Kidney Disease: Causes, Symptoms, and Treatment

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.

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.”

¹¹¹³¹²

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.

“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.

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.

“Early nephrology referral for patients at increased risk of ESRD is linked to improved patient-centered outcomes and reduced mortality.”

²⁷

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

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.

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