Diabetes Complications

Chronic Kidney Disease: Symptoms, Causes, And Treatment

Chronic kidney disease (CKD), also known as chronic renal failure, is a common condition, affecting an estimated 37 million people in the U.S.

It is a long term disease, whereby the kidneys do not function correctly over a gradual period of time.

In the early stages, a person may not experience symptoms. However, as the condition worsens, serious complications can arise, including high blood pressure, anemia, weak bones, and nerve damage. That’s why early diagnosis is essential.

In this article, we will be discussing what chronic kidney disease is, the causes of it, and the treatment options available.

The purpose of the kidney’s

The kidneys form part of the renal system and act as filters for the human body. Waste is removed from the blood to reduce the risk of damage to cells, along with excess fluid that might be present in the body.

The fluids and waste are then sent toward the bladder, which is expelled through urination.

The kidneys filter out waste materials from various substances, including medication and food. Excess minerals from blood are also removed by the kidneys to avoid potential adverse events in the body.

When kidney disease develops, it can cause several complications. Kidney disease can be either acute or chronic. In cases of chronic kidney disease, the condition will gradually develop and become worse over time.

According to the NIDDK, an estimated 14% of the adult population in the United States suffers from chronic kidney disease.

Because early stages of the disease do not yield apparent symptoms, many people will only be diagnosed at a later stage – when the condition starts to produce complications in their body.

Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease and end-stage renal disease (ESRD)

Causes of Kidney Disease

There are several reasons why the prevalence of chronic kidney disease remains quite high in the United States, according to the National Kidney Foundation.

There are both direct causes and potential risk factors that patients need to be wary of. Understanding what may lead to the development of kidney disease is critical. This helps the patient identify their risk of developing problems.

In this section, we consider both common causes of kidney disease and also look at some risk factors that patients need to be aware of.

What are the most common causes of Kidney Disease?

Diabetes is often noted as one of the most important causes of kidney disease to consider. Chronic kidney disease is considered only one of the many complications of diabetes. Patients need to note that both type 1 diabetes and type 2 diabetes can cause them to suffer from chronic kidney disease.

Other possible causes that have also been linked to chronic kidney disease include:

  • Hypertension, which is when a patient consistently experiences elevated blood pressure levels, has been associated with several complications – including heart attacks and strokes. Since blood pumps through the kidneys, this condition may also affect their functionality.

    One research paper explains that there seems to be a two-way connection here. High blood pressure (Hypertension) may cause a patient to develop kidney damage. This may lead to the development of chronic kidney disease. On the other hand, individuals who are diagnosed with chronic kidney disease are at an increased risk of developing hypertension.

  • Vesicoureteral reflux is another crucial issue that has a direct impact on kidney function. It has also been linked to a higher likeliness of chronic kidney disease. This condition is when urine is pushed back into the patient’s kidneys.

  • Pyelonephritis is yet another condition to be taken note of here. This is a term that describes a recurrent infection that affects the kidneys. When pyelonephritis develops, it can gradually cause damage to the cells and tissue that make up the kidneys. In turn, this could lead to the development of chronic kidney disease.

  • Urinary tract obstructions may also have a direct impact on kidney function. An enlarged prostate is a condition to take note of. Other issues include certain types of cancers, as well as the development of kidney stones.

  • Glomerulonephritis can also cause a patient to suffer from chronic kidney disease. With this condition, there is an inflammation of the filtering units, known as the glomeruli, that help the kidneys filter waste material from the blood.

  • Inflammation of the tubules and the surrounding structures can also cause this disease.

What are the most common risk factors for developing Kidney Disease?

Patients also need to be wary of certain risk factors that could increase their likeliness of developing the condition. Many of these factors are directly related to the individual’s lifestyle.

Some risk factors are uncontrollable, while others can be controlled. While there is no way to reduce the risk when affected by uncontrollable risk factors, millions of people do have the ability to make specific lifestyle changes to reduce the risk.

Some of the uncontrollable risk factors that patients need to be aware of include:

  • Having an abnormal structure of the kidneys.

  • There does seem to be an increased risk of kidney disease with age.

  • It has been found that Asian-Americans, Native Americans, and African-Americans are at a higher risk of chronic kidney disease.

  • Individuals with a family history of kidney disease are also at an increased risk of developing the condition.

