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Chronic Kidney Disease: Symptoms, Early Diagnosis, and Treatment

Hands holiding red heart with kidney.

One in six people will develop chronic kidney disease at some point in their lives. Damage to the kidneys is sometimes permanent, so it’s important to protect yourself. The changes you should make are easy to understand and are helpful to much more than your kidneys. Improving your diet, getting more exercise, and drinking more water will give you more energy while also protecting your kidneys and other organs, too. 

March is national kidney month, so let’s take the opportunity to raise awareness of this preventable condition. Continue reading to better understand the warning signs of chronic kidney disease.

The Kidney

The average adult body contains around 1.2 to 1.5 gallons of blood. All of this blood is filtered through the kidneys, two organs about the size of a fist, multiple times a day. This filtering is done to ensure that your body keeps what it needs to keep and gets rid of whatever it needs to excrete in order to maintain a healthy blood supply.

Physician shows to patient shape of kidney with focus on chronic kidney diseases.
Understanding How Small The Functional Units Are Can Help Make It Clear How Sensitive Our Kidneys Are (Image Source: Shutterstock)

This feat is achieved by nephrons, the smallest functional kidney unit. Each nephron consists of a glomerulus and a tubule. The glomerulus consists of numerous small blood vessels that act as a filter. Small molecules and water are allowed to pass through while larger molecules are not. The tubules then work to recover anything in the filtrate that the body still needs. Understanding how small the functional units are can help make it clear how sensitive our kidneys are to even the smallest problems. Being aware of factors that can affect our kidney function is an important part of preventing chronic kidney disease.

As we age, everyone experiences a slow loss of kidney function. This can be made worse by physical injury, inherited kidney diseases, high blood pressure, diabetes, and certain autoimmune disorders, as well as other causes. The kidneys are remarkably resilient so a loss of function usually does not lead to noticeable symptoms in the early stages. These stages are assigned primarily by looking at the estimated glomerular filtration rate (GFR). This is calculated by looking at your age, gender, muscle mass, ethnicity, and the creatinine levels in your blood. Other factors like protein in the urine are also used to assess severity.

Stages and Signs of Kidney Failure

Stage 1 refers to kidney damage being present but with no negative effects on kidney function, so the GFR remains normal.

ABCs of Kidney Disease | Treatment Options for Chronic Kidney Disease (CKD) – Johns Hopkins Medicine

Stage 2 is when you start to see a drop in kidney function and an abnormal GFR. Due to the resilience of the kidneys, you may not see symptoms during these two early stages. You may experience swelling in your legs, high blood pressure, or changes in urination. You may also experience fatigue and general malaise. These symptoms can be easily mistaken for just being tired or working hard.  

Stage 3 is divided into two parts: mild to moderate loss of function, and moderate to severe loss. At this stage and in the following stages, the signs of kidney failure become significantly pronounced and could include fatigue, nausea, loss of appetite, back pain, and muscle cramps.

Stage 4 is designated as a severe loss of function with a drastically reduced GFR. At this stage, levels of blood urea nitrogen and other waste products may rise to levels that cause symptoms like metallic taste in the mouth, dry/itchy skin, bad breath, difficulty concentrating, and nerve problems. Since the kidney also plays a role in maintaining bone health and red blood cells, problems like anemia and abnormal calcium or phosphorus serum levels may arise. It is important to stay vigilant for any of the symptoms outlined in these prior stages. Noting these symptoms and discussing them with your physician could significantly change the trajectory of the disease.

The final stage, stage 5, with a GFR of less than 15, represents end-stage renal disease. ESRD is permanent kidney failure that requires dialysis or a kidney transplant for survival. However, things do not have to progress to stage 5. Treatment of CKD involves addressing the underlying cause and modifying behaviors and lifestyle accordingly.

Diabetes, Cardiovascular Disease, and CKD

Although the causes of CKD range widely, the two main major causes are diabetes and hypertension. These two diseases are important to discuss because their treatment and the treatment for CKD have significant overlap. Diabetes causes abnormally high blood sugar levels that can cause damage to organs, nerves, and blood vessels. As discussed in the beginning, the blood vessels of the glomeruli are small yet process vast amounts of blood per minute. High blood sugar leads to a narrowing of these blood vessels along with a breakdown in the structure of the glomeruli. In addition to damaging the kidney directly, high sugar levels can damage the nerves that control the emptying of the bladder. A full bladder increases the pressure on the kidneys, leading to damage. Not being able to empty the bladder could also lead to urinary tract infections that could spread to the kidney.

Urologist examining male patient in clinic.
High Sugar Levels Can Damage The Nerves That Control The Emptying Of The Bladder (Image Source: Shutterstock)

Diabetes prevention involves diet modifications and incorporating exercise. Getting your blood sugar under control can prevent further damage. However, be careful with fad diets like low-carb diets. Hypertension, like diabetes, also leads to a narrowing of the arteries over time and damage to the kidneys. The unique thing about hypertension is that it can be both a cause and a symptom of CKD. The kidney plays a key role in regulating blood pressure by monitoring blood pressure and hormones. Once the kidney is damaged, its ability to maintain blood pressure within normal limits is compromised. Fluid retention also increases blood pressure and puts extra pressure on the heart. The number one cause of mortality in dialysis patients is cardiovascular disease. 

Protecting Your Kidneys

Following a heart-healthy diet focused on low sodium and exercising is the key to preventing further complications. The treatment plans for a person with CKD are similar to those for patients with heart problems. Eating healthy, getting more exercise, and taking Carlyle GPLC Glycine Propionyl-L-Carnitine can make things easier on your kidneys and help your heart at the same time. You can also see improvement by quitting or reducing alcohol and tobacco use and lowering your cholesterol levels.

The main obvious difference between CKD and heart disease is that with your kidneys, you must keep an eye on your protein, phosphorus, and potassium intake. If you can detect CKD early, you can make easy changes that will dramatically improve your life. 

Your kidneys are important, and it’s easy to treat them right. I recommend you drink more water and add some fresh fruits and vegetables to your diet. Talk to your doctor if you think you’re at risk.