Daily Health Tips: Trusted Medical Information, Health Tips and Advices

Chronic kidney disease cannot be prevented in most situations. You may be able to protect your kidneys from damage, or slow the progression of the disease by controlling your underlying conditions such as diabetes mellitus and high blood pressure. Kidney disease is usually advanced by the time symptoms appear. If you are at high risk of developing chronic kidney disease, see your health care practitioner as recommended for screening tests. If you have a chronic condition such as diabetes, high blood pressure, or high cholesterol, follow the treatment recommendations of your health care practitioner. See your healthcare practitioner regularly for monitoring. Aggressive treatment of these diseases is essential. Avoid exposure to drugs especially NSAIDs (nonsteroidal antiinflammatory drugs), chemicals, and other toxic substances as much as possible.

Follow-up If you have chronic kidney disease, your health care practitioner will recommend a schedule of regular follow-up visits. At these visits, your underlying condition and your kidney status will be evaluated. You will have regular blood and urine tests and possibly imaging studies as part of this ongoing evaluation.

Kidney Transplantation offers the best outcomes and the best quality of life. Successful kidney transplants occur every day in the United States. Transplanted kidneys may come from living related donors, living unrelated donors, or people who have died of other causes (cadaveric donors). In people with type I diabetes, a combined kidney-pancreas transplant is often a better option. However, not everyone is a candidate for a kidney transplant. People need to undergo extensive testing to ensure their suitability for transplantation. Also, there is a shortage of organs for transplantation, requiring waiting times of months to years before getting a transplant. A person who needs a kidney transplant undergoes several tests to identify characteristics of his or her immune system. The recipient can accept only a kidney that comes from a donor who matches certain of his or her immunologic characteristics. The more similar the donor is in these characteristics, the greater the

In end-stage kidney disease, kidney functions can be replaced only by dialysis or by kidney transplantation. The planning for dialysis and transplantation is usually started in Stage 4 of chronic kidney disease. Most patients are candidates for both hemodialysis and peritoneal dialysis (see below). There are few differences in outcomes between the two procedures. Your physician or an educator will discuss the appropriate options with you and help you make a decision that will match your personal and medical needs. It is best to choose your modality of dialysis after understanding both procedures and matching them to your lifestyle, daily activities, schedule, distance from the dialysis unit, support system, and personal preference. Your doctor will consider multiple factors when recommending the appropriate point to start dialysis, including your laboratory work and your actual or estimated glomerular filtration rate, nutritional status, fluid volume status, the presence

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. Strategies for slowing progression and treating conditions underlying chronic kidney disease include the following: Control of blood glucose: Maintaining good control of diabetes is critical. People with diabetes who do not control their blood glucose have a much higher risk of all complications of diabetes, including chronic kidney disease. Control of high blood pressure: This also slows progression of chronic kidney disease. It is recommended to keep your blood pressure below 130/80 mm Hg if you have kidney disease. It is often useful to monitor blood pressure at home. Blood pressure medications known as angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) have special benefit in protecting the ki

Chronic kidney disease is a disease that must be managed in close consultation with your health care practitioner. Self-treatment is not appropriate. There are, however, several important dietary rules you can follow to help slow the progression of your kidney disease and decrease the likelihood of complications. This is a complex process and must be individualized, generally with the help of your health care practitioner and a registered dietitian. The following are general dietary guidelines: Protein restriction: Decreasing protein intake may slow the progression of chronic kidney disease. A dietitian can help you determine the appropriate amount of protein for you. Salt restriction: Limit to 4-6 grams a day to avoid fluid retention and help control high blood pressure. Fluid intake: Excessive water intake does not help prevent kidney disease. In fact, your doctor may recommend restriction of water intake. Potassium restriction: This is necessary in

Chronic kidney disease usually causes no symptoms in its early stages. Only lab tests can detect any developing problems. Anyone at increased risk for chronic kidney disease should be routinely tested for development of this disease. Urine, blood, and imaging tests (X-rays) are used to detect kidney disease, as well as to follow its progress. All of these tests have limitations. They are often used together to develop a picture of the nature and extent of the kidney disease. In general, this testing can be performed on an outpatient basis. Urine Tests Urinalysis: Analysis of the urine affords enormous insight into the function of the kidneys. The first step in urinalysis is doing a dipstick test. The dipstick has reagents that check the urine for the presence of various normal and abnormal constituents including protein. Then, the urine is examined under a microscope to look for red and white blood cells, and the presence of casts and crystals (solids).

Several signs and symptoms may suggest complications of chronic kidney disease. Call your health care practitioner if you notice any of the following symptoms: Change in energy level or strength Increased water retention (puffiness or swelling) in the legs, around the eyes, or in other parts of the body Shortness of breath or change from normal breathing Nausea or vomiting Lightheadedness Severe bone or joint pain Easy bruising Itching If you have diabetes, high blood pressure, or kidney problems, see your health care practitioner right away if you know or suspect that you are pregnant. See your health care practitioner as recommended for monitoring and treatment of chronic conditions such as diabetes, high blood pressure, and high cholesterol. The following signs and symptoms represent the possibility of a severe complication of chronic kidney disease and warrant a visit to the nearest hospital emergency department. Change in level of cons

The kidneys are remarkable in their ability to compensate for problems in their function. That is why chronic kidney disease may progress without symptoms for a long time until only very minimal kidney function is left. Because the kidneys perform so many functions for the body, kidney disease can affect the body in a large number of different ways. Symptoms vary greatly. Several different body systems may be affected. Notably, most patients have no decrease in urine output even with very advanced chronic kidney disease. Effects and symptoms of chronic kidney disease include; need to urinate frequently, especially at night (nocturia); swelling of the legs and puffiness around the eyes (fluid retention); high blood pressure; fatigue and weakness (from anemia or accumulation of waste products in the body); loss of appetite, nausea and vomiting; itching, easy bruising, and pale skin (from anemia); shortness of breath from fluid accumulation in the lungs

Although chronic kidney disease sometimes results from primary diseases of the kidneys themselves, the major causes are diabetes and high blood pressure. Type 1 and Type 2 diabetes mellitus cause a condition called diabetic nephropathy, which is the leading cause of kidney disease in the United States. High blood pressure (hypertension), if not controlled, can damage the kidneys over time. Glomerulonephritis is the inflammation and damage of the filtration system of the kidneys, which can cause kidney failure. Postinfectious conditions and lupus are among the many causes of glomerulonephritis. Polycystic kidney disease is an example of a hereditary cause of chronic kidney disease wherein both kidneys have multiple cysts. Use of analgesics such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) regularly over long durations of time can cause analgesic nephropathy, another cause of kidney disease. Certain other medications can also damage the kidneys

Normal Kidneys and Their Function 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. Each nephron is made of a glomerulus and a tubule. The glomerulus is a miniature filtering or sieving device while the tubule is a tiny tube like structure attached to the glomerulus. The kidneys are connected to the urinary bladder by tubes called ureters. Urine is stored in the urinary bladder until the bladder is emptied by urinating. The bladder is connected to the outside of the body by another tube like structure called the urethra. The main function of the kidneys is to remove waste products and excess water from the blood. The kidneys process about 200 liters of blood every day and produce about two liters of urine. The waste products are generated from normal metabolic processes including the breakdown of ac