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Chronic Kidney Disease

The kidneys filter out excess fluids and waste products from the blood. They also play an important role in maintaining the body’s electrolyte balance, controlling blood pressure and stimulating the production of red blood cells. Chronic kidney failure occurs when there is a progressive decrease in kidney function over time. It is also known as chronic kidney/renal failure.

The most common causes of chronic kidney disease are diabetes and high blood pressure. However, chronic kidney failure can also be caused due to high cholesterol levels, kidney infections, glomerulonephritis (inflammation of the kidney’s filtering units) and blockage in the flow of urine (due to enlarged prostate).

Signs and symptoms

Most of the people do not experience the symptoms until the extent of kidney damage becomes advanced. Symptoms associated with chronic kidney disease include:

  1. Decreased urine output
  2. Frequent urge to urinate (especially at night)
  3. Nausea
  4. Unusual tiredness
  5. Loss of appetite
  6. Hypertension (high blood pressure)
  7. Sleep problems
  8. Swollen ankles, feet or hands (edema)
  9. Persistent itching
  10. Muscle cramps

Diagnosis of chronic kidney disease

Blood and urine tests are the primary tests to assess the kidney function.

Blood test

A sample of your blood would be collected to assess the following:

  1. Serum Creatinine level: Creatinine is a waste product which is normally excreted through urine. When the kidneys don’t function well, creatinine is not filtered, and its level rises in blood.
  2. Blood urea nitrogen level: Urea is a waste product formed due to the breakdown of proteins. When the kidneys don’t function well, urea is not filtered, and its level rises in blood.
  • Glomerular filtration rate: GFR indicates how well the kidneys are removing wastes and excess fluid from the blood. Fall in the GFR means that the kidneys function is impaired.
Parameter Normal Values Interpretation
Serum Creatinine Male – ≤1.4mg/dl

Female – ≤1.2mg/dl

Increase serum creatinine levels would indicate decrease in kidney function
Blood Urea Nitrogen(BUN) 7-20mg/dl Increase BUN levels would indicate a decrease in kidney function.
Glomerular Filtration Rate(GFR) ≥90mg/dl Decrease in GFR indicates kidney failure

30-44mg/dl- moderate to severe decline in kidney function

<15mg/dl- severe decline in kidney function

 

Urinalysis: Your urine sample would be collected to assess the following:

  1. pH of urine: Abnormal ranges of urine pH may be due to renal infection, renal stone or other kidney disorders.
  2. Blood: Blood in the urine may indicate a serious kidney problem and needs further investigation.
  3. Albumin: Albumin is a protein that cannot be passed through the urine. When there is damage to the filtering units of the kidneys, albumin can be traced in your urine. Therefore, the presence of albumin in urine would indicate kidney dysfunction.
  4. White blood cells: Increased levels of white blood cells in the urine indicates infection.

 

Parameter Normal Values Interpretation
Urine pH 5.5-7.5 pH>7.5 may indicate infection
Blood ≤3 RBCs Indicates kidney dysfunction
Protein(albumin) ≤150 mg/d Increase would indicate serious renal dysfunction
WBC ≤2-5 WBCs/hpf Increase would indicate infection

Hpf- High power field

Imaging tests: Imaging tests like ultrasound, CT- scan and MRI help to visualize the kidney and assess the location and severity of damage. These tests help in detection of obstructions in the kidney. They also help to detect structural abnormalities and alterations in the position of the kidneys.

Kidney biopsy: In this procedure, a small portion of the kidney is sliced using a needle and is examined under a microscope. The biopsy results can help to find out the underlying cause of chronic kidney disease and to detect cancer.

How to treat chronic kidney disease?

Early detection and treatment of chronic kidney disease prevent from worsening of the condition.

Medications: Some of the common complications associated with chronic kidney disease are hypertension, anemia, and edema. Drugs like ACE inhibitors, angiotensin II receptor blockers (ARBs) and diuretics help in controlling high blood pressure. Erythropoietin and iron supplements are used for treating anemia. Diuretic medications can prevent edema in chronic renal failure.

Dialysis: Dialysis is a procedure where waste materials and extra fluids are filtered out from the patient’s blood using an external machine. The doctor recommends dialysis procedure when the kidney function is severely impaired. Dialysis are of two types, hemodialysis is a procedure where a machine filters out excess fluids and waste materials from your blood and in peritoneal dialysis, a catheter is inserted into your abdominal cavity, which filters the waste products and excess fluids.

 

Kidney transplantation: Kidney transplantation is a surgical procedure where a diseased kidney is replaced by a healthy kidney, which is obtained from a donor. A kidney transplant is recommended when the patient has severe kidney failure and when the patients stops responding to other treatments.

Complications

  • Chronic renal failure decreases the immune response, which in turn may increase susceptibility to infections.
  • Increased potassium levels in your blood could impair your heart function.
  • Chronic kidney disease can cause damage to your nervous system.
  • Fluid retention can develop pulmonary edema (fluid in the lungs) or swelling in your arms and legs.
  • Bones become weak eventually and there is an increased risk of bone fractures.
  • Kidney disease could lead to anemia (due to decreased production of erythropoietin).

Preventive measures

  • Maintain a healthy weight to reduce the risk of diabetes, blood pressure, and heart disease.
  • Reduce the salt intake as it could lead to hypertension and increase the functional load on the kidneys.
  • Avoid smoking as it can lead to atherosclerosis, which results in decreased blood flow to the kidney and increased blood pressure.
  • Maintain the blood sugar levels by limiting sugar intake, exercise, and medications.

Why choose Apollo Diagnostics?

We have the expertise of 34 + years in healthcare. Our labs are equipped with EQUAS (External Quality Assurance System) and loaded with full automated machines to ensure error free reports, with a quick turnaround time, and at an affordable price. For your convenience, we offer free home collection of samples.

For appointments, please call 4444 2424.

Reference

  1. Chronic kidney disease. https://medlineplus.gov/chronickidneydisease.html . Accessed on 31-10-2017
  2. Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521 . Accessed on 31-10-2017
  3. Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/diagnosis-treatment/drc-20354527 . Accessed on 01-11-2017
  4. Complications. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521 . Accessed on 31-10-2017
  5. Chronic kidney disease – prevention. https://www.webmd.com/a-to-z-guides/tc/chronic-kidney-disease-prevention . Accessed on 31-10-2017


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