Chronic Kidney Disease

 

What Increases Your Risk
There are four main risk factors for the development of chronic kidney disease.

Risk factors you cannot control

  • Age. The kidney begins to get smaller at about age 35. By age 80 most people have lost about 30% of their kidney mass.
  • Race. Both African-Americans and Native Americans are more likely to develop chronic kidney disease.
  • Gender. Men have a higher risk for developing chronic kidney disease than women.
  • Family history. Family history is a factor in the development of both diabetes and high blood pressure, the major causes of chronic kidney disease. Polycystic kidney disease is one of several inherited diseases that cause kidney failure.
Cause

The cause of kidney disease is not always known. However, many conditions and diseases can damage kidneys and lead to chronic kidney disease.
  • Diabetes causes about 35% of all chronic kidney disease. High blood sugar levels caused by diabetes damage blood vessels in the kidneys. If the blood sugar level remains high, this damage gradually reduces the function of the kidneys.
  • High blood pressure (hypertension) causes another 30% of all kidney disease. Because blood pressure often rises with chronic kidney disease, high blood pressure may further damage kidney function even when another medical condition initially caused the disease.
  • Glomerulonephritis is the third most common cause of chronic kidney disease. Glomerulonephritis is a disease that causes inflammation of the filtering structures (glomeruli) inside the kidney, impairing the kidney's ability to remove waste products from the blood. There may be no symptoms in the early stages. As kidney damage becomes more serious, symptoms such as blood in the urine and swelling (edema) may develop.
  • Other causes of kidney disease include:
    • Medication use or overuse.
    • Infection and obstruction of the kidneys(pyelonephritis).
    • Inherited genetic diseases, such as polycystic kidney disease.
Symptoms

Many people who develop chronic kidney disease do not have symptoms. This is known as the "silent phase" of chronic kidney disease. As kidney function declines, early symptoms of severe chronic renal insufficiency (CRI) and end-stage renal disease (ESRD) may develop, including:
  • Decreased urinary output (oliguria).
  • Fluid retention and swelling (edema).
  • Increasing fatigue.
  • Nausea and vomiting.
  • Loss of appetite (anorexia).
  • Changes in mental functioning.
  • Insomnia or increased sleepiness (lethargy).

Treatment Overview

The goal of treatment for chronic kidney disease is to prevent or slow additional damage to your kidneys. Since another condition usually causes kidney disease, kidney disease is treated by:
  • Treating and managing other diseases, such as diabetes or high blood pressure, that can cause it.
  • Preventing diseases or avoiding situations, such as medication use, that can cause kidney damage.

Initial treatment

One of the most effective ways to treat chronic kidney disease is to treat and manage the disease that caused your kidney damage. You and your health professional will develop a plan to aggressively treat and manage your diabetes or high blood pressure to slow additional damage to your kidneys.

You will also need to be evaluated for other conditions or diseases that may cause kidney damage, including:

  • Use of medications, such as antibiotics or nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Blockage (obstruction) in the urinary tract.
Prevention

Chronic kidney disease may sometimes be prevented by avoiding situations or controlling the other diseases that can contribute to kidney disease. The earlier a person alters factors that damage the kidneys, the better. Controlling the following factors may slow the progression of kidney damage in a person who has chronic kidney disease. People who have already developed end-stage renal disease (ESRD) also need to focus on these factors to prevent complications of ESRD.

  • Maintain blood pressure at less than 130/85 mm Hg with medication, diet, and exercise. 
  • Maintain strict blood glucose control in people with diabetes. 
  • Maintain healthy levels of fats (lipids), such as cholesterol and triglycerides. For more information, see the topic High Cholesterol.
  • Stop smoking or using other tobacco products. If you do not smoke, do not start. For more information, see the topic Quitting Tobacco Use.

Source: Healthwise



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