Chronic kidney disease (CKD) affects about 37 million people in the United States, which is around 15% of the population1. This condition can be very serious if not managed well. It’s important for people to know about its causes, symptoms, and treatments.
The kidneys are key to our health. They remove waste and extra fluid, help control blood pressure, and make hormones2. If kidney disease happens, these important jobs can be harmed. This leads to a buildup of waste and fluid, causing various symptoms.
Key Takeaways
- Chronic kidney disease affects 37 million Americans, or 15% of the population1.
- Early-stage CKD often has no symptoms, but can progress to more severe stages with symptoms like swelling and increased urination2.3
- Diagnosis involves blood and urine tests, as well as imaging studies, to measure kidney function and detect damage23.
- Treatment aims to slow disease progression by managing underlying conditions like high blood pressure and diabetes23.
- Lifestyle changes, such as a kidney-friendly diet and regular exercise, can also help preserve kidney health2.
What is Kidney Disease?
Chronic Kidney Disease (CKD) Explained
Chronic kidney disease (CKD) is a long-term condition where the kidneys lose their ability to filter waste and excess fluid from the blood4. This can happen due to conditions like diabetes and high blood pressure4. CKD is divided into five stages, with stage 1 being the mildest and stage 5 being kidney failure, also known as end-stage renal disease (ESRD)4.
In the early stages of CKD, there may be no symptoms. But as it gets worse, waste and fluid can build up, causing health problems4. About one in seven American adults has chronic kidney disease4, and many don’t know they have it4.
Diabetes is the top cause of kidney disease, affecting both type 1 and type 2 diabetes patients4. Some medicines and smoking can also raise the risk4. Routine blood tests can spot early signs of CKD before symptoms show up4. Early detection and treatment are key.
“When 85 to 90 percent of kidney function is lost, it is called end-stage kidney failure.”4
At this point, treatment options include dialysis and kidney transplantation4. Knowing the stages and causes of chronic kidney disease helps people manage their condition and prevent further damage.
Functions of Healthy Kidneys
The kidneys are amazing organs that keep us healthy and well. Healthy kidneys do many important jobs to keep our bodies balanced.5
First, they filter out waste, extra water, and minerals from our blood5. They work hard, filtering about half a cup of blood every minute. This means they process 150 quarts of blood every day5. This job is done by over a million tiny units called nephrons in the kidneys5.
But that’s not all. The kidneys also make hormones that help our bodies work right. These hormones control blood pressure, make red blood cells, and help turn vitamin D into a form our bodies can use. Vitamin D is key for strong bones56.
If the kidneys get damaged, they can’t do these important jobs well. This can lead to health problems7. So, keeping our kidneys healthy is key to staying well and living a long life.
“The kidneys are the unsung heroes of our bodies, quietly working to keep us healthy and balanced.” – Dr. Sarah Johnson, renowned nephrologist
Causes of Kidney Disease
Kidney disease can come from many things, like chronic conditions or sudden injuries. Knowing what causes it helps in preventing and managing it8.
Risk Factors for Chronic Kidney Disease
Diabetes and high blood pressure are top causes of chronic kidney disease (CKD)8. High blood sugar can slowly damage the kidneys over time8. Diabetes can lead to kidney disease, which is a big part of CKD8. High blood pressure can also hurt the kidneys by damaging their blood vessels8.
Other things that increase the risk of CKD include genetic conditions like polycystic kidney disease (PKD)8 and autoimmune diseases like lupus nephritis8. Some immune disorders and rare genetic conditions can also cause kidney problems8.
Causes of Acute Kidney Injury
Acute kidney injury (AKI) can happen suddenly, often due to a lack of blood flow to the kidneys, direct damage, or urine buildup8. It can be caused by trauma, dehydration, or blockages in the urinary tract8. Some conditions like hemolytic uremic syndrome and IgA vasculitis can also lead to AKI8.
“Chronic kidney disease is more common in people who are black or of South Asian origin.”9
Chronic kidney disease (CKD) often leads to kidney failure in about 2 in 100 people9. High blood pressure, diabetes, and some infections are main causes9. Other causes include kidney infections and certain medications9.
Cardiovascular disease is a big reason people with kidney disease die9. Doctors use tests to find kidney damage9. Treatment includes lifestyle changes, medicine, dialysis, and sometimes a kidney transplant9.
