What is CKD and what are its causes? CKD also known as Chronic Kidney disease is when there is subtle or complete dysfunction in your kidney, in serious cases, where CKD has grown a lot, it also causes kidney failure. CKD develops in a time of 3 months minimum. Our kidney’s job is to regulate the blood, remove waste, keep the electrolytes steady and stable and produce hormones. Our kidney filters our blood daily, in detail, filters 120-100 ml per minute per 1.73m^3 of our body. This differs as it is stated that this amount is lower in women than in men, and as our body grows older, the amount filtered is slowly decreasing. The filtration process of our kidneys is known as Glomerular filtration, and its rate mentioned as 120 - 100 ml per minute*. Now, there are many causes of CKD, one being Hypertension, hypertension is a cycle, it is when, there is less fluid delivered to the kidney to filter, this causes the kidney to spread a distress signal, which makes it release renin, which is a hormone which instructs the body to increase the blood pressure more than needed, and this increased blood pressure causes hypertension, this reason states as why we should drink more water and fluids throughout the day. Now, Hypertension causes the renal artery to widen, which makes the lumen narrow, this is the reason less fluid is delivered to the kidney, due to this low amount of fluid that is received, this resulting in the kidney to have an ischemic injury to the glomerulus, which filter the fluid within the kidney, due to this injury, Foam like cells called macrophages tend and very likely slip into the injured glomerulus, these macrophages secrete the growth of TGF, TGF is an important function which helps in recovering from injury, releasing anti-inflammatory functions in to the body, this function causes the mesangial cells to regress or turn into a more devolve and immature state of itself known as mesoangioblasts. These mesoangioblasts start to secrete extracellular matrix, extracellular matrix is when a network of an array of macromolecules is formed around our body, specifically here, in our kidney, extracellular matrix is extra tissue around our glomerulosclerosis, which is the element in the kidney that filters all the fluids, to harden, which diminishes the nephron’s ability to release the filtered fluid, and this causes chronic kidney disease, There are many more causes to CKD such as Lupus, Rheumatoid arthritis, HIV, NSAIDS, And toxins within tobacco. A normal kidney Filters Urea, which is normally present in our urine filtered, this is when we have a healthy glomeruli, but on the other hand, if one has CKD, because of hardening of our glomerulosclerosis, the urea is not properly filtered, leading the left our urea into the blood, which causes azotemia, this disease causes body ache and nausea, and if not treated, it becomes the reason of going into a coma or even death. Same as Urea, our kidney is also responsible for keeping our electrolytes balanced, this includes potassium levels to be stable and managed, a kidney without CKD properly filtered the extracted potassium in our urine, but a kidney with CKD forces the unfiltered potassium enter our blood, causing hyperkalemia, which is a reason of cardiac arrest, less fluid consumed causes hypertension, which causes CKD and if not treated results in fatal situations, and this explains why we should consume fluids like water or few juices that help our kidney to filter us properly, now this relates to osmosis in our body which is further mentioned. How does osmosis help with CKD Osmosis is the process in which water is the process when water molecules go through a semipermeable membrane from a highly concentrated area to a low concentrated area. Now the process of osmosis helps our kidneys and is a very important process for one’s human body, now because of osmosis, blood is refined and purified as much as it can by the process of osmosis. The water in our blood is refined not entirely but, partially filters the blood, this making sure that no blood is passed and thrown out through urine, in many cases the blood is not able to be refined and as because of that it is present in urine, in cancer patients, this happens frequently as their kidneys done work to their full potential, osmosis helps filtering water in blood in the kidney in simple words, and is very helpful for patients who have their kidneys in a bad state, in simple words, osmosis helps water to be filtered from one’s blood and prevent it to be transferred into one’s urine Stages of CKD There are a total of 5 stages of Chronic Kidney disease, as time passes, CKD and one’s kidney starts to worsen, and if not treated properly then it worsens very quickly, that's why precautions, medications and consultancy must be taken by a kidney specialist. In stages 1-3 one’s kidney is still able to function appropriately and filter out waste from our blood. But in stages 4-5 it is very hard for the kidney to filter anything making it nearly impossible to filter one’s blood, and in these stages (4-5) we must keep our kidney in use and as healthy as possible. Here are the 5 Stages: Stage 1 - In stage one, our kidney is mostly functional, and works fine, knowing that CKD has been identified, yet there is still mild damage to one’s kidney, it cannot be identified as there is damage to the kidney, physically seen or signs of damage, Stage one is intended to state that your filtration rate is normal, thought protein is present in your urine, which is a direct indication that one has CKD Stage 1, The eGFR result should be 90 or higher (>=90). Doctors check one’s body for CKD by taking an eGFR test (A blood test, where the blood is specifically examined for kidney damage identification), Blood pressure test, and urine test. Natural Symptoms of CKD stage 1 are high blood pressure, Swelling in feet or hands, kidney damage seen in CT scans (etc.), protein or blood in urine. Stage 