What Is Chronic Kidney Disease
Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by filtering wastes from your blood. If kidney disease worsens, wastes can build to high levels in your blood and make you feel sick. You may develop complications like:
- high blood pressure
- poor nutritional health
Kidney disease also increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long time. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.
What Causes Kidney Failure
The most common causes of kidney failure are diabetes and high blood pressure. Sometimes, though, kidney failure happens quickly due to an unforeseen cause.
When the kidneys lose function suddenly , its called acute kidney failure . This type of kidney failure is often temporary. Common causes of acute kidney failure can include:
- Autoimmune kidney diseases
- A urinary tract obstruction
- Uncontrolled systemic disease like heart or liver disease
Kidney failure usually doesnt happen overnight. Chronic kidney disease refers to a group of health conditions that affect how well your kidneys function over time. If left untreated, chronic kidney disease can lead to kidney failure.
The biggest causes of kidney failure from chronic kidney disease are:
- Diabetes: Unmanaged diabetes can lead to uncontrolled blood sugar levels. Consistently high blood sugar can damage the bodys organs, including the kidneys.
- High blood pressure: High blood pressure means blood travels through your bodys blood vessels with increased force. Over time, untreated high blood pressure levels can damage the kidneys tissue.
Other causes of chronic kidney disease include:
- Polycystic kidney disease, a hereditary condition where cysts grow inside your kidneys.
- Glomerular diseases, such as glomerulonephritis, which affect how well the kidneys can filter waste.
- Lupus and other autoimmune diseases that can affect multiple body systems.
How Is Kidney Disease Diagnosed
As with high blood pressure, you may not realize that you have kidney disease. Certain laboratory tests can indicate whether your kidneys are eliminating waste products properly. These tests include serum creatinine and blood urea nitrogen elevated levels of either can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.
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Why Does It Happen
The kidneys are two bean-shaped organs, the size of your fist, located on either side of the body, just beneath the ribcage. The main role of the kidneys is to filter waste products from the blood before converting them into urine. The kidneys also:
- help maintain blood pressure
- maintain the correct levels of chemicals in your body which, in turn, will help heart and muscles function properly
- produce the active form of vitamin D that keeps bones healthy
- produce a substance called erythropoietin, which stimulates production of red blood cells
Chronic kidney disease is the reduced ability of the kidney to carry out these functions in the long-term. This is most often caused by damage to the kidneys from other conditions, most commonly diabetes and high blood pressure.
Read more about the causes of chronic kidney disease
Low Blood Pressure Could Spell Disaster For Kidney Disease Patients
Theres undoubtedly a distinct connection between thriving in the face of kidney disease and maintaining balanced health, all-around. Any kind of extremes, whether they be declines or increases, can throw off kidney function when its already impaired. And, in the case of chronic kidney disease patients, these imbalances can often prove fatal. One component of cardiovascular health that needs to be maintained in a balanced state of equilibrium as much as possible, is hypertension or high blood pressure. A new study has identified a link between intensive blood pressure lowering and significant decline of renal function.
Doctor Elaine Ku of the University of California, San Franciscos Dept. of Medicine Nephrology Division, along with her colleagues, had showcased previous study results which indicated acute kidney function declines higher than or equal to 20 percent, concurrent with active measures to significantly lower blood led to a much greater risk of escalating CKD into end-stage renal disease.
For High Blood Pressure
- Reduce sodium intake, dont season food with salty seasonings or add salt to sauces which often have tons of sodium already
- Maintain a healthy weight for your height and body type.
- Fit in fitness time, even with a brisk walk each day, youll be amazed at how it adds up in the long run.
- Avoid smoking, coffee and alcohol along with processed foods.
For Low Blood Pressure
- Avoid low blood pressure triggers like standing for long periods of time.
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What Are The Risk Factors Of Chronic Kidney Disease
Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:
- have a family history of kidney failure
- belong to a population group with a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians
Blood Pressure Profile And Targets In Advanced Ckd
Two important patterns characterized the hypertensive phenotype in people with advanced CKD. The first is the high prevalence of nocturnal hypertension17 and uncontrolled masked hypertension due mainly to elevated BP values at night.18,19 The second is the high proportion of patients with apparent or truly resistant hypertension.20 The elevated nighttime BP in patients with advanced CKD can be explained in several ways including an increased prevalence of sleep apnea syndrome due to sodium and water retention,21,22 an increased sympathetic nerve activity and a reduced capacity to excrete sodium during daytime as GFR declines.23 Indeed, a high nocturnal BP enables to maintain the 24 h sodium balance when kidney function is impaired. In this respect, Fukuda et al have nicely shown that as GFR declines sodium excretion, albuminuria and BP increase during the night.24 Regarding resistant hypertension, several studies have demonstrated a high prevalence in patients with advanced CKD. In a recent review written by Georgianos and Agarwal, the prevalence of resistant hypertension in treated hypertensive patients with CKD ranged between 28.1% and 40.4%.20 Both nocturnal and resistant hypertension are associated with an increased risk of cardiovascular events.18,19
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Table 1 Target Blood Pressures in the General Population and CKD and Diabetes According to Various Guidelines |
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Ckd By Age Sex And Race/ethnicity
According to current estimates:*
- CKD is more common in people aged 65 years or older than in people aged 4564 years or 1844 years .
