kidney Disease?

The kidneys are two organs located in your abdominal cavity on either side of your spine in the middle of your back, just above the waist. They perform several life-sustaining roles: They cleanse your blood by removing waste and excess fluid, maintain the balance of salt and minerals in your blood, and help
regulate blood pressure.
When the kidneys become damaged, waste products and fluid can build up in the body, causing swelling in your ankles, vomiting, weakness, poor sleep, and shortness of breath. If left untreated, diseased kidneys may eventually stop functioning completely. Loss of kidney function is a serious -- and potentially fatal -- condition

Healthy kidneys handle several specific roles. Healthy kidneys:

• Maintain a balance of water and concentration of minerals, such as sodium, potassium, and phosphorus, in your blood
• Remove waste by-products from the blood after digestion, muscle activity, and exposure to chemicals or medications
• Produce renin, an enzyme that helps regulate blood pressure
• Produce erythropoietin, which stimulates red blood cell production
• Produce an active form of vitamin D, needed for bone health

  What Causes Acute Kidney Injury?

  The sudden loss of kidney function is called acute kidney injury, also known as acute renal failure (ARF). ARF has three main causes:
• Lack of blood flow to the kidneys
• Direct damage to the kidneys themselves
• Blockage of urine from the kidneys

Common causes include:

• A traumatic injury with blood loss
• Dehydration
• Damage to the kidneys from shock during a severe infection called sepsis
• Obstruction of urine flow, such as with an enlarged prostate
• Damage from certain drugs or toxins
• Pregnancy complications, such as eclampsia and pre-eclampsia, or related HELLP Syndrome

Marathon runners and other athletes who don't drink enough fluids while competing in long-distance endurance events may suffer acute renal failure due to a sudden breakdown of muscle tissue. This muscle breakdown releases a large amount of protein into the bloodstream called myoglobin that can damage the kidneys.

What Causes Chronic Kidney Disease?

Kidney damage and decreased function that lasts longer than 3 months is called chronic kidney disease (CKD). Chronic kidney disease is particularly dangerous, because you may not have any symptoms until considerable, often irreparable, kidney damage has occurred. Diabetes (types 1 and 2) and high blood pressure are the most common causes of CKD. Other causes are:

• Immune system conditions such as lupus and chronic viral illnesses such as HIV/AIDS, hepatitis B, and hepatitis C
• Urinary tract infectionswithin the kidneys themselves, called pyelonephritis, can lead to scarring as the infection heals. Multiple episodes can lead to kidney damage.
• Inflammation in the tiny filters (glomeruli) within the kidneys; this can happen after strep infection and other conditions of unknown cause.
• Polycystic kidney disease, in which fluid-filled cysts form in the kidneys over time. This is the most common form of inherited kidney disease.
• Congenital defects, present at birth, are often the result of a urinary tract obstruction or malformation that affects the kidneys; one of the most common involves a valve-like mechanism between the bladder and urethra. These defects, sometimes found while a baby is still in the womb, can often be surgically repaired by an urologist.
• Drugs and toxins, including long-term exposure to some medications and chemicals, such as NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen and naproxen, and use of intravenous “street” drugs.

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