When it comes to looking at the controllable risk factors, two of the most important ones would include smoking and obesity.

An estimated 480,000 deaths in the United States each year are contributed to directly by smoking. When you take a look at global statistics, this number increases to as many as six million people.

Obesity affects millions of people. This condition has been linked to several complications in the body. Individuals with obesity are more likely to develop diabetes. This is yet another risk factor for the development of chronic kidney disease.

How can your diet and lifestyle affect your susceptibility of Kidney Disease?

Diet has a significant role to play in how healthy the body is. People adapt their diets when they are trying to lose weight, when they identify food sensitivities or when they wish to achieve specific goals – such as to gain more muscle mass.

The same goes for patients who are diagnosed with chronic kidney disease. It is critical to understand that some foods can cause kidney disease to become worse.

Several lifestyle factors may cause a higher likeliness of kidney disease progressing faster. This could put a patient at a much more severe risk for end-stage kidney disease.

Some of the essential foods and drinks that people should avoid if they have been diagnosed with kidney disease include:

  • Sodas that contain added phosphorus. The main aim here is to eliminate the intake of dark-colored cola drinks. The added phosphorus is an additive and not in a natural form, which makes it harder for the kidneys to filter and process.

  • While potassium is critical for the human body, high doses of potassium can be harmful to people with kidney disease. Therefore, those with renal dysfunction and kidney disease need to reduce their intake of bananas and especially avocados.

  • Canned and processed foods are also definitely on the no-no list for people with existing chronic kidney disease. These foods often contain many additives and preservatives that can be toxic to the kidneys. The main culprit in these foods would be the added salt.

A kidney-friendly diet may also help protect your kidney from further damage. Foods to add to your diet include:

  • Protein is a crucial part of a healthy diet. However, when your body uses protein, it produces waste, and so eating more protein than you need may make your kidneys work harder. Therefore it is important to consume the right protein in small amounts. Good sources include skinless chicken, fish, macadamia nuts, and beans.

  • Although egg yolks are high in phosphorus, egg whites provide a kidney-friendly source of protein. They are also beneficial for people undergoing dialysis treatment, as they have higher protein needs but need to limit phosphorus.

  • To help keep fat from building up in your blood vessels, heart, and kidneys, it is essential to consume heart-healthy foods, such as fruits and vegetables, omega fatty fish, lean meats, avocado, and macadamia nuts. Although fish are high in phosphorus, sea bass contains lower amounts than other seafood choices.

  • Cranberries are also worth adding to your diet. These small tart fruits, popular during the Christmas season, have been found to help prevent urinary tract infections, a common risk for those with chronic kidney disease. They contain phytonutrients called A-type proanthocyanidins, which prevent bacteria from sticking to the lining of the urinary tract, preventing infection.

In terms of lifestyle factors, one of the most critical things to consider is physical activity. Failure to remain active can be harmful to the entire body. Not only does it put more strain on the kidneys, but it also increases the risk of suffering from conditions that further contribute to chronic kidney disease.

Signs and symptoms of Kidney Disease

Chronic kidney disease is a condition that tends to progress gradually. In its early stages, it can usually be treated much more effectively.

With this in mind, people must understand what symptoms to look out for.

There are many cases where the disease will not produce obvious signs in the beginning. Once any unusual symptoms are experienced, a visit to a physician for a physical examination becomes critical.

When it comes to looking at the symptoms associated with kidney disease, it is essential to note that a patient with these signs might not necessarily be suffering from this condition.

The symptoms tend to be non-specific, which means another condition may also cause them.

Symptoms that patients do need to be wary of include:

  • Nausea and vomiting are relatively common and may also be a sign of chronic kidney disease progressing.

  • There may be a loss of appetite in some patients.

  • Fatigue is common, especially as the condition becomes more severe. The fatigue will often be accompanied by weakness.

  • There may be a change in the amount of urine that comes out during urination. Either frequent urination or decrease in the amount of the urine output can be signs of both diabetes and kidney failure.

  • Some patients may experience cramps and twitches in their muscles.

  • Hypertension may develop if the patient had not previously experienced problems with elevated blood pressure. Individuals with chronic kidney disease will often also find that high blood pressure is difficult to keep under control, even with the appropriate medication. Angiotensin-converting enzyme inhibitors (ACE inhibitors) are commonly prescribed to manage blood pressure levels.