- CKD is slightly more common in women than men .
- CKD is more common in non-Hispanic Black adults than in non-Hispanic White adults or non-Hispanic Asian adults .
- About 14% of Hispanic adults have CKD.
High Blood Pressure Is Dangerous
Dr. Jose Mayorga MD, executive director, UCI Health Family Health Centers tells us, “High blood pressure causes the heart to work harder. Although our heart is a special muscle, this is not your bicep. You do not want it to grow big and bulky because it pumps blood inefficiently putting you at risk for heart attacks, heart failure, and strokes if left uncontrolled.I like to explain high blood pressure to my patients in this matter. If you use a garden and do not put your thumb over the nozzle, water flows very nicely, smoothly, and with little pressure. Once you put your finger over the nozzle, what happens? The pressure increases, water sprays out faster with more force. This is what is happening when you have high blood pressure. All your internal organs from your eyes to your brain to your kidneys are getting hit with this force. Overtime, this causes damage and, in some cases, irreversible damage that can lead to blindness, strokes, and even kidney failure. In fact, the number one cause of kidney failure is due to hypertension .”
Dr. Jacob Hascalovici MD, PhD Clearing Chief Medical Officer says, “High blood pressure can wear you out, contributing to fatigue andpain while also making it more likely you could have a heart attack or stroke. Untreated high blood pressure can also lead to problems with your kidneys, heart, mental health, and eyesight, among other things.”
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What Is Normal Blood Pressure
Normal blood pressure is defined as a systolic blood pressure of less than 120 and a diastolic blood pressure of less than 80. These values are based on averages and may vary depending on factors such as age, health status, medications, and lifestyle choices.
High blood pressure is defined as a systolic blood pressure of 140 or higher and/or a diastolic pressure of 90 or higher. These values are also based on averages, and they may vary depending on the same factors as above.
Effects Of Sbp In Different Strata On Renal Function
The GFR and prevalence of renal insufficiency and proteinuria in different SBP strata are presented in Figure 2. When SBP decreased from stratum 90-100mmHg to stratum 80-90mmHg, GFR was reduced by 3.6ml/min/1.73m2 while BUN, Scr and UA respectively increased by 0.2mmol/L, 1.93μmol/L and 7.5μmol/L . GFR decreased progressively and continuously with increase in SBP, approximately going down by 1.13ml/min/1.73m2 for every 10mmHg increase in SBP that occurs within the range of 140 to 230mmHg while BUN, Scr and UA increased by 0.08mmol/L, 1.54μmol/L and 1.73μmol/L for every 10mmHg increase in SBP. OR values of renal insufficiency and proteinuria in different SBP strata are shown in Table 3.
Effects of different SBP strata on GFR, renal insufficiency prevalence and proteinuria prevalence. GFR was expressed in mean±SE. A, B, C, D, E, F, G, H, I, J, K, L, M and N represents 80-89mmHg, 90-99mmHg, 100-109mmHg, 110-119mmHg, 120-129mmHg, 130-139mmHg, 140-149mmHg, 150-159mmHg, 160-169mmHg, 170-179mmHg, 180-189mmHg, 190-199mmHg, 200-209mmHg and 210-220mmHg stratum, respectively.
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Lifestyle Factors & Changes
The DASH diet is an eating plan that has been shown to lower blood pressure. The DASH diet is rich in fruits, vegetables, whole grains, and low-fat dairy foods and low in unhealthy saturated fat and cholesterol. To learn more about the DASH diet visit: https://www.dashdiet.org/
To follow the DASH diet, you should eat more vegetables. Choose fresh vegetables with no added salt or sugar. Aim for at least four servings of vegetables per day. Try to eat more whole grains. Choose whole-grain breads, pasta, and rice. Consider eating less sodium. Cut back on foods that are high in sodium, such as cured meats, bacon, sausage, lunch meats, cheeses, gravies, and sauces. Try to also go for more Grass-fed options if you do want to indulge.
Drink less alcohol. If you drink alcohol, limit it to two drinks per day for men and one drink per day for women. Another life style change would be to exercise regularly. People who exercise regularly tend to have lower blood pressure than those who do not exercise. To get the most benefit from exercise, aim for at least 30 minutes of moderate-intensity activity most days of the week. Moderate-intensity activities include walking, biking, and swimming. You can also break up your exercise into shorter periods of 10 minutes or more.
Keeping Your Kidneys Healthy
There are a number of things you can do to keep your kidneys healthy, including:
- If you have diabetes, make sure that your blood sugar control is excellent. Follow your doctors advice about insulin injections, medicines, diet, physical activity and monitoring your blood sugar.
