Are you concerned about your kidneys? Everything you need to know about Chronic Kidney Disease

Have you ever thought that our kidneys are like two super filters? Yes, that's exactly what happens. The main job of the kidneys is to filter out the unwanted waste products, toxins, and excess water in our blood. But sometimes this filter gets damaged and stops working properly. This gradual decline in kidney function over time is what we call Chronic Kidney Disease (CKD) .

Simply put, what is chronic kidney disease (CKD)?

Imagine that your home water filter is slowly becoming clogged. At first, you won't notice much difference, but over time, the water flow slows down and the taste of the water changes. That's what happens when your kidneys are damaged.

When the kidneys are damaged, they are unable to properly filter and remove waste products from the blood. These waste products then start to accumulate in the blood. The word "chronic" is used because this condition develops over time. This is not a disease that develops overnight.

What really happens to our kidneys?

We have two kidneys. These bean-shaped organs are located on our backs, on either side of our spine, just below our rib cage. The size of a single kidney is about the size of the palm of our hand. Although their main job is to filter the blood, they also perform many other important functions.

• Blood purification: Waste products, toxins, and excess water in the blood are excreted as urine.
• Balancing salts and minerals: Helps maintain the right amount of electrolytes (salts) needed by the body, such as sodium and potassium.
• Hormone production: Hormones that control blood pressure and hormones that make red blood cells are produced by the kidneys.
• Keeps bones strong: Vitamin D activates and helps keep bones strong.

If these things aren't done properly, waste products accumulate in the body and we become sick.

What are the 5 stages of kidney disease?

Doctors, there is a measure of how well your kidneys are working. It is called GFR (Glomerular Filtration Rate) . Simply put, this measures how many milliliters of blood your kidneys filter per minute. This GFR value is used to divide the disease into five stages. This value can be found through blood and urine tests.

What are the symptoms of this disease?

The biggest problem with this disease is that it doesn't show any symptoms in the early stages . It can take years for the waste to build up in the body and show symptoms. That's why many people don't know they have this disease. As the disease progresses, you may experience things like:

• Needing to urinate frequently.
• Feeling very tired and lifeless.
• The food is tasteless.
• Swelling of the hands, feet, and ankles.
• Difficulty breathing.
• Foamy (bubbly) urine.
• Swelling under the eyes.
• Dry and itchy skin.
• Difficulty concentrating on something.
• Insomnia.
• Tingling in some parts of the body.
• Nausea or vomiting.
• Muscle cramps.
• Increased blood pressure.
• Darkening of the skin.

These symptoms can also occur in other diseases, so if you experience anything like this, the best thing to do is to see your doctor for advice.

What are the main causes of kidney disease?

This disease occurs when the kidneys are damaged and no longer function properly. In chronic kidney disease, this damage occurs gradually, over many years. There are two main reasons for the development of this disease in Sri Lanka and around the world.

1. High Blood Pressure: When blood pressure increases, the delicate blood vessels that supply blood to the kidneys are damaged. Over time, this damage reduces the kidneys' ability to filter blood.

2. Diabetes: When blood sugar levels increase, it also damages the fine filtering units (glomeruli) in the kidneys.

In addition to these two main reasons, there may be many other reasons.

Who is most at risk?

Anyone can develop chronic kidney disease. However, you are at higher risk if you have any of the following:

• If you have diabetes.
• If you have high blood pressure.
• If you have heart disease.
• If anyone in the family has had kidney disease.
• If you are over 60 years old.
• If you have been taking painkillers (NSAIDs) , that is, certain types of painkillers that you can buy at the pharmacy, for a long time.

How to diagnose the disease?

When you go to see a doctor, he or she will ask about your medical history, family history, medications you take, and symptoms you're experiencing. Then, they will perform a physical exam and order several blood and urine tests to check your kidney function.

• Blood tests: These mainly look at your GFR and serum creatinine levels. Creatinine is a waste product produced by our muscles. Healthy kidneys excrete it in the urine. When the kidneys fail, creatinine builds up in the blood.
• Urine tests: This checks for protein (albumin) or blood in the urine. Healthy kidneys do not allow these things to pass into the urine.

Sometimes, something like an ultrasound scan may be done to check the size and shape of the kidneys. Or, a kidney biopsy may be done, which involves taking a very small piece of the kidney and examining it.

How is it treated?

Chronic kidney disease cannot be completely cured. But we can reduce the damage to the kidneys and keep them functioning at a good level for as long as possible. Here are some things to do.

Lifestyle changes

• Visit your doctor regularly: Visit your nephrologist on scheduled dates and get the necessary tests done.
• Diabetes and blood pressure control: If you have diabetes or high blood pressure, control them well.
• Avoid medications that are harmful to the kidneys: Do not continue to take painkillers, especially without the advice of a doctor.
• Kidney-friendly diet: This is very important. You will be advised to reduce salt (sodium), potassium, limit protein intake, and eat foods low in cholesterol.
• Avoid smoking.
• Exercise: Exercise for 30 minutes a day, at least 5 days a week.
• Maintain a healthy weight.

Medicines

Depending on your condition, your doctor may prescribe various medications. For example:

• Blood pressure lowering medications (ACE inhibitors, ARBs).
• Diuretics are medicines that remove excess water from the body.
• Cholesterol-lowering medication.
• If you have anemia, take medications that help produce red blood cells.
• Things like vitamin D to prevent bone weakness.

What to do if the kidneys fail completely (End-Stage Kidney Disease)?

If the disease reaches stage 5, which means complete kidney failure, you will have to resort to other methods to survive. There are two main options for that.

1. Dialysis: Dialysis is the process of cleaning the blood that the kidneys are unable to do with the help of a machine.

• Hemodialysis: This is where your blood is sent to a machine, where waste products are removed and then returned to your body. This is usually done three times a week, for about 4 hours each time.
• Peritoneal Dialysis: In this, a special fluid is injected through a tube placed in your abdomen. After the fluid absorbs waste products from your body, it is then removed through the same tube. This can be done at home, without going to the hospital.

2. Kidney Transplant: The surgical replacement of a damaged kidney with a healthy kidney. This can be done from a living person (usually a family member) or from a deceased person (organ donor).

Chronic Kidney Disease, CKD, Kidney Failure, Dialysis, GFR, Creatinine, Kidney Transplant