Chronic Kidney Disease And Strategies
To Promote Kidney Health
Chronic kidney disease (CKD) also known as chronic kidney failure, chronic renal failure
and chronic renal insufficiency is the gradual loss of kidney function. Kidneys clean your
blood by removing excess fluids, minerals and wastes from your blood, contribute to
bone health and stimulate red blood cell production. Because CKD is a condition in
which the kidneys are damaged and unable to filter blood as well as possible, this can
result in waste build up in the body that leads to other health conditions including
anemia, cardiovascular disease and bone disease.
It is a progressive condition that occurs in stages where the loss of function usually takes
months or years to occur. Chronic kidney disease is a growing problem in the United
States, with more than 20 million (over 10 percent) of adults are estimated to have CKD,
and most are unaware of their conditioned and undiagnosed. Chronic Kidney Disease is
more common among women than men; and is expected to continue to grow because of
the increase in the incidence of risk factors such as hypertension, diabetes, obesity, a
family history of CKD and aging in the United States.1
In the early stages there may be no or few symptoms because signs and symptoms of
kidney failure tend to develop slowly over a period of time. Chronic kidney disease may
not become apparent until there is substantial damage to the kidney and significant
impairment to kidney function. Tests that are used to diagnose CKD are a blood test that
estimates kidney function and a urine test that determines kidney damage. Once it is
detected, CKD can be treated through medication and lifestyle changes to slow the
progression of the condition, and to prevent or delay the onset of kidney failure. The
final stage of chronic kidney disease is called end-stage renal disease (ESRD). When
chronic kidney disease reaches this advanced stage, also known as kidney failure, the
kidneys are not able to function at a level necessary to prevent dangerous levels of fluids,
wastes and electrolytes from accumulating in a person's body. When end-stage renal
disease occurs the treatment options are artificial filtering (dialysis) or a kidney
transplant. Hypertension and diabetes are the primary causes of ESRD, and accounts for
72 percent of all new cases of kidney failure in the United States.
Symptoms
The early symptoms of chronic kidney disease are frequently symptoms of other
illnesses. 2 These may be the only symptoms until CKD progresses:
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Appetite loss
Headaches
Itching (pruritus) and dry skin
General ill feeling and fatigue
Nausea
Weight loss without trying to lose weight
Other symptoms that may develop include the following:
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Abnormally dark or light skin
Bone pain
Sleep problems
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Decreased mental sharpness
Swelling of feet and hands (edema)
Shortness of breath
Muscle twitching and cramps
Vomiting
Frequent hiccups
High blood pressure
Exercise/Physical Conditioning Programs for Individuals with ESRD
Several exercise and physical conditioning programs are recommended for individuals
with ESRD who undergo dialysis; and it is suggested that persons who have received
kidney transplants may also find rehabilitation programs beneficial. Individuals with
ESRD have been found to benefit from almost any method of increasing physical
activity. 3 There is considerable evidence that indicates most persons with ESRD
undergoing dialysis should receive an initial assessment, establish specific goals and
begin at a low level as tolerated and move toward their set goals. Specific exercises that
are beneficial include a moderate level walking program, Tai Chi, yoga, water exercise
or swimming and low-level strengthening programs. Additionally, individuals with
problems walking may derive benefits from Physical Therapy (PT) to improve muscle
strengthening, gait training and help with increasing mobility. Those with ESRD,
receiving dialysis, have also found physical therapy (PT) in the form of a home exercise
program consisting of stretching exercises to be quite valuable.4
Promoting Kidney Health
Keeping in mind that it is important to engage in activities that promote kidney health
and reduce the risk of chronic kidney disease the following recommendations are made:
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Do not smoke.
Drink alcohol in moderation, if at all.
Eat meals low in fat and cholesterol.
Follow instructions on over-the-counter medications.
Keep your blood sugar and blood pressure under control.
Avoid eating too much salt or potassium.
Maintain a healthy weight.
Get regular exercise (consult with your health professional before starting an
exercise program).
If you have signs or symptoms of chronic kidney disease or risk factors see your
physician and be aware of the measures you can take to maintain kidney health.
References
1. Chronic Kidney Disease Initiative. Centers for Disease Control and Prevention.
October 30, 2012.
2. Chronic Kidney Failure. Mayo Clinic. May, 2012.
3. Johansen, KL. "Exercise in the End-Stage Renal Disease Population". Journal of the American Society of
Nephrology. 2007.
4. Stugart, P. and Weiss, J. "Exercise, Rehabilitation and the Dialysis Patient: One Unit's Positive
Experiences". Dialysis and Transplantation. 1999.