Chronic kidney disease (CKD) impacts about 37 million people in the United States and leads to significant health care costs, disability and a shortened life expectancy, especially if the disease is …
Chronic kidney disease (CKD) impacts about 37 million people in the United States and leads to significant health care costs, disability and a shortened life expectancy, especially if the disease is not picked up early.
CKD is found in one out of seven people, or about 15 percent of the U.S. population.
Most importantly, it is estimated that nine out of 10 adults do not know they have some level of CKD, and two out of five adults with severe disease are unaware they are close to the complete shutdown of their kidneys.
CKD can be present in children and young people, but is mostly encountered in people over 65 years of age. It is more common in women than men and is found in a higher percentage of Black and Hispanic adults than in other groups.
Chronic kidney disease means that your kidneys are damaged and losing the ability to filter your blood of toxins. Early on, there are no symptoms, but as it progresses, untreated people begin to feel ill.
Other conditions begin to appear, such as anemia, high blood pressure, brittle bones that lead to fractures, and the swelling of legs and ankles.
Also associated with CKD are heart and blood vessel diseases. The two most important conditions associated with chronic kidney disease are hypertension and diabetes.
There are a number of medical conditions that damage the kidneys and lead to chronic dysfunction. The most common conditions cited in the medical literature are glomerulonephritis, kidney malformation found at birth, polycystic kidney disease, inherited and immune diseases (e.g. lupus), obstruction from an enlarged prostate, kidney stones and repeated urinary tract infections. It is not unusual to find evidence of CKD following a serious illness that required intensive care and hospitalization.
This condition is usually discovered when a blood specimen is drawn that measures serum creatinine and a calculated glomerular filtration rate (GFR).
The GFR is a complicated formula with abnormal levels that are below 60 GFR units. It is staged 1 through 5, with 5 indicating the potential need for kidney dialysis or transplant.
A GFR measurement over 90 units (stage 1) is considered normal. See “Stages of chronic kidney disease,” on the right side of this page, to learn more.
Your primary care doctor or kidney specialist will help interpret the results if a lower GFR is discovered.
The best way to treat chronic kidney disease is early detection. Early treatment includes:
Exercise on a regular basis
Lifestyle changes such as stopping smoking and decreasing daily intake of alcohol and salt
Dietary changes, including a decreased daily intake of meat protein. Increase intake of green and colored vegetables. Avoid dark-colored colas and sugared drinks. A dietician will be helpful in reviewing your current eating selection and offering suggestions.
Medication is now available for stabilizing renal function for persons with more severe disease, to slow decline or prevent the need for dialysis. Discuss this with your doctor if you are a candidate.
If you have diabetes and/or high blood pressure, you need to carefully manage these conditions.
If there is a question of CKD, a referral for nephrology care is important.
There are two forms of dialysis—hemodialysis and peritoneal (abdominal). Hemodialysis requires three or four treatments per week, and peritoneal is performed on a daily basis. Often dialysis continues until a transplant is found for the person. Home dialysis is gaining more acceptance.
Kidney transplants are performed frequently in many medical centers when a single kidney is donated by a living donor—often a family member, a spouse or a friend. The U.S. Renal Data System estimates that more than 22,000-plus renal transplants are performed each year.
However, there are over 100,000 Americans waiting for a transplant or organs at any given time, and people die on a daily basis while waiting for a transplant.
The demand for donors will only increase in the future. This makes early detection and diagnosis more important.
There are also social and racial disparities in communities that can influence the availability of dialysis, transplants and early detection due to a lack of primary care.
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