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Chronic Kidney Disease

Chronic kidney disease

Chronic kidney disease is caused by conditions that damage your kidneys over a prolonged period of time and decrease their ability to perform their normal functions  the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick.

You may develop complications like high blood pressure, anemia, weak bones, poor nutritional health and nerve damage.

Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders.

Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

Chronic kidney disease is quite common, and people often have the condition without knowing it.

In many people when the kidneys are working only slightly less well than usual there may not be any symptoms and they may not need any treatment.

Chronic kidney disease can be caused by several conditions, including diabetes and high blood pressure. It is classified into stages depending on how advanced it is. Stages 4 and 5 are sometimes called advanced chronic kidney disease.

Tests for chronic kidney disease

There are simple tests that can tell whether you have a kidney condition or not. For example, a blood test can be used to estimate your GFR (or glomerular filtration rate). This is a measure of how well your kidneys are working.

A urine sample can show if there is protein in your urine (this is called proteinuria), which can also be a sign that your kidneys are not working properly. You should be offered these tests if you are at risk. For example, you may be at risk if you have certain other conditions such as high blood pressure or diabetes, or if there is a history of kidney disease in the family.

The following table shows how the GFR relates to the different stages of chronic kidney disease and what this means in terms of diagnosis. Stages 3–5 can be diagnosed by GFR alone, but stages 1 and 2 also need other evidence of kidney damage, such as proteinuria. Generally, the higher your GFR, the healthier your kidneys are.

People who should undergo regular testing
If you have any of the following you should be tested for chronic kidney disease:
• diabetes
• high blood pressure
• cardiovascular disease
• structural renal tract disease, kidney stones or an enlarged prostate
• diseases that affect several parts of the body and may affect the kidneys, such as systemic lupus erythematosus
• family history of chronic kidney disease or an inherited kidney disease
• blood in your urine (this is called haematuria) or protein in your urine (proteinuria) where there is no known cause.

When should you be seen by a Nephrologist

• large amount of protein in your urine
• both protein and blood in your urine
• kidney function (Creatinine/ Blood Urea) that is rapidly worsening
• blood pressure that remains high even though you are taking at least four different types of medicines to control it

• stage 3, 4 or 5 chronic kidney disease

• a suspected or confirmed rare or genetic cause of chronic kidney disease
• suspected narrowing of the arteries to your kidneys (renal artery stenosis)
• urinary tract obstruction
After you have been seen, you would be evaluated in detail and a plan is made to manage your kidney disease, and to do your regular check-ups.