  • Persistent itching may be another potential sign of chronic kidney disease.

  • Mental sharpness may start to decline in some patients.

  • As chronic kidney disease progression, there will be an increased accumulation of fluids in the body. This may lead to a swelling of the ankles and feet. If fluids build up in the patient’s lungs, they may also find it more difficult to breathe. The fluid that accumulates around the heart could lead to chest pain.

How is Kidney Disease diagnosed?

The diagnosis of kidney disease can sometimes be complicated, primarily since many of the symptoms associated with the condition have been linked to another disease too. Thus, a physical examination is not enough to provide a patient with a diagnosis.

CKD is usually first suspected when serum creatinine rises. Therefore, the initial step is to determine whether the renal failure is acute, chronic, or acute superimposed on chronic.

The physician will conduct a thorough examination to determine if the patient has a family history of kidney disease.

The patient should also mention to the physician if they have been diagnosed with any other conditions. Particularly those that have been associated with a higher risk of chronic kidney disease.

For a more accurate diagnosis, the physician is likely to order several tests. These tests may include:

  • Urine tests, such as the creatinine clearance test, are used to determine if any abnormalities could indicate problems with the patient’s kidneys.

  • Imaging tests to help the physician get a better view of the structure, as well as the size of the patient’s kidneys.

  • Blood tests, which helps the physician determine if the kidneys are effectively filtering waste materials from the patient’s blood. If levels of urea and creatinine are persistently high, the doctor will most likely diagnose end-stage kidney disease.

  • Glomerular filtration rate (GFR) is a test used to check how well the kidneys are working. Specifically, GFR estimates how much blood passes through the glomeruli each minute.

  • In some cases, a kidney biopsy may also be required. In such a case, a small sample of the kidney’s tissue will be removed. The procedure is done through local anesthesia. A thin needle is used to collect the tissue sample. The biopsy is then analyzed at a laboratory to detect if there are abnormalities with the kidneys.

Who can diagnose Kidney Disease?

The process of diagnosing kidney disease starts with a consultation at a general physician. They will provide the patient with a physical examination and take a look at the patient’s medical history. The physician may also order additional tests.

If the patient is suspected of suffering from kidney disease, however, they will usually be referred to a nephrologist. This is a type of specialist that only deals with patients that are affected by kidney diseases.

Stages of Chronic Kidney Disease

Chronic kidney disease is generally divided into multiple stages. When the patient is diagnosed with kidney disease, the specialist will usually tell the person what stage kidney disease they have. Each stage has unique characteristics – and some of the stages are more serious than others.

There are five stages of kidney disease that a patient may be diagnosed with. The severity of the disease indicates to the physician which stage of the disease the patient currently has.

The disease will most often progress gradually, but some patients do find that the damage dealt with their kidneys happen faster. This may lead to a more serious level of kidney and renal dysfunction sooner than the patient might have expected.

It is important to realize that the progression of the disease does tend to differ from one patient to the next.

The individual should ask the physician who made the diagnosis more about their current stage and has frequent follow-ups to determine the progression of their unique situation and how he can help your kidneys.

What are the characteristics of each stage of Kidney Disease?

We take a look at the five stages and the characteristics associated with each below:

  • Stage 1 means there is still normal kidney function, but signs of kidney disease are present.

  • Stage 2 means kidney damage has led to the development of a mild reduction in the functioning of the kidneys.

  • Stage 3 is characterized by a moderate loss of functionality by the kidneys.

  • Stage 4, the kidneys have been severely affected and are unable to function effectively.

  • Stage 5 is often referred to as end-stage chronic kidney disease and is usually when the kidneys fail. At this stage, the patient will require dialysis. In some cases, the patient may need a kidney transplant.

Treatment for Chronic Kidney Disease

At present, there is no cure for chronic kidney disease. However, some treatments can help to manage symptoms, reduce the risk of complications, and slow down the progression of the disease.

  • Some kidney disease patients may develop anemia, which is a lack of red blood cells. This often occurs with people with advanced-stage CKD. In such cases, patients may be administered injections of erythropoietin, a hormone that helps your body produce more red blood cells.

  • As discussed above, phosphate is difficult for the kidneys to filter, so patients will be advised to reduce phosphate intake.

