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Chronic Kidney Disease

Chronic Kidney Disease
Credit: Bumrungrad International hospital

Chronic kidney disease - The serious threat not to be ignored

Our kidneys are the command center of the body’s waste management system, quietly filtering out harmful toxins from the bloodstream day after day. But today’s fast-paced modern lifestyles are leading to more and more cases of chronic kidney disease (CKD).

For expert insight on this serious threat, Better Health consulted Dr. Sira Sooparb, a board-certified specialist in nephrology who has spent many years treating patients with CKD.

CKD’s causes

Chronic kidney disease can result from certain kidney tissue diseases, as well as non-kidney related conditions, including hypertension, diabetes, obesity-related lupus (SLE), HIV/AIDS, syphilis, and hepatitis B or C – diseases which place a heavy burden on the kidneys.

Dr. Sira explains: “Kidney damage is often caused by diabetes, which increases sugar levels in the kidneys; hypertension, which increases blood pressure in the kidneys; and obesity, which overburdens the kidneys. And smoking has also been shown to cause kidney damage.”

A silent threat

The progression of CKD is divided into five stages which reflect the level of kidney function (see table below). CKD typically produces no symptoms in its dormant early stages.

Most patients don’t know they have CKD until the fourth stage, when kidney function has declined by at least 70 percent. “Most people don’t even know whether or not they have CKD; kidney function can decline by 50 percent and still not produce any noticeable symptoms,” notes Dr. Sira. “The surest way to detect it is through periodic health check-ups. Even nephrologists don’t know they have it unless they go for a check-up!”
 

Preventing CKD

Dr. Sira emphasizes the importance of dealing with the conditions that eventually lead to CKD. That means keeping diabetes under control, lowering blood pressure, and maintaining a healthy body weight – all of which require good nutrition habits. Controlling salt, protein and phosphates (which are found in milk and beans) in one’s diet is crucial, as these substances exert a heavy burden on the kidneys.

It’s also important to get plenty of sleep, avoid smoking, and reduce stress. “Eating healthy is a challenge for many patients, but medication alone won’t work without a proper diet,” Dr. Sira notes. “For patients having trouble sticking to their diet, I recommend meditation, not only to help with their diet, but also to improve their mood.” ENend.gif

The progression of chronic kidney disease

In its early stages, CKD typically produces no noticeable symptoms. Kidney function, checked through a simple blood test, is measured by GFR (Glomerular Filtration Rate), which determines the current stage of the disease.

Stage GFR* Symptoms
First stage 90 to 100 % Kidneys are functioning normally, but patients are unable to take antibiotics or anti-inflammatory medication. Some patients experience protein leakage in urine.
Second stage 60 to 89 % Blood test usually appears normal. Blood pressure may be slightly elevated. Lifestyle modification may prevent further medical protocol.
Third stage 30 to 59 % Blood test reveals CKD diagnosis. Patients usually show mild symptoms including malaise, fatigue and swelling of the ankles. Dialysis may be prescribed.
Fourth stage 15 to 29 % Patients tire easily, feel fatigued and weak, skin is pale and dry, ankles swell. Patients with glomerular nephritis experience protein build-up in urine. Blood pressure must be strictly controlled, and dialysis is vital.
Fifth stage Below 15 % The condition is extremely serious and potentially fatal. Patients are highly susceptible to infection, and immediate dialysis is usually required to allow for possible recovery.

* Full kidney function (100% ) equates to GFR 90 to 120 m.

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