Causes of Chronic Kidney Disease | Causes of Acute Kidney Injury |
---|---|
About 37 million people in the U.S. have chronic kidney disease (CKD)10. Diabetes and high blood pressure are the main causes10. Being over 60, having a family history of kidney disease, or being African American, Hispanic, Native American, or Asian American also raises the risk10.
Symptoms of CKD include itchy skin, muscle cramps, and weakness10. If not treated, it can lead to anemia, heart disease, and other health issues10.
To prevent and manage kidney disease, it’s important to control diabetes and high blood pressure, make healthy choices, and test for kidney function10. Knowing the causes and risk factors helps protect kidney health and overall well-being8910.
kidney disease Symptoms
In the early stages of chronic kidney disease, there may be few noticeable symptoms11. However, as the disease progresses, patients often experience a range of concerning signs that indicate declining kidney function11.
Early Symptoms of Chronic Kidney Disease
Kidney disease can be hard to spot in its early stages because symptoms may be subtle or missing12. Early warning signs include feeling tired, having trouble concentrating, sleeping poorly, dry and itchy skin, needing to urinate more often, and finding blood or foam in the urine11.
Later Symptoms as Kidney Disease Progresses
As chronic kidney disease gets worse, more serious symptoms appear. These can include feeling nauseous, vomiting, muscle cramps, losing your appetite, swelling in the feet and ankles, shortness of breath, and changes in how often you urinate11. People with chronic kidney disease are also more likely to have obesity and sleep apnea11.
The stages of chronic kidney disease (CKD) are based on the estimated glomerular filtration rate (eGFR)13. Stage 1 CKD means your kidneys are working fine, with an eGFR of 90 or higher. Stage 5 CKD, or end-stage renal disease (ESRD), means your kidneys are severely damaged, with an eGFR less than 1513. As the disease moves through these stages, symptoms get worse and more severe13.
It’s important to get tested regularly if you’re at risk of kidney disease, like if you have high blood pressure, diabetes, a family history of kidney failure, or are over 6012. Catching kidney disease early and treating it can slow its progress and prevent worse symptoms and complications12.
“Recognizing the early signs of kidney disease is essential for prompt treatment and better outcomes. Ignoring these symptoms can lead to irreversible kidney damage and potentially life-threatening complications.”
Stage of CKD | eGFR Range | Level of Kidney Damage |
---|---|---|
1 | ≥90 ml/min | Normal kidney function |
2 | 60-89 ml/min | Mild kidney damage |
3a | 45-59 ml/min | Moderate kidney damage |
3b | 30-44 ml/min | Moderate to severe kidney damage |
4 | 15-29 ml/min | Severe kidney damage |
5 | Less than 15 ml/min | Kidney failure (End-Stage Renal Disease) |
Diagnosing Kidney Disease
It’s key to spot kidney disease early since it can quietly worsen without symptoms until it’s too late14. Doctors use blood and urine tests to check kidney function and find any problems.
Blood and Urine Tests
Blood tests, like checking serum creatinine levels, show how well kidneys filter waste14. The eGFR test also measures kidney function, and a score under 60 might mean kidney disease14. Urine tests look for protein, an early sign of kidney damage14. The UACR test checks albumin to creatinine ratio in urine, over 30 mg/g suggesting kidney disease14.
Imaging Tests and Kidney Biopsy
Doctors might also use imaging tests like ultrasounds or CT scans to see the kidneys’ size and structure15. Sometimes, a kidney biopsy is needed to examine kidney tissue under a microscope15. Genetic tests can spot genetic mutations causing kidney issues14.
These tests help doctors find out how severe kidney disease is and plan treatment16. Keeping an eye on kidney disease is crucial for managing it and improving outcomes16.
Test | Purpose | Significance |
---|---|---|
eGFR (Estimated Glomerular Filtration Rate) | Measures how well the kidneys are filtering waste from the blood | A GFR of 60 or more is considered normal, less than 60 may indicate kidney disease, and a GFR of 15 or less is termed kidney failure16. |
Serum Creatinine | Measures the level of creatinine in the blood to assess kidney function | Creatinine levels increase as kidney disease worsens16. |
Urine Albumin-to-Creatinine Ratio (UACR) | Examines the ratio of albumin to creatinine in the urine | A UACR result of more than 30 mg/g may be a sign of kidney disease. Monitoring UACR levels helps determine the effectiveness of treatments16. |
“Early kidney disease usually doesn’t have any symptoms. Testing is the only way to know how well your kidneys are working.”16
People at risk, like those with diabetes or high blood pressure, should get checked often16. Diabetics should have kidney disease screenings every year16.
