What is kidney disease? An expert explains – Learn more from kidney doctor Andrew Bentall, M.D. I’m Dr. Andrew Bentall, a kidney doctor at Mayo Clinic. I look after patients with kidney disease, either in the early stages, or with more advanced kidney disease considering dialysis and transplantation as treatment options.
- In this video, we’ll cover the basics of chronic kidney disease.
- What is it? Who gets it? The symptoms, diagnosis and treatment.
- Whether you are looking for answers for yourself or for someone you love, we’re here to give you the best information available.
- Chronic kidney disease is a disease characterized by progressive damage and loss of function in the kidneys.
It’s estimated that chronic kidney disease affects about one in seven American adults. And most of those don’t know they have it. Before we get into the disease itself, let’s talk a little bit about the kidneys and what they do. Our kidneys play many important roles keeping our bodies in balance.
They remove waste and toxins, excess water from the bloodstream, which is carried out of the body in urine. They helped to make hormones to produce red blood cells, and they turn vitamin D into its active form, so it’s usable in the body. There are quite a few things that can cause or put you at higher risk for chronic kidney disease.
Some of them are not things that can be avoided. Your risk is simply higher if you have a family history of certain genetic conditions like polycystic kidney disease or some autoimmune diseases like lupus or IgA nephropathy. Defects in the kidney structure can also cause your kidneys to fail, and you have an increased risk as you get older.
- Sometimes, other common medical conditions can increase your risk.
- Diabetes is the most common cause of kidney disease.
- Both type 1 and type 2 diabetes.
- But also heart disease and obesity can contribute to the damage that causes kidneys to fail.
- Urinary tract issues and inflammation in different parts of the kidney can also lead to long-term functional decline.
There are things that are more under our control: Heavy or long-term use of certain medications, even those that are common over-the-counter. Smoking can also be a contributing factor to chronic kidney disease. Often there are no outward signs in the earlier stages of chronic kidney disease, which is grouped into stages 1 through 5.
Generally, earlier stages are known as 1 to 3. And as kidney disease progresses, you may notice the following symptoms. Nausea and vomiting, muscle cramps, loss of appetite, swelling via feet and ankles, dry, itchy skin, shortness of breath, trouble sleeping, urinating either too much or too little. However, these are usually in the later stages, but they can also happen in other disorders.
So don’t automatically interpret this as having kidney disease. But if you’re experiencing anything that concerns you, you should make an appointment with your doctor. Even before any symptoms appear, routine blood work can indicate that you might be in the early stages of chronic kidney disease.
- And the earlier it’s detected, the easier it is to treat.
- This is why regular checkups with your doctor are important.
- If your doctor suspects the onset of chronic kidney disease, they may schedule a variety of other tests.
- They may also refer you to a kidney specialist, a nephrologist like myself.
- Urine tests can reveal abnormalities and give clues to the underlying cause of the chronic kidney disease.
And this can also help to determine the underlying issues. Various imaging tests like ultrasounds or CT scans can be done to help your doctor assess the size, the structure, as well as evaluate the visible damage, inflammation or stones of your kidneys.
- And in some cases, a kidney biopsy may be necessary.
- And a small amount of tissue is taken with a needle and sent to the pathologist for further analysis.
- Treatment is determined by what is causing your kidneys to not function normally.
- Treating the cause is key, leading to reduced complications and slowing progression of kidney disease.
For example, getting better blood pressure control, improved sugar control and diabetes, and reducing weight are often key interventions. However, existing damage is not usually reversible. In some conditions, treatment can reverse the cause of the disease.
So seeking medical review is really important. Individual complications vary, but treatment might include high blood pressure medication, diuretics to reduce fluid and swelling, supplements to relieve anemia, statins to lower cholesterol, or medications to protect your bones and prevent blood vessel calcification.
A lower-protein diet may also be recommended. It reduces the amount of waste your kidneys need to filter from your blood. These can not only slow the damage of kidney disease, but make you feel better as well. When the damage has progressed to the point that 85 to 90 percent of your kidney function is gone, and they no longer work well enough to keep you alive, it’s called end-stage kidney failure.
But there are still options. There’s dialysis, which uses a machine to filter the toxins and remove water from your body as your kidneys are no longer able to do this. Where possible, the preferred therapy is a kidney transplant. While an organ transplant can sound daunting, it’s actually often the better alternative, and the closest thing to a cure, if you qualify for a kidney transplant.
If you have kidney disease, there are lifestyle choices. Namely quit smoking. Consuming alcohol in moderation. If you’re overweight or obese, then try to lose weight. Staying active and getting exercise can help not only with your weight, but fatigue and stress.