- Control high blood pressure. Have your blood pressure checked regularly. Medications used to lower blood pressure , such as ACE inhibitors or angiotensin blockers, can slow the development of kidney disease.
- If you have one of the risk factors for kidney disease, have a kidney health check at least every two years .
- Treat urinary tract infections immediately.
- Control blood cholesterol levels with diet and medications if necessary.
- Drink plenty of water and choose foods that are low in sugar, fat and salt, but high in fibre. Stick to moderate serving sizes.
- Drink alcohol in moderation only.
- Stay at a healthy weight for your height and age.
- Try to exercise moderately for at least 30 minutes a day.
A reduction in kidney filtration is common in older people but can also indicate kidney damage and should be checked by your GP.
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How Do Doctors Treat Stage 3 Ckd
Doctors treat Stage 3 CKD with medicines that help with your symptoms and with other health problems kidney disease can cause, such as diabetes and high blood pressure.
These medicines include:
- Blood pressure medicines like ACE inhibitors and ARBs
- Diabetes medicines to keep your blood sugar at a healthy level
- Calcium and vitamin D supplements to keep your bones strong
- Diuretics to help with swelling
- Iron supplements to help with anemia
You may also need to stop taking certain medicines that can worsen the damage to your kidneys, such as pain medicines called NSAIDs and some arthritis medicines. Tell your doctor about all the medicines you takeeven ones they did not prescribe.
If you do not have a nephrologist , talk to your regular doctor about finding one. You and your nephrologist can work together to make a treatment plan just for you. Your nephrologist will also do lab tests to check your kidney health often, usually every 90 days .
How Is Kidney Failure Treated
Kidney failure treatment is determined by the cause and extent of the problem. Treating your chronic medical condition can delay the progression of kidney disease. If your kidneys start losing their function gradually, your doctor may use one or more methods to track your health. By watching you closely, your doctor can help you maintain your kidneys function as long as possible.
Your doctor may gauge your kidney function with:
- Routine blood tests
- Blood pressure checks
Because the kidneys serve such an important purpose, people in kidney failure need treatment to keep them alive. The main treatments for kidney failure are:
- Dialysis: This treatment helps the body filter the blood .
- In hemodialysis, a machine regularly cleans your blood for you. People often receive this kidney failure treatment at a hospital or dialysis clinic, 3 or 4 days each week.
- Peritoneal dialysis cleans the blood in a slightly different way using a dialysis solution and a catheter. Sometimes, people can do their treatment at home.
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High Blood Pressure Isn’t Inevitable And Can Be Prevented
According to Richards, “Modifying lifestyle habits that contribute to high blood pressure is the best way to help lower your high blood cut down or stop smoking, cut back on alcohol consumption, engage in even light to moderate physical activity, and integrate a diet rich in whole foods and low in sodium. Knowing your risk is important to lowering and / or preventing high blood pressure.” 6254a4d1642c605c54bf1cab17d50f1e
Dr. Mayorga states, “It seems very cliché but eating healthy and exercising is a great way to lower high blood pressure. Regular exercise or physical activity can help lower high blood pressure. If your job requires that you do extraneous activity this may not be enough because our bodies are very efficient and will get accustomed to routines. Therefore, it won’t burn more calories. If you do the same activity every day it won’t necessarily equate to added weight loss especially if you have a poor diet. This is why you should still make time to do other physical activity.
Other ways to prevent high blood pressure is eating a diet rich in whole grains, fruits, vegetables, and low in saturated fat and cholesterol. Studies suggest this can lower high blood pressure by up to 11 mm Hg! Furthermore, losing 5-10 pounds can manage or prevent high blood pressure in many individuals who are overweight . Some data suggests that even losing 2.2 pounds of weight can reduce your blood pressure by 1 mmHg.”
How Serious Is Stage 3 Ckd
You might think of Stage 3 CKD as a “middle stage” of kidney disease. Your kidneys are damaged, but they still work well enough that you do not need dialysis or a kidney transplant.
Kidney disease often cannot be cured in Stage 3, and damage to your kidneys normally is not reversible. However, with treatment and healthy life changes, many people in Stage 3 do not move to Stage 4 or Stage 5, which is kidney failure.
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Over Time High Blood Pressure Harms Renal Blood Vessels
The nephrons in the kidneys are supplied with a dense network of blood vessels, and high volumes of blood flow through them. Over time, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden. These damaged arteries are not able to deliver enough blood to the kidney tissue.
- Damaged kidney arteries do not filter blood well. Kidneys have small, finger-like nephrons that filter your blood. Each nephron receives its blood supply through tiny hair-like capillaries, the smallest of all blood vessels. When the arteries become damaged, the nephrons do not receive the essential oxygen and nutrients and the kidneys lose their ability to filter blood and regulate the fluid, hormones, acids and salts in the body.
- Damaged kidneys fail to regulate blood pressure. Healthy kidneys produce a hormone called aldosterone to help the body regulate blood pressure. Kidney damage and uncontrolled high blood pressure each contribute to a negative spiral. As more arteries become blocked and stop functioning, the kidneys eventually fail.