Don’t let kidney disease sneak up on you

The kidneys are a pair of bean-shaped organs on either side of your spine, below your ribs and behind your belly, roughly the size of a large fist. The kidneys’ job is to filter or clean your blood. They remove wastes, control the body’s fluid balance, and keep the right levels of electrolytes.

All of the blood in your body passes through them several times a day. The process starts with blood coming into the kidney, waste gets removed, and salt, water and minerals are adjusted, if needed. The filtered blood goes back into the body. Waste gets turned into urine, which collects in the kidney’s pelvis, a funnel-shaped structure that drains down a tube called the ureter to the bladder

Each kidney has around a million tiny filters called nephrons. You could have only 10% of your kidneys working, and you may not notice any symptoms or problems. If blood stops flowing into a kidney, part or all of it could die. That can lead to kidney failure.

Chronic kidney failure is the gradual loss of kidney function described above. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which could kill you if artificial filtering (dialysis) or a kidney transplant is not done.

If you have a medical condition that increases your risk of kidney disease, your doctor is likely to monitor your blood pressure and kidney function with urine and blood tests during regular doctor visits. Ask your doctor whether these tests are necessary for you.

Make an appointment with your doctor if you have any signs or symptoms of kidney disease. Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

Picture: iStock

Symptoms

Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include:

• Nausea.
• Vomiting.
• Loss of appetite.
• Fatigue and weakness.
• Sleep problems.
• Changes in how much you urinate.
• Decreased mental sharpness.
• Muscle twitches and cramps.
• Swelling of feet and ankles.
• Persistent itching.
• Chest pain, if fluid builds up around the lining of the heart.
• Shortness of breath, if fluid builds up in the lungs.
• High blood pressure (hypertension) that’s difficult to control.

Causes

Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years. Diseases and conditions that cause chronic kidney disease include:

Type 1 or type 2 diabetes

• High blood pressure.
• Glomerulonephritis), an inflammation of the kidney’s filtering units (glomeruli).
• Interstitial nephritis, an inflammation of the kidney’s tubules and surrounding structures.
• Polycystic kidney disease.
• Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers.
• Vesicoureteral reflux, a condition that causes urine to back up into your kidneys.
• Recurrent kidney infection, also called pyelonephritis.

AFP/Philippe Huguen

Risk factors

Factors that may increase your risk of chronic kidney disease include:

• Diabetes.
• High blood pressure.
• Heart and blood vessel (cardiovascular) disease.
• Smoking.
• Obesity.
• Family history of kidney disease.
• Abnormal kidney structure.
• Older age.

Complications

Chronic kidney disease can affect almost every part of your body. Potential complications may include:

• Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary oedema).
• A sudden rise in potassium levels in your blood (hyperkalaemia), which could impair your heart’s ability to function and may be life-threatening.
• Heart and blood vessel (cardiovascular) disease.
• Weak bones and an increased risk of bone fractures.
• Anaemia.
• Decreased sex drive, erectile dysfunction or reduced fertility.
• Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures.
• Decreased immune response, which makes you more vulnerable to infection.
• Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium).
• Pregnancy complications that carry risks for the mother and the developing foetus.
• Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival.

Picture: iStock

Prevention

To reduce your risk of developing kidney disease:

Follow instructions on over-the-counter medications. When using nonprescription pain relievers, such as aspirin and brufen, follow the instructions on the package. Taking too many pain relievers could lead to kidney damage and generally should be avoided if you have kidney disease. Ask your doctor whether these drugs are safe for you.

Maintain a healthy weight. If you’re at a healthy weight, work to maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss. Often, this involves increasing daily physical activity and reducing calories.

Don’t smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you’re a smoker, talk to your doctor about strategies for quitting smoking. Support groups, counselling and medications can all help you to stop.

Manage your medical conditions with your doctor’s help. If you have diseases or conditions that increase your risk of kidney disease, like hypertension and diabetes, work with your doctor to control them.

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