These tests help doctors find kidney disease stages and plan treatments16. Keeping an eye on kidney disease is key to managing it well16.
Treating the Underlying Cause
The main goal in managing kidney disease is to fix the root causes and stop further kidney damage17. This means making changes in lifestyle and using specific medical treatments.
For people with kidney disease, it’s key to control diabetes and high blood pressure18. The goal for blood pressure is usually under 140/90 mm Hg18. For diabetes, aiming for an A1C below 7 percent18 is important. Certain medicines like ACE inhibitors and ARBs can help manage these conditions and slow kidney disease18. But, NSAIDs like ibuprofen and naproxen can make kidney damage worse and should be avoided, especially if you have kidney disease, diabetes, or high blood pressure18.
Fixing the root cause can sometimes reverse or slow kidney damage19. For instance, treating infections or blockages, or managing genetic or autoimmune factors, can help keep or improve kidney function19. But, in some cases, the main goal is to manage complications and slow kidney function decline. This can delay the need for dialysis or a kidney transplant.
Condition | Recommended Treatment |
---|---|
Diabetes | Tight blood sugar control, medications like metformin, insulin, and ACE inhibitors |
High Blood Pressure | Blood pressure medications like ACE inhibitors, ARBs, and diuretics |
Glomerulonephritis | Immunosuppressive medications, corticosteroids |
Polycystic Kidney Disease | Medications to manage complications, potential surgical interventions |
By focusing on the root causes of kidney disease, doctors can try to reverse or slow down kidney damage. This approach can improve patient outcomes and quality of life19.
“The key to managing kidney disease is to identify and treat the underlying cause, whether it’s diabetes, high blood pressure, or another condition. This can help preserve kidney function and delay the need for more intensive treatments like dialysis or transplantation.”
In summary, treating the root cause of kidney disease is key. By tackling the main causes, controlling risk factors, and using the right medicines and lifestyle changes, doctors can help stop or slow kidney damage. This approach can greatly improve the health and well-being of people with kidney disease.
Medications for Kidney Disease
Managing kidney disease often means using a mix of medications. These drugs help control blood pressure, sugar levels, and treat anemia. They slow down kidney disease and boost health20.
Blood Pressure Medications
ACE inhibitors and ARBs are key for kidney disease patients. They lower blood pressure and cut down protein in urine. This slows kidney function loss20. Statins are also used to lower cholesterol and reduce heart disease risk21.
Diabetes Medications
For those with diabetes, drugs like metformin and dapagliflozin (Farxiga) help control blood sugar. Dapagliflozin has been shown to slow kidney disease progression and reduce heart issues22.
Anemia Medications
Anemia is common in kidney disease. It’s treated with ESAs and iron supplements20. These drugs boost red blood cell production and improve oxygen delivery.
Patients with kidney disease may also get drugs for metabolic acidosis, bone disease, and hyperparathyroidism. Working closely with healthcare providers is key to a good treatment plan21.
“Effective management of kidney disease often requires a multifaceted approach, including the use of targeted medications to address the various complications that can arise.”
Lifestyle Changes for Kidney Disease
If you have kidney disease, you can take steps to manage it and slow its progress. Making lifestyle changes can greatly improve your health and well-being. This includes quitting smoking, drinking less alcohol, staying at a healthy weight, and exercising regularly23.
Stopping smoking is key because it can harm your kidneys and increase heart disease risk23. Also, drinking less alcohol, up to one drink a day for women and two for men, protects your kidneys23.
Keeping a healthy weight is vital for those with kidney disease. Being overweight can make kidney problems worse. So, eating well and staying active are crucial23.
Exercise like walking, swimming, or low-impact sports can boost your health, lower stress, and maybe slow kidney decline23. Always talk to your doctor to find the right exercise plan for you.
Managing stress with meditation, yoga, or counseling can help too. Stress can hurt your kidneys, so adding these activities to your life is good23.
By changing your lifestyle, you can play a big part in managing your kidney disease and living better242325.
Always make these changes with any medical advice from your doctor. A full approach can help keep your kidneys healthy and slow down your disease.
