Chronic Kidney Disease

The kidneys are vital organs. Located on either side of the spine under the lower ribs (in the small of the back), the kidneys are bean-shaped organs that are about the size of a clenched fist. The main function of the kidneys is to filter the blood and excrete excess water and waste products in the form of urine. These waste products, which consist of normal substances found in the body, can become toxic if they are not removed from the body. The kidneys are therefore responsible for removing waste as it is produced by the body. These organs also play a role in regulating the level of minerals and salts in the blood. In addition, the kidneys produce certain hormones that have essential functions such as regulating blood pressure and making red blood cells.

Chronic kidney disease is characterized by a progressive deterioration of the kidneys and, more specifically, their ability to filter blood. Kidneys are highly efficient and, as a result, the disease usually progresses silently, often destroying most of the kidney function before causing any symptoms. In fact, a kidney has the ability to double its workload when necessary. When certain parts of the kidney are no longer effective, other parts can compensate, often masking any problem. This is also the reason why we can live with only one healthy kidney. The symptoms of kidney disease appear when the kidneys are working at 20 to 30% of their normal capacity.

Causes

Kidney disease often results from a complication of another disease. Hypertension, diabetes and kidney disorders are but a few examples. A urinary tract obstruction (ex. kidney stones, prostatic malformations or hypertrophy) can also damage the kidneys and lead to kidney disease. Persons with a family history of kidney disease and those over 60 years of age are more at risk. Also, taking certain medications or street drugs can increase the likelihood of developing kidney disease.

Symptoms

It may take several years for symptoms to appear. They do so gradually and can go unnoticed for quite some time.

  • frequent need to urinate, even at night
  • muscle cramps
  • difficulty concentrating
  • difficulty urinating
  • persistent generalized itching
  • shortness of breath
  • fatigue, weakness
  • unpleasant taste in the mouth
  • hypertension
  • nausea and vomiting
  • loss of appetite or weight
  • blood in the urine
  • yellowish or pale brown complexion
  • dark, cloudy or foamy urine
  • passing of less urine
  • swollen eyes, hands and feet

Diagnosis

People at risk of developing kidney disease should be evaluated regularly. Since there may no be symptoms, urine and blood analyses are used determine whether or not one has kidney disease. Otherwise, if symptoms appear, the physician will begin with tests (blood and urine) and will take your blood pressure. The results will indicate whether or not kidney disease is present. However, in order to take a closer look at the state of the kidneys and to make sure there are no abnormalities, a variety of examinations can be requested. These include ultrasound, x-ray, scintiscan, computerized axial tomography (CAT) and magnetic resonance imaging (MRI). These are all medical imaging tests that allow medical professionals to visualize a two or three dimensional view of the kidneys and abdomen.

Treatment

There is no cure for kidney disease. Treatment is intended to reduce symptoms, prevent complications and slow the deterioration of the kidneys. The first step to treating kidney disease involves making changes to one's diet and taking medication. We recommend that you see a dietician who will be able to help you establish a diet and allow you to better manage the disease.

When the kidneys are at the point where they are only working at 10 or 15% of their normal capacity, diet and medication are no longer enough to remedy the problem. This is when dialysis or transplant becomes a serious option to consider. Dialysis is an artificial way of removing waste products from the blood when the kidneys have failed. There are two types of dialysis - hemodialysis and peritoneal dialysis.

Peritoneal Dialysis

The peritoneum is a membrane that surrounds all the organs in the abdominal cavity. Peritoneal dialysis uses this membrane as a filter. A neutral solution known as dialysate is injected into the abdomen (peritoneal cavity) and the excess water and waste pass from the blood through the membrane into the dialysis fluid. The fluid is changed regularly to eliminate waste from the blood. This type of dialysis is not suitable for everyone and can also become less effective over time.

Hemodialysis

As for hemodialysis, the blood is filtered through a machine, outside the body. Blood is pumped from the body into a dialyzer which is a machine that filters the blood and removes waste. The clean blood is then sent back into the body. The blood is filtered several times to ensure the best possible results. Hemodialysis is generally performed in a hospital or specialized clinic. Hemodialysis sessions usually last four hours and several sessions a week are required.

A kidney transplant is another treatment option. The procedure involves removing the unhealthy kidney and replacing it with a healthy one. The healthy kidney can be donated by a living donor - who is often a family member - or by a recently deceased donor. Whatever the case may be, the donor and recipient must have the same blood type and must be a good match in terms of tissues and cells. The greatest risk associated with kidney transplant is rejection. To prevent this from happening, one must take anti-rejection drugs which have adverse effects. If the transplant is successful and medication is taken as prescribed, the new kidney will work normally.

It is important to speak to your doctor or pharmacist before taking any new medication or natural product, even if it is sold over the counter. Any health care professional you consult should be made aware of the situation so that they may be able to advise you accordingly.

For more information or for support:

The Kidney Foundation of Canada

www.kidney.ca

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