2 - Stage two is just slightly worse than stage 1, one’s kidney will still function and filter right to appropriate amounts of one’s blood, Yet, there is still slightly more damage seen and difficulties. Doctors identify Stage 2 by, CT scans, blood test or eGFR and blood pressure tests. The eGFR result should be 60 - 89. In stage 2 of CKD, one’s kidney works slightly worse than stage one 1, difficulties start to occur slowly and damage can be seen, in this stage of CKD might be irreversible, natural symptoms such as swelling in hands or feet, visible kidney damage, protein or blood in urine. Stage 3: Stage 3a : Stage 3a is when your kidney starts to get more damaged, filters one’s blood, but, struggles doing so, unfiltered waste can build up and start harming one’s body as well, this build up can cause high blood pressure, anemia and bone defects and problems. Stage 3 is the middle, it is stated that CKD after one’s kidneys have reached stage 3 is irreversible and can only be controlled by following instructions by your doctor, this stage does not fully shut down one’s kidneys, they still work and there is yet no need of a kidney transplant or dialysis. Doctors check for this by blood pressure test, eGFR (blood test specifically to obtain information regarding one’s kidney) the eGFR test for stage 3a is (45-59), Kidney biopsy, and this can also be passed genetically from your parents or your family tree (preferably if one’s family member (Father or Mother) had it). There are more symptoms present now, a few new ones being: feeling weak or tired, skin turning dry or itchy, muscle cramp, sleep deprivation or any sleeping problems, restless leg syndrome, more or less urination and urine is more dark and more concentrated than usual. Stage 3a is mostly irreversible and cannot be cured, it can only be monitored and controlled. Both stages 3a and 3b are the same but stage 3b has a lower eGFR rate. Stage 3b: Stage 3b is when your kidney starts to get more damaged, filters one’s blood, but, struggles doing so, unfiltered waste can build up and start harming one’s body as well, this build up can cause high blood pressure, anemia and bone defects and problems. Stage 3 is the middle, it is stated that CKD after one’s kidneys have reached stage 3 is irreversible and can only be controlled by following instructions by your doctor, this stage does not fully shut down one’s kidneys, they still work and there is yet no need of a kidney transplant or dialysis. Doctors check for this by blood pressure test, eGFR (blood test specifically to obtain information regarding one’s kidney) the eGFR test for stage 3a is (30-44), Kidney biopsy, and this can also be passed genetically from your parents or your family tree (preferably if one’s family member (Father or Mother) had it). There are more symptoms present now, a few new ones being: feeling weak or tired, skin turning dry or itchy, muscle cramp, sleep deprivation or any sleeping problems, restless leg syndrome, more or less urination and urine is more dark and more concentrated than usual. Stage 3a is mostly irreversible and cannot be cured, it can only be monitored and controlled. Both stages 3a and 3b are the same but stage 3b has a lower eGFR rate. Stage 4: Stage 4 is the last stage before kidney failure, so it is very important to keep precautions and take care of our kidney appropriately, as Stage 4 forms, health problems also start to occur throughout one’s body, problems such as: heart disease, anemia, high blood pressure, high phosphorus and potassium, metabolic acidosis and bone disease. New natural symptoms also kick in, such as: loss of appetite, pain in one’s lower back, feeling heavy nausea and headaches and feeling sick making one vomit, this stage can be tested by eGFR reports and urine test. One’s eGFR result is to be 15-29 to be diagnosed as stage 4 CKD. one’s consultant or doctor is to decide if one needs a kidney transplant or dialysis, if one’s kidney is close to stage 5 or significantly failing, the doctor will inform one, if a kidney transplant is to be taken place, or dialysis, there is no going back now and the only option is to properly maintain our kidneys. Stage 5: stage 5 is the final stage, either one’s kidney is at the brim of failing or it has already failed, There is no cure and it is impossible to be reversed, same health problems but more serious this stage, stage 5 can only be tested by eGFR or urine tests, your eGFR is to be <15 or less than 15 to be diagnosed, after reaching stage 5, it is necessary to have a kidney transplant or dialysis. New natural symptoms like; no or very less urine, breathing issues and change in skin color start to occur. It is again important to start dialysis or have a kidney transplant. Symptoms of CKD Chronic kidney disease should mostly be confirmed by a urine test or an eGFR test, though, we should all be aware of natural symptoms or alerts that one’s body receives. Some of the few symptoms that are found are: ● Itchy and dry skin ● Muscle cramps ● Frequent vomiting and stomach ache ● Loss of appetite ● Swelling in hands, feet, ankles or leg ● Less urination ● Breathing issues ● Sleep deprivation and other sleeping issues ● Pain in lower back ● High Blood pressure ● These symptoms do not always start to come through from stage 1, many people have experienced these symptoms from the start of stage 3, the best way is to get tested for CKD and be on a safer side. causes of CKD Diabetes: Diabetes also is a cause for CKD in one’s body, as Diabetes is when your blood sugar is high, unmanaged and not monitored for a while, and the rising high sugar level can slowly and unknowing damage many organs in one’s body, which also includes affecting the kidney and slowing its functionality. To be exact, diabetes affects your kidney and does not allow them to filter our blood properly. It damages the blood vessels, and it also takes the nephron’s ability and makes it difficult for