  • Antihistamines may be recommended to combat symptoms of itchiness.

  • There are 2 main types of dialysis. Hemodialysis, a form of dialysis where blood is pumped out of the patient’s body and goes through a dialyzer (an artificial kidney). The patient undergoes hemodialysis about three times per week.

  • Peritoneal dialysis, whereby a catheter is implanted into the abdomen, into which a dialysis solution is infused and drained out as to remove waste and excess fluid.

  • A Kidney transplant is a form of surgery that transfers a healthy kidney from a person who has just died, into your body to filter your blood.

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), except when advised by a medical professional. If you have kidney disease, these medications can harm your kidneys.

Best supplements for Kidney Disease

A quick stop at a health store or even browsing the internet will present patients with a significant number of supplements that are promoted to assist in improving kidney function.

The problem is, many of the formulas given to patients does not hold scientific evidence to prove its effectiveness.

What should you avoid when you are diagnosed with Kidney Disease?

When looking to use supplements as a way to potentially improve kidney function, the patient should start by learning about specific ingredients or products that they should altogether avoid.

Various herbal supplements have been proven actually to make kidney disease worse.

According to one publication, specific supplements that patients do need to be wary of if they have existing chronic kidney disease include:

  • American ginseng

  • Feverfew

  • Garlic leaf

  • Stinging nettle leaf

  • Turmeric rhizome

  • Lemongrass

  • Dandelion

  • Alfalfa

  • Noni

The primary reason why it is often advised to avoid these supplements is due to the possibility that the products may contain potassium, a mineral that might be essential to health, but could be disastrous to patients with kidney disease.

What are the most effective supplements for Kidney Disease?

While individual supplements may be harmful to patients with chronic kidney disease, scientists have proven other herbal ingredients might help to either prevent kidney disease or improve existing symptoms, like renal pain or some severe symptoms like blood in the urine.

L-arginine is a natural supplement that has gained a lot of recognition. It has been shown to improve the dilation of blood vessels. It may also be a potential remedy for helping patients with chronic kidney disease experience a possible improvement in their kidney function, and some of the symptoms like kidney pain.

Apart from L-arginine, patients might also want to take a look at supplements that contain these ingredients:

  • Astragalus

  • N-Acetyl Cysteine

  • Soy

  • Rhubarb

  • Rehmannia

At the moment, research is limited in terms of how well these supplements might be able to help improve symptoms of kidney function. They might, however, be potential remedies for patients who do find themselves at risk of developing kidney disease.

Additional supplements might be considered to reduce specific risk factors too.

For example, a patient with diabetes might consider using scientifically-proven supplements that help to improve blood glucose regulation and the release of insulin in their bodies. In turn, this could potentially help to reduce the risk that the condition may lead to chronic kidney disease.

Conclusion

The kidneys play an essential role in ensuring any waste materials in the body can be filtered out and removed through urination.

When kidney disease develops, then the functions that these organs play in the body become impaired. This leads to excess waste materials accumulating in the body.

Since the kidneys also eliminate some fluids, there may also be an accumulation of excess fluids in the body.

Sources

  1. Tedla FM, Brar A, Browne R, Brown C. Hypertension in chronic kidney disease: navigating the evidence. Int J Hypertens. 2011;2011:132405. doi:10.4061/2011/132405
  2. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease
  3. https://www.kidney.org/
  4. https://www.pharmacist.com/article/chronic-kidney-disease-and-use-dietary-supplements
  5. Lovre D, Shah S, Sihota A, Fonseca VA. Managing Diabetes and Cardiovascular Risk in Chronic Kidney Disease Patients. Endocrinol Metab Clin North Am. 2018;47(1):237–257. doi:10.1016/j.ecl.2017.10.006
  6. Bouhairie VE, McGill JB. Diabetic Kidney Disease. Mo Med. 2016;113(5):390–394.
  7. Radica Z. Alicic, Michele T. Rooney, Katherine R. Tuttle CJASN Dec 2017, 12 (12) 2032-2045; DOI: 10.2215/CJN.11491116
  8. Flood D, Garcia P, Douglas K, et alScreening for chronic kidney disease in a community-based diabetes cohort in rural Guatemala: a cross-sectional studyBMJ Open 2018;8:e019778. doi: 10.1136/bmjopen-2017-019778

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