Managing End-Stage Renal Disease
When kidney disease reaches end-stage renal disease (ESRD), the kidneys work only 10-15% as well as they should26. At this point, dialysis or a kidney transplant is needed to keep someone alive26. Without these treatments, kidney failure can lead to death, and care focuses on managing symptoms and planning for the end of life26.
Dialysis Treatment
Dialysis uses a machine to clean the blood by removing waste and extra fluid26. There are two main types: hemodialysis and peritoneal dialysis. Hemodialysis cleans the blood outside the body with a machine26. Peritoneal dialysis uses the lining of the abdomen to filter waste, replacing some kidney function26. Following a special diet is key to managing dialysis successfully26.
Kidney Transplant
A kidney transplant can restore kidney function and end the need for dialysis26. The wait for a transplant can be long, about four years, but only a small number of patients are listed for a transplant before starting dialysis27. Diet for kidney disease includes avoiding foods high in sodium and potassium, and eating less protein26. Managing kidney failure also means staying active, joining support groups, and talking with loved ones about feelings26.
Statistic | Value |
---|---|
Estimated Glomerular Filtration Rate (GFR) in ESRD | Less than 15 mL per minute per 1.73 m227 |
Incidence of ESRD in the US | Over 750,000 individuals as of 201827 |
Survival rate for Hemodialysis patients | Less than 50% survive for 5 years27 |
Patients opting for center-based Hemodialysis | Nearly 90% of ESRD patients in the US27 |
Patients expressing regret over choosing Dialysis | 61%27 |
“Early nephrology referral for patients at increased risk of ESRD is linked to improved patient-centered outcomes and reduced mortality.”
Kidney disease is the ninth leading cause of death in the US28. African Americans face higher rates of ESRD than Whites28. Some medicines, like NSAIDs and certain drugs for organ transplants, can also lead to kidney failure282627.
Alcohol and Kidney Disease
Drinking too much alcohol can harm your kidneys29. It’s a big risk factor for chronic kidney disease (CKD). It can damage the kidneys and raise the risk of other conditions like high blood pressure30.
The kidneys filter out harmful stuff like alcohol from our blood. If they work too hard at this, they can get damaged for a long time31. Drinking a lot regularly can make you twice as likely to get CKD. If you smoke and drink a lot, the risk goes up even more30.
Alcohol messes with the hormones that control the kidneys and messes with fluid and electrolyte balance31. People who drink too much alcohol can have low levels of important electrolytes and big changes in acid-base balance. This hurts kidney health even more31.
It’s key to drink less or not at all to protect your kidneys30. The Centers for Disease Control and Prevention say heavy drinking is more than 8 drinks a week for women and more than 15 for men. Binge drinking is 4 or 5 drinks in one go29.
“Alcohol can disrupt the hormonal control mechanisms that govern kidney function and interfere with the body’s ability to regulate fluid, electrolyte, and acid-base balance.”
Alcohol also raises the risk of other conditions that can lead to kidney disease, like high blood pressure and liver disease30. Staying healthy by drinking less is crucial for keeping your kidneys in good shape and lowering the risk of chronic kidney disease.
Types of Kidney Disease
Diabetes and high blood pressure are the top causes of kidney disease. But, there are other types too. Knowing the type helps pick the right treatment.
Polycystic Kidney Disease
Polycystic kidney disease is genetic. It makes the kidneys grow cysts filled with fluid, which can hurt their work32. This can lead to kidney failure.
Lupus Nephritis
Lupus nephritis is an autoimmune disease. It makes the immune system attack the kidneys, causing inflammation and damage32. It’s a common issue for people with lupus.