- If your condition allows, keep up with your routine, whether that’s working, hobbies, social activities, or other things you enjoy.
- It can be helpful to talk to someone you trust, a friend or relative who’s good at listening.
- Or your doctor could also refer you to a therapist or social worker.
- It can also be helpful to find a support group and connect with people going through the same thing.
Learning you have chronic kidney disease and learning how to live with it can be a challenge. But there are lots of ways to help you to be more comfortable for longer before more drastic measures are needed. And even then, there is plenty of hope. If you’d like to learn even more about chronic kidney disease, watch our other related videos or visit mayoclinic.org.
- We wish you well.
- Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function.
- Your kidneys filter wastes and excess fluids from your blood, which are then removed in your urine.
- Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes and wastes to build up in your body.
In the early stages of chronic kidney disease, you might have few signs or symptoms. You might not realize that you have kidney disease until the condition is advanced. Treatment for chronic kidney disease focuses on slowing the progression of kidney damage, usually by controlling the cause.
- 0.1 How do you know if something is wrong with your kidneys?
- 0.2 Can a kidney disease be cured?
- 0.3 Can you live without kidneys?
- 1 Do kidneys heal themselves?
How do you know if something is wrong with your kidneys?
Signs of Kidney Disease –
You’re more tired, have less energy or are having trouble concentrating. A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. This can cause people to feel tired, weak and can make it hard to concentrate. Another complication of kidney disease is anemia, which can cause weakness and fatigue. You’re having trouble sleeping. When the kidneys aren’t filtering properly, toxins stay in the blood rather than leaving the body through the urine. This can make it difficult to sleep. There is also a link between obesity and chronic kidney disease, and sleep apnea is more common in those with chronic kidney disease, compared with the general population. You have dry and itchy skin. Healthy kidneys do many important jobs. They remove wastes and extra fluid from your body, help make red blood cells, help keep bones strong and work to maintain the right amount of minerals in your blood. Dry and itchy skin can be a sign of the mineral and bone disease that often accompanies advanced kidney disease, when the kidneys are no longer able to keep the right balance of minerals and nutrients in your blood. You feel the need to urinate more often. If you feel the need to urinate more often, especially at night, this can be a sign of kidney disease. When the kidneys filters are damaged, it can cause an increase in the urge to urinate. Sometimes this can also be a sign of a urinary infection or enlarged prostate in men. You see blood in your urine. Healthy kidneys typically keep the blood cells in the body when filtering wastes from the blood to create urine, but when the kidney’s filters have been damaged, these blood cells can start to “leak” out into the urine. In addition to signaling kidney disease, blood in the urine can be indicative of tumors, kidney stones or an infection. Your urine is foamy. Excessive bubbles in the urine – especially those that require you to flush several times before they go away—indicate protein in the urine. This foam may look like the foam you see when scrambling eggs, as the common protein found in urine, albumin, is the same protein that is found in eggs. You’re experiencing persistent puffiness around your eyes. Protein in the urine is an early sign that the kidneys’ filters have been damaged, allowing protein to leak into the urine. This puffiness around your eyes can be due to the fact that your kidneys are leaking a large amount of protein in the urine, rather than keeping it in the body. Your ankles and feet are swollen. Decreased kidney function can lead to sodium retention, causing swelling in your feet and ankles. Swelling in the lower extremities can also be a sign of heart disease, liver disease and chronic leg vein problems. You have a poor appetite. This is a very general symptom, but a buildup of toxins resulting from reduced kidney function can be one of the causes. Your muscles are cramping. Electrolyte imbalances can result from impaired kidney function. For example, low calcium levels and poorly controlled phosphorus may contribute to muscle cramping.
Can a kidney disease be cured?
There’s no cure for chronic kidney disease (CKD), but treatment can help relieve the symptoms and stop it getting worse. Your treatment will depend on the stage of your CKD. The main treatments are:
lifestyle changes – to help you stay as healthy as possiblemedicine – to control associated problems, such as high blood pressure and high cholesterol dialysis – treatment to replicate some of the kidney’s functions, which may be necessary in advanced (stage 5) CKD kidney transplant – this may also be necessary in advanced (stage 5) CKD
What is the first stage of kidney failure?
What is Stage 1 CKD? – In Stage 1 CKD, the damage to your kidneys is mild. Your kidneys are still working well, but you may have signs of kidney damage or physical damage to your kidneys. Stage 1 CKD means you have a normal estimated glomerular filtration rate (eGFR) of 90 or greater, but there is protein in your urine (i.e., your pee). The presence of protein alone means you are in Stage 1 CKD. At stage 1 CKD, you may not notice any effects on your health. While the damage to your kidneys may not be reversible, there is a lot you can do at this stage to keep your kidneys working well for as long as possible.
