CKD – Chronic Kidney Disease – A Silent Epidemic
Courtesy Recover Health, Recover Health, Linn County LIVING WELL Magazine
The kidneys are a pair of bean-shaped organs that lie on either side of the spine in the lower middle of the back. Each kidney weighs about ¼ pound and contains approximately one million filtering units called nephrons. The main function of the kidneys is to remove waste products and excess water from the blood. The kidneys prevent the toxic byproducts from normal metabolic process from building up to harmful levels. The kidneys process about 200 liters of blood every day and produce about 2 liters of urine.
Chronic kidney disease (CKD) occurs when one suffers from gradual and usually permanent loss of kidney function over time. This happens gradually, usually months to years. In the U.S., more than 10% of people, or more than 20 million, aged 20 years or older have CKD.
CKD is usually an irreversible and progressive disease and can lead to kidney failure, also called end stage renal disease (ESRD), over time if it is not treated. End stage renal disease (ESRD) occurs when the kidneys are no longer able to provide waste removal functions for the body. At this point, dialysis or kidney transplantation becomes necessary for survival. While CKD is more common among women, men with CKD are 50% more likely than women to progress to kidney failure. There is a significant racial disparity in the prevalence of ESRD in different ethnic groups. African Americans were nearly four times more likely to develop ESRD than whites. Hispanics have 1.5 times the rate of kidney failure compared to non-Hispanic whites.
Adults with diabetes or hypertension are at an increased risk of developing CKD. It is estimated that CKD is present in more than 35% of people with diabetes and 20% of people with hypertension. Other risk factors for developing CKD include cardiovascular disease, obesity, elevated cholesterol, kidney stones, prostate problems, autoimmune diseases, urinary obstruction and a family history of CKD. Repeated episodes of acute kidney injury from a variety of causes (infections, anti-inflammatory drugs like Aleve/Advil, or toxins injurious to the kidney) can also contribute to progression of CKD to kidney failure. The risk of developing CKD increases with age largely because risk factors for kidney disease become more common as one ages.
CKD does not cause any symptoms in most people until the disease is fairly advanced. This makes early diagnosis of CKD difficult. This is called the “silent” phase of the disease. As the kidney function gets progressively worse symptoms become more apparent. Common symptoms include decrease in amount of urination, night time urination urge, fluid buildup, fatigue, bone pain and fractures, loss of weight and appetite, numbness in the feet or hands, nausea, trouble sleeping, restless legs and trouble thinking clearly. There is no cure for chronic kidney disease. The four goals of therapy are to: slow the progression of disease; treat underlying causes and contributing factors; treat complications of disease; and replace lost kidney function. When someone is diagnosed with end stage kidney stage (ESRD), they have two choices: start dialysis or get a transplant. Dialysis is a process that filters a person’s blood when their kidneys fail. It is not a cure, but it can help control most of the symptoms of ESRD. Kidney transplant is a better choice, as transplant patients lead much healthier lives compared to patients on dialysis. However, there is nationwide shortage of organ donors. The waiting period can range from three to five years for a kidney that is a good match for a person’s blood and tissue type. Transplanted patients have to take lifelong immune suppressing medicines in order to prevent rejection. This reduces their immunity levels and exposes them to opportunistic infections periodically.
The most efficient way to reduce the burden of CKD is to prevent and treat its risk factors. Screening individuals at high risk for CKD (people older than 50 years; people with a history of diabetes mellitus, hypertension, cardiovascular disease; or people who have a family history of CKD) may prevent or delay kidney failure. The only ways for early detection of CKD are through a blood test to estimate kidney function (creatinine level) and a urine test to detect protein and blood leakage to assess kidney damage. The leakage of blood in urine is more often microscopic and undetectable to the naked eye.
It is important to discuss with your family doctor about your risk factors for chronic kidney disease and also to find out what you can do to prevent it. Nowhere is the proverb “prevention is better than cure” more applicable than in this disease.
For more information contact Recover Health at 319-373-6294.