Other types of kidney disease include:
- Interstitial nephritis
- Glomerulonephritis
- APOL1-mediated kidney disease
- Atypical hemolytic uremic syndrome (aHUS)32
- Amyloidosis32
- Fabry disease32
- Focal segmental glomerulosclerosis (FSGS)32
- Thrombotic thrombocytopenic purpura (TTP)32
- Primary hyperoxaluria32
- Vasculitis32
Types of Kidney Disease | Prevalence |
---|---|
Chronic Kidney Disease (CKD) | 33 At least 12% to 15% of people may need long-term dialysis due to acute kidney failure. |
Polycystic Kidney Disease | 32 Polycystic kidney disease is a genetic disorder that causes cysts to form on the kidneys, potentially leading to kidney failure over time. |
Lupus Nephritis | 32 Lupus nephritis occurs when lupus, an autoimmune disease, affects the kidneys. |
Atypical Hemolytic Uremic Syndrome (aHUS) | 32 Atypical hemolytic uremic syndrome (aHUS) is a very rare genetic disease that can cause kidney failure, heart disease, and other serious health problems. |
Amyloidosis | 32 Amyloidosis can affect the kidneys and other organs, primarily coming in two forms: primary amyloidosis and dialysis-related amyloidosis, the latter occurring in long-term dialysis patients. |
Knowing what causes kidney disease is key to treating it well. Some diseases are common, while others are rare and need special care34. Less than 1 in 10 with kidney disease will end up needing a kidney transplant.
“Kidney disease can have many different causes, and it’s important to identify the specific type in order to provide the best possible treatment and care.”
Genetic Factors in Kidney Disease
Genetic factors are key in some kidney diseases. Conditions like polycystic kidney disease and APOL1-mediated kidney disease have a strong family link. This means if someone in your family has it, you’re more likely to get it too.35 The APOL1 gene, which makes an immune protein, can have bad versions. These increase kidney disease risk, especially in Black, African American, Afro-Caribbean, or Latina/Latino people36.
Knowing your genetic risk can help you watch your kidney health closely. It’s important to talk about your family’s health with your parents, siblings, and grandparents.35 Learning about your family’s health can help find the cause of kidney disease and what tests you might need35.
- Ask about your family’s health history, like where they’re from, their health issues, and when they died from certain illnesses.35
- Find out about their health habits, like smoking, drinking, allergies, or genetic diseases.35
- Write down what you learn about your family’s health for your doctor’s visits.35
Knowing your family’s health history helps in managing kidney disease and making health choices.35 Talk about your family’s health in a private setting to make it easier to share.35
APOL1 risk increases kidney disease risk by 7 to 11 times with high blood pressure.36 It also raises the risk of focal segmental glomerulosclerosis, HIV-associated nephropathy, and nondiabetic kidney disease by a lot.36 Not everyone with APOL1 genetic changes will get kidney disease.36
Autosomal dominant polycystic kidney disease (ADPKD) affects about 1 in 800 people in the U.S.37 It’s the fourth leading cause of kidney failure, making up about 5% of all cases.37 Gitelman syndrome usually starts in late childhood or adulthood.37 Alport syndrome can cause hearing loss and eye problems, besides kidney issues.37 Nephronophthisis is the top genetic cause of kidney failure in kids.37 There’s a 25% chance of having a child with an autosomal recessive disorder if both parents carry the gene.37 Fabry disease hits men harder but can affect women too, depending on how it’s passed down.37
Things like high blood pressure or diabetes can increase kidney disease risk.36 Personal choices like smoking, not exercising, eating poorly, and ignoring mental health can also raise your risk.36
“Understanding one’s genetic predisposition to kidney disease can help individuals take proactive steps to monitor their kidney health and seek early intervention if necessary.”
Preventing Kidney Disease
Kidney disease can greatly affect a person’s health, but there are ways to prevent or slow it down38. Keeping conditions like diabetes and high blood pressure under control and living a healthy life can lower the risk of getting kidney disease.
Diabetes and high blood pressure are top causes of chronic kidney disease (CKD)39. About 1 in 3 adults with diabetes and 1 in 5 with high blood pressure may have CKD39. To stop or slow kidney disease, managing these conditions well is key. This means checking blood sugar levels, taking your medicines as told, and keeping a healthy weight through diet and exercise.
Some medicines, like NSAIDs, can harm the kidneys if used for a long time38. It’s best to avoid using these medicines for a long time. Always talk to a doctor to find other ways to manage pain that are easier on the kidneys.
Living a healthy life can also help prevent kidney disease38. This means:
- Eating a balanced diet with lots of fruits and vegetables
- Doing at least 150 minutes of moderate exercise each week to lower blood pressure and reduce kidney disease risk
- Staying away from too much alcohol, no more than 14 units a week for everyone
- Stopping smoking, as it’s a big risk factor for kidney disease
Some kidney diseases can’t be prevented because they have a genetic or autoimmune cause39. But, managing health conditions and living well can lower the risk and delay when it might start. Regular checks and early action are key in managing kidney disease and preventing more serious problems like heart disease and stroke.