What is the main cause for kidney disease?
Diabetes and high blood pressure are the most common causes of chronic kidney disease (CKD). Your health care provider will look at your health history and may do tests to find out why you have kidney disease. The cause of your kidney disease may affect the type of treatment you receive.
What is mild kidney disease?
Stage 1 of CKD Stage 1 CKD means you have a normal eGFR of 90 or greater and mild damage to your kidneys. Your kidneys are still working well, so you may not have any symptoms. You may have other signs of kidney damage, such as protein in your urine.
Can you live without kidneys?
Can you live without kidneys? – Because your kidneys are so important, you cannot live without them. But it is possible to live a perfectly healthy life with only one working kidney.
Do kidneys heal themselves?
Kidney damage in acute kidney failure can be reversed with hospitalization and lifestyle modifications. However, chronic kidney failure is often irreversible Kidney damage is divided into two types:
Acute kidney disease or acute kidney failure : Damage has occured in a short period, such as in hours or a few days Chronic kidney disease or chronic kidney failure : Damage has occured over several months or years
While a damaged kidney typically can’t repair itself, the condition can be treated if caught early. Acute kidney failure can be reversed with prompt hospitalization, although the recovery process can take weeks to months and requires regular monitoring, diet modifications, and medications.
What is the best indicator of kidney disease?
Article Sections – The Kidney Disease Outcome Quality Initiative of the National Kidney Foundation published clinical practice guidelines on chronic kidney disease in February 2002. Of the 15 guidelines, the first six are of greatest relevance to family physicians.
Part II of this two-part review covers guidelines 4, 5, and 6. Glomerular filtration rate is the best overall indicator of kidney function. It is superior to the serum creatinine level, which varies with age, sex, and race and often does not reflect kidney function accurately. The glomerular filtration rate can be estimated using prediction equations that take into account the serum creatinine level and some or all of specific variables (age, sex, race, body size).
In many patients, estimates of the glomerular filtration rate can replace 24-hour urine collections for creatinine clearance measurements. Urine dipsticks generally are acceptable for detecting proteinuria. To quantify proteinuria, the ratio of protein or albumin to creatinine in an untimed (spot) urine sample is an accurate alternative to measurement of protein excretion in a 24-hour urine collection.
- Patients with persistent proteinuria have chronic kidney disease.
- Other techniques for evaluating patients with chronic kidney disease include examination of urinary sediment, urine dipstick testing for red and white blood cells, and imaging studies of the kidneys (especially ultrasonography).
- These techniques also can help determine the underlying cause of chronic kidney disease.
Family physicians should weigh the value of the National Kidney Foundation guidelines for their clinical practice based on the strength of evidence and perceived cost-effectiveness until additional evidence becomes available on the usefulness of the recommended quality indicators.
In February 2002, the Kidney Disease Outcome Quality Initiative (K/DOQI) of the National Kidney Foundation (NKF) published clinical practice guidelines for chronic kidney disease 1, 2 that were based on a systematic literature review. A uniform format for summarizing strength of evidence was developed based on an evaluation of study size, applicability, results, and methodologic quality.
Guideline statements were prepared from the analysis of the review, with each rationale statement graded according to the supporting level of evidence ( Table 1 ).1 The evidence grading system differs from the system used in American Family Physician (AFP) : only AFP’ s evidence level C (consensus/expert opinion) compares with the NKF grade O (opinion).
- Part I 3 of this two-part article reviewed the guidelines on definition and stages of chronic kidney disease, evaluation and treatment, and risk factor identification.
- Chronic kidney disease is defined by kidney damage (often manifested by proteinuria) or a decreased glomerular filtration rate (GFR) for three or more months.
The degree of decrease in the GFR provides the basis for straightforward classification of chronic kidney disease by stages (see Table 3 in part 1 3 ). Treatment should focus on slowing disease progression and preventing complications, especially the development of cardiovascular disease.
Can you have kidney disease and feel fine?
What are the first warning signs of kidney failure? – Many people experience few or no symptoms in the early stages of kidney disease. However, chronic kidney disease (CKD) may still cause damage even though you feel fine. CKD and kidney failure symptoms vary between people. If your kidneys aren’t working properly, you may notice one or more of the following signs:
Extreme tiredness ( fatigue ). Nausea and vomiting, Confusion or trouble concentrating. Swelling ( edema ), particularly around your hands, ankles or face. Peeing more often. Cramps ( muscle spasms ). Dry or itchy skin. Poor appetite or food may taste metallic.