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Kidney Disease

Sometimes the kidneys become unable to perform their life-maintaining functions because of disease or physical damage. The kidneys are not able to remove extra water and waste products from the blood, causing you to feel sick. This is known as kidney or renal failure and it can be either acute or chronic.

Acute Renal Failure is sudden, severe damage to or loss of kidney function. Acute renal failure can be caused by severe infections, extensive burns, chemical or drug poison, and injury or blockage to the kidneys. This condition can usually be reversed when the source of the problem is eliminated. People with acute renal failure sometimes go on dialysis temporarily until their kidneys recover.

There are several terms which you may hear that describe kidney disease. They are Chronic Renal Failure or “CRF”, Chronic Renal Insufficiency or “CRI”, and pre-End Stage Renal Disease or “pre-ESRD”. These terms will be used when you have kidney disease but have not received a transplant or started dialysis therapy. Chronic renal failure is a condition that cannot be reversed or cured. There are different stages of chronic renal failure. The degree of failure is measured by blood and urine tests.

The term End Stage Renal Disease or “ESRD” is used when you have begun dialysis therapy, need a kidney transplant, or have received a transplant.

Some signs of kidney failure are:

Extreme tiredness
Nausea and vomiting
Shortness of breath
Difficulty sleeping
Swelling in the hands, face, and feet
Loss of appetite
Itchiness
High blood pressure

Some symptoms or signs are due to the buildup of waste products in the bloodstream that are harmful to the body. This buildup is called uremia. Symptoms may also be due to the buildup of excess fluid in the body.

Some people with chronic renal failure may keep urinating. Even if you urinate, the amount of waste products in the urine is low and will continue to build up in the blood without treatment. Periodically, you may be asked to collect your urine over a 24-hour span of time and have a blood test. Your doctor will review these tests, with particular interest in creatinine and urea. The results enable your doctor to see how much kidney function remains and set your fluid intake guidelines.

Kidney disease progresses in stages and can continue in its early stages for many years without showing any obvious symptoms. As your kidneys stop working, you may feel symptoms of kidney failure. This is why it is so important that you have a nephrologist oversee your medical care. These stages are determined by your glomerular filtration rate (GFR), which is a measurement of kidney function.

The stages of kidney disease are classified as follows:

Stage GFR Description
1 90 cc/min/1.73m² Kidney damage with normal or high GFR
2 60 – 89 cc/min/1.73m² Kidney damage with mild decreased GFR
3 30 – 59 cc/min/1.73m² Moderately decreased GFR
4 15 – 29 cc/min/1.73m² Severely decreased GFR
5 Less than 15 cc/min/1.73m² Kidney Failure

There are many diseases that can directly or indirectly cause chronic renal failure. Two major causes are Diabetes and High Blood Pressure.

Some of the other causes of kidney failure are:

Glomerulonephritis
Arteriosclerosis
Congenital abnormalities of urinary system
Obstructions of urinary system
Toxins
Polycystic kidney disease
Infection
Kidney stones
Trauma (physical injury)
Ask your doctor for more information about the causes of renal failure.

The Importance of Early Diagnosis and Treatment for Kidney Disease
When it comes to kidney disease, getting a diagnosis, and putting yourself under a doctor’s care is very important. The quicker you get diagnosed and start therapy, the better you will feel. Diet and medications are important treatments for kidney failure. In the early stages of kidney disease, simple diet changes can help you feel better. Your nephrologist and dietitian will construct a diet to help preserve your kidney function. Your nephrologist may also order medications to help problems such as blood pressure control and water removal.

Once kidney function is lost, it may not come back. Symptoms will continue without medical intervention. Anything you can do, under your doctor’s care, to slow down this loss of kidney function is worth doing. Learn as much as you can. Work closely with your healthcare team. Your medical team, including your primary care physician and nephrologist, will help guide you through the stages of kidney disease. Kidney disease must not be left untreated.

When your kidneys no longer function enough on their own to maintain your health, you will need medical treatment. Medical treatment may include either a kidney transplant or dialysis. Click on treatment options for this information.

Steps to potentially Slow Down the progression of Kidney Disease

See your doctor regularly, detecting kidney disease early is key
Work with your doctor & health care team.
If you are a diabetic, always maintain good blood sugar control.
Take your high blood pressure medication as prescribed by your doctor.
Follow medication & diet changes given to you by your doctor.
Take an active role in your care. Learn about your disease and it’s treatments.