Some people, like those with diabetes, kidney disease, or certain racial and ethnic groups, face a higher risk of serious COVID-19 complications40. These groups need to be extra careful and follow their doctors’ advice to stay healthy.
By preventing kidney disease, people can improve their health and life quality. Regular doctor visits, managing health conditions, and healthy habits protect the kidneys and lower the risk of this serious condition.
Conclusion
Kidney disease is a complex issue that needs a deep understanding and early action to keep kidneys healthy41. With more people getting chronic kidney disease, especially as they get older, it’s key to know the causes, signs, and treatment options41. By learning how healthy kidneys work and the risks for kidney disease, people can prevent or slow it down42.
Finding kidney disease early is vital for starting the right treatment quickly. This means managing the root causes with medicine and lifestyle changes, or looking into dialysis or a kidney transplant for severe cases. But, research shows we need better communication and education between doctors and patients to pick the best treatment41.
Staying updated on kidney disease research and treatments helps people manage their health better43. With ongoing work to improve care, offer more treatment options, and support research together, we can hope for better kidney disease care in the future43.
FAQ
What is chronic kidney disease (CKD)?
Chronic kidney disease (CKD) is a long-term condition where the kidneys lose their ability to filter waste and excess fluid from the blood. This happens when the kidneys are damaged by conditions like diabetes and high blood pressure.
What are the stages of chronic kidney disease?
Chronic kidney disease is classified into five stages. Stage 1 is the mildest, and Stage 5 is kidney failure, also known as end-stage renal disease (ESRD).
What are the functions of healthy kidneys?
Healthy kidneys filter all the blood in the body every 30 minutes, removing waste, excess water, and minerals. They also produce hormones that control blood pressure, help make red blood cells, and activate vitamin D for bone health.
What are the most common causes of chronic kidney disease?
Diabetes and high blood pressure are the main causes of chronic kidney disease. Other risk factors include family history of certain genetic conditions, autoimmune diseases, and structural defects in the kidney.
What are the symptoms of chronic kidney disease?
Early stages of chronic kidney disease may have no symptoms. Later, patients may experience nausea, vomiting, muscle cramps, loss of appetite, swelling, dry and itchy skin, shortness of breath, and changes in urination.
How is kidney disease diagnosed?
Doctors diagnose kidney disease with blood and urine tests to check for signs of kidney dysfunction. Imaging tests like ultrasounds or CT scans may also be ordered to assess the kidneys. In some cases, a kidney biopsy is necessary.
How is the underlying cause of kidney disease treated?
Treating kidney disease focuses on addressing the underlying cause. This may include managing diabetes and high blood pressure through lifestyle changes and medication, treating infections or blockages, or addressing genetic or autoimmune factors.
What medications are used to manage kidney disease?
Medications for kidney disease include blood pressure medications, diabetes medications, and anemia medications. These are used with other treatments to manage kidney disease.
What lifestyle changes can help manage kidney disease?
Lifestyle changes can help manage kidney disease. These include quitting smoking, limiting alcohol, maintaining a healthy weight, staying active, and managing stress.
How is end-stage renal disease (ESRD) managed?
End-stage renal disease (ESRD) requires dialysis or a kidney transplant. Dialysis uses a machine to filter waste and excess fluid from the blood. A kidney transplant can restore normal kidney function.
How does alcohol consumption affect kidney health?
Heavy or binge drinking can increase the risk of high blood pressure, a leading cause of chronic kidney disease. It can also directly damage the kidneys, leading to acute kidney injury or worsening chronic kidney disease.
What are some other types of kidney disease?
Other types of kidney disease include polycystic kidney disease, a genetic condition causing fluid-filled cysts on the kidneys, and lupus nephritis, an autoimmune disease attacking the kidneys.
How do genetic factors contribute to kidney disease?
Genetic factors can significantly affect certain types of kidney disease, such as polycystic kidney disease and APOL1-mediated kidney disease. Knowing one’s genetic risk can help in monitoring kidney health and seeking early intervention.
How can kidney disease be prevented?
Preventing kidney disease involves controlling diabetes and high blood pressure, avoiding certain medications, and adopting a healthy lifestyle. This includes quitting smoking, limiting alcohol, maintaining a healthy weight, and staying active.
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