the kidney to function in a healthy state. (Type 1 and type 2 diabetes) Hypertension Hypertension is a cycle, it starts with something we all do sometimes, not consuming enough fluid such as water, this causes a hormone called renin to be released and give a distress signal throughout the body, this signal causes the blood pressure to increase in our body, and if this happens regularly and is not maintained properly, this could result in hypertension, and this takes our kidneys ability to function and filter properly, our kidneys part is to keep control of the electrolytes in our body, keep them steady, potassium plays an important role in that, because of our kidney is not being able to filter any substance properly, potassium that should have been excreted through urine is now transferred in our blood, this causes hyperkalemia, which in many cases causes cardiac arrest, resulting to death. Interstitial nephritis Interstitial nephritis is when our kidney is surrounded by an extracellular matrix, a substance which not only takes away the ability of filtering gradually, but also damages the inside of our kidneys, scarring and hardening them, and so, blood is not filtered properly. Glomerulonephritis Glomerulonephritis is when one’s kidney is inflamed and is not able to filter properly, it is an inflammation in the glomeruli which makes the glomeruli very hard to filter our blood, and as this increases, the kidney is no longer in a state where it can filter any blood. Things that increase your CKD ● Diabetes ● High blood pressure ● Heart (cardiovascular) disease ● Smoking ● Obesity ● Family history of kidney disease ● Abnormal kidney structure ● Older age ● Frequent use of medications that can damage the kidneys Complaints ● Fluid retention, which could lead to swelling in your arms and legs ● A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart's function and can be life-threatening ● Anemia ● Heart disease ● Weak bones and an increased risk of bone fractures ● Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures ● Decreased immune response, which makes you more vulnerable to infection ● Pericarditis, an inflammation of the saclike membrane that envelops your heart Ways to help reduce the risk of CKD (increase in stages) Lifestyle Changes: we can always improve our lifestyle to counter CKD, getting enough sleep 8-10 hours a day, Eating food and drinking water regularly, not having any junk food or soft drinks/ soda, maintaining body discipline, working out, etc.. Healthy Diet: we can change our diet, a diet provided by your consultant or doctor, or one that suits your body type, this will help decrease the effects of CKD and help balance the state of your kidneys, such as consuming carbohydrates, protein, vitamins, minerals and fiber. No smoking and alcohol: smoking and alcohol can be really deadly if not immediately stopped, smoking destroys your kidneys and lungs, and a slightly high amount of alcohol can also affect your kidney in many ways which increases the seriousness of CKD. Having a medicine routine: Consuming prescribed medicine through the most efficient way helps our body to not only be overdosed but then also helps the medicine to act quickly helping out the body in many different ways. 3 ways CKD is controlled Its serious Dialysis: When CKD has reached Stage 5, it is necessary to take actions such as dialysis, dialysis is used for a time, planning if you will be needing a kidney transplant or not, but dialysis itself is a very efficient way to counter CKD, dialysis is the method where waste substances and materials are removed, There are two type of Dialysis: Haemodialysis: Haemodialysis is the process in which blood from one’s body, being that a needle is injected into one’s arm, that blood that is taken is then transferred into an external machine or device that filters the blood for you, then it is transferred back into the body using another tube, this makes the kidneys job easy the filter blood, as it already coming back filtered, This is to be done as per consulted, some have to do it 4 times a week for 4 hours and come have to do it for 6 days a week for 8 hours (overnight) it depends on how serious the matter is and what actions have to be taken in order to control CKD. Hemodialysis risks include: ● low blood pressure ● anemia, or not having enough red blood cells ● muscle cramping ● difficulty sleeping Peritoneal: CAPD is "continuous," machine-free and done while you go about your normal activities such as work or school. You do the treatment by placing about two quarts of cleansing fluid into your belly and later draining it. APD differs from CAPD in that a machine delivers and then drains the cleansing fluid for you. This process is done three, four or five times in a 24-hour period while you are awake during normal activities. Other risks include: ● abdominal muscle weakening ● high blood sugar due to the dextrose in the dialysate ● weight gain Kidney Transplant End-stage CKD occurs when the kidneys have lost about 90% of their ability to function normally. A kidney transplant is a surgery to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly. The risks associated with a kidney transplant include those associated directly with the surgery and rejection of the donor organ. Advantages of Dialysis The advantages of dialysis are many, some of which are there is no waiting period, the process of dialysis can start immediately, as in kidney transplant, one has to wait for a donor. in Peritoneal dialysis, there is no need of a machine and it is easy to travel and life expectancy also increases, there are no needles required, fewer diet restrictions. Advantages of Kidney Transplant There are more advantages than disadvantages for kidney transplants, few being: patients live longer and healthy lives, There is no need of dialysis after a kidney transplant higher energy and stamina, work and travel becomes easier, less diet instructions.
