FAQs

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What is Chronic Kidney Disease?

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease.

These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders.

Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life

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What causes kidney failure?

The main cause of chronic kidney disease in America is diabetes, followed by high blood pressure.

Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes.

High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease.

Long standing hypertension deteriorates the small vessels of the kidneys. As a result, there is no proper handling of the salt and fluids. This causes the accumulation of salt and fluids, and more hypertension. As the small vessels of the kidney progressively harden, the kidney progressively loses its function.

Other conditions that affect the kidneys are the following:

  • Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units. These disorders are the third most common type of kidney disease.
    • Inherited diseases, such as polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue.
    • Malformations that occur as a baby develops in its mother’s womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
    • Lupus and other diseases that affect the body’s immune system.
    • Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men.
    • Bacterial infections of the throat, urinary tact or, skin
    • Syphilis,
    • tuberculosis
    • hepatitis(B and C)
    • HIV disease
    • Antibiotics( penicillins, Sulfa, Vancomycin, etc)
    • Aspirin containing analgesics commonly used for pain
    • Non-steroidal anti-inflammatory drugs (such as Motrin, Ibuprofen, Advil, Indocin)
    • Diuretics ( hydrochlorothiazide, furosemide, etc)
    • Kidney stones
    • Tumors of the abdomen and pelvis
    • Prostatic hypertrophy in men
    • Dehydration due to excess heat exposure, nausea, vomiting or diarrhea
    • Excess exercise may cause muscle damage and this can also cause severe renal injury.
    • Protein in the urine, whether as a result of inherited or acquired diseases, may cause deterioration of renal function over time
    • In addition, malignant diseases like colon cancer, multiple myeloma, lymphoma, and renal cell carcinoma, can affect the kidneys.
    • More recently a new link of heavy smoking and kidney disease has been found as well.
Is anemia associated with kidney problems?

Yes. The kidneys produce the hormone erythropoietin. Low levels of this hormone (which may happen when the kidneys fail) generally result in anemia (low production of red cells).

Is kidney disease hereditary?

In some cases kidney condition may be hereditary. This is the case of polycystic kidney disease, which is inherited generation after generation.

Causes of Kidney Failure

What are the symptoms of chronic kidney disease or renal failure?

Most people may not have any severe symptoms until their kidney disease is advanced:

With Chronic Kidney Disease, you may experience the following:

  • High blood pressure
  • Feel more tired and have less energy
  • Have trouble concentrating
  • Have a poor appetite
  • Have trouble sleeping
  • Have muscle cramping at night
  • Have swollen feet and ankles
  • Have puffiness around your eyes, especially in the morning
  • Have dry, itchy skin
  • Need to urinate more often, especially at night
  • Poor appetite
  • Weight loss
  • Weakness
  • Trouble sleeping
  • Heart arrhythmias
  • Decreased muscle function

In the beginning, kidney failure may not produce any symptoms. Unrecognized or untreated, life-threatening circumstances can develop, however.

As kidney function decreases, symptoms related to the inability to regulate water and electrolyte balances, to clear waste products from the body, and to promote red blood cell production will appear. These symptoms will include weakness, shortness of breath and generalized swelling. Generalized weakness also can be due to anemia because lower levels of erythropoietin do not adequately stimulate the bone marrow.

As waste products build in the blood, loss of appetite, lethargy, and fatigue become apparent. This will progress to the point where mental function will decrease and coma may occur.

When the kidneys cannot address the rising acid load in the body, breathing will become more rapid

Blood pressure also may rise because of the excess fluid, and this fluid can be deposited in the lungs, causing congestive heart failure.

Metabolic acidosis, or increased acidity of the body due to the inability to manufacture bicarbonate, will alter enzyme and oxygen metabolism, causing organ failure.

Inability to excrete potassium and rising potassium levels in the serum is associated with fatal heart rhythm disturbances

Rising urea levels in the blood (uremia) can affect the function of a variety of organs ranging from the brain with alteration of thinking, to inflammation of the heart lining, to decreased muscle function because of low calcium levels.

What Diet Should I Follow if I have Kidney Disease or am on Dialysis?

If you have chronic kidney disease, diet and nutrition are important concerns. The following are general diet guidelines if you have been diagnosed with chronic kidney disease:

• Limit fluids

• Eat a low-protein diet

• Restrict salt

• Restrict

Read more about What Diet Should I Follow if I have Kidney Disease or am on Dialysis?[…]

Risk factors for kidney disease

Risk factors for kidney disease are factors that do not seem to be a direct cause of the disease, but seem to be associated in some way. Having a risk factor for kidney disease makes the chances of getting a condition higher but does not always lead to kidney disease. Also, the absence of any risk factors does not necessarily protect you against getting kidney disease.

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

  • Diabetes
  •  High blood pressure (hypertension)
  • Heart disease
  • Smoking
  • Obesity
  • High cholesterol
  • African-American, American Indian or Asian-American race
  • A family history of kidney disease
  • Age 65 or older
  • Kidney stones
  • Drug Abuse

Family history is a significant risk factor. For example a patient with HIV disease whose parents or relatives suffer from renal failure or are on dialysis have much higher risk for renal failure than the general population without the same family history. In addition, a family history of polycystic kidney disease, hepatitis B or C, HIV, increases the risk as well.

Proteinuria of any origin increases the chances of renal failure as well as the risks for cardiovascular disease. Proteinuria means the presence of an excess of serum proteins in the urine. The protein in the urine often causes the urine to become foamy. Since serum proteins are readily reabsorbed from urine, the presence of excess protein indicates either an insufficiency of absorption or impaired filtration by the kidneys. The most common cause of proteinuria is diabetes.

According to a study by the American Journal of Medicine, race as well as lower social economic level are increased factors for kidney disease. African Americans in particular have been found to be genetically linked to renal failure and its complications. African Americans, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans are three times more likely to suffer from kidney failure than Americans of European descent. Studies have also shown that the African American population fares worse after renal transplantation and have a higher mortality level once on dialysis.

How is Kidney Failure Diagnosed?

To diagnose kidney failure, blood tests are generally used to measure the buildup of waste products in the blood. The two major blood chemical levels that are measured are the “creatinine level” and the “blood urea nitrogen” (BUN) level. With kidney failure, BUN and creatinine become elevated, and the glomerular filtration rate decreases. The glomerular filtration rate is the rate with which blood is filtered through the kidneys and can be calculated based upon the creatinine level, age, race, and gender of the patient.

Doctors use a urine test, the “creatinine clearance,” to measure the level of kidney function. The patient saves urine in a special container for one full day. The waste products in the urine and in the blood are estimated by measuring the creatinine. By comparing the blood and urine level of this substance, the doctor has an accurate idea of how well the kidneys are working. This result is called the creatinine clearance.

Urine tests may also be used to measure the amount of protein, to detect the presence of abnormal cells, or to measure the concentration of electrolytes. Abdominal ultrasound can also be used to assess the size of the kidneys and to help identify whether any obstruction exists. A biopsy of the kidney may also be done to get bits of kidney tissue to examine under the microscope.

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