chronic kidney disease

• what is chronic kidney disease

  Chronic kidney disease (CKD) is when the kidneys have become damaged over time (for at least 3 months) and have a hard time doing all their important jobs. CKD also increases the risk of other health problems like heart disease and stroke. Developing CKD is usually a very slow process with very few symptoms at first. So, CKD is divided into 5 stages to help guide treatment decisions.
• what causes CKD

  Too much glucose in your blood damages your kidneys’ filters. Over time, your kidneys can become so damaged that they no longer do a good job filtering wastes and extra fluid from your blood. When the filters are damaged, a protein called albumin. A healthy kidney doesn’t let albumin pass from the blood into the urine. If the blood vessels in your kidneys are damaged, your kidneys may not work as well to remove wastes and extra fluid from your body. Extra fluid in the blood vessels may then raise blood pressure even more, creating a dangerous cycle.
• Changes in urination

  •Your urine may be foamy or bubbly; you may urinate more or less often; amounts may be greater or less than usual; the color may be darker or paler than usual; you may see blood in the urine; you may have difficulty urinating
• Swelling

  •When your kidneys don’t work, excess fluid isn’t removed from your body. It can build up and cause swelling in the legs, ankles, feet, face, and/or hands.
• Fatigue


  The kidneys make a hormone called erythropoietin, or EPO, which tells your body to make oxygen-carrying red blood cells. If your kidneys are damaged, they make less EPO, which means fewer red blood cells are available to carry oxygen. This is called anemia, and it which can be treated
• Skin Rash/Itching


  When the kidneys can’t remove wastes from the body, it builds up in your blood and can cause severe itching.
• Metallic Taste in Mouth/Ammonia Breath


  •When waste builds up in the blood it is called uremia. This can make food taste different and cause bad breath. It is not uncommon to stop liking to eat meat, or to lose weight because you don't feel like eating
• Shortness of Breath

  •Extra fluid in the body can build up in the lungs. This build up, combined with anemia, can result in shortness of breath.•
• A urine test is also done too: check the levels of substances called albumin and creatinine in your urine – known as the albumin: creatinine ratio, or ACR. check for blood or protein in your urine. Alongside your eGFR, urine tests can help give a more accurate picture of how well your kidneys are working.
• Your ACR result is given as a stage from 1 to 3:

  •A1 – an ACR of less than 3mg/mmol

  •A2 – an ACR of 3 to 30mg/mmol

  •A3 – an ACR of more than 30mg/mmol
• Your eGFR results is given as a stage from 1 of 5:

  •stage 1 (G1) – a normal eGFR above 90ml/min, but other tests have detected signs of kidney damage

  •stage 2 (G2) – a slightly reduced eGFR of 60 to 89ml/min, with other signs of kidney damage

  •stage 3a (G3a) – an eGFR of 45 to 59ml/min

  •stage 3b (G3b) – an eGFR of 30 to 44ml/min

  •stage 4 (G4) – an eGFR of 15 to 29ml/min

  •stage 5 (G5) – an eGFR below 15ml/min, meaning the kidneys have lost almost all of their function
•   Hyperkalaemia can cause muscle weakness, stiffness and tiredness. If it becomes severe, it can cause an irregular heartbeat (arrhythmia) which can lead to a heart attack. If you have CKD, it's important to avoid taking potassium supplements and some medicines used to treat high blood pressure and heart failure because they can make your potassium levels too high. A medicine called sodium zirconium cyclosilicate can be used to treat hyperkalaemia in adults, but only if it's used.
• You may get swelling in your ankles, feet and hands if you have kidney disease.This is because your kidneys are not as effective at removing fluid from your blood, causing it to build up in body tissues .You may be advised to reduce your daily salt and fluid intake, including fluids in food such as soups and yoghurts, to help reduce the swelling.In some cases you may also be given diuretics (tablets to help you pee more), such as furosemide .Side effects of diuretics can include dehydration  and reduced levels of sodium and potassium in the blood.
• For a small proportion of people with CKD, the kidneys will eventually stop working. This usually happens gradually, so there should be time to plan the next stage of your treatment. One of the options when CKD reaches this stage is dialysis. This is a method of removing waste products and excess fluid from the blood.
• •peritoneal dialysis – this involves pumping dialysis fluid into a space inside your tummy to draw out waste products from the blood as they pass through vessels lining the inside of your tummy
• haemodialysis – this involves diverting blood into an external machine, where it's filtered before being returned to the body
• Haemodialysis is usually done about 3 times a week, either at hospital or at home. Peritoneal dialysis is normally done at home several times a day, or overnight.

  If you don't have a kidney transplant, treatment with dialysis will usually need to be lifelong.