Common Kidney Diseases – Symptoms, Causes and Treatment
Kidneys are a pair of organs that have the size of a human fist located on the lower side of the body at the bottom of the rib cage. The two kidneys are placed on each side of the spine. Kidneys are the significant organs in a body that helps maintain a healthy body. They are blood purifiers. The major purpose of kidneys is to filter and eliminate the toxins and waste products that are formed in the body on a day to day basis.
Kidneys perform some other essential functions such as producing hemoglobin, regulating the blood pressure and strengthen the bones by synthesizing active Vitamin B. There are multiple functions that kidneys perform in a body. The most common problem in people is Chronic Kidney Disease.
Here is an excerpt from a video interview with Dr. J.N Srinivasulu, Nephrologist – Department of Nephrology at Omni RK, Vizag on common problems related to kidney, symptoms and causes of some Kidney diseases and how to treat it. Get to know the major steps one should follow to take care in order to cure various kidney problems.
Q. What is Chronic Kidney Disease?
A. Chronic Kidney Disease is a gradual decline in the functioning of a kidney over a period of three months, then the person is said to have chronic kidney disease. In short, it is referred to as CKD. Due to this disease, there will be significant damage to kidneys and reduces the kidney’s ability to maintain a healthy body.
In India, more than 7.85 million population are affected by CKD. On the other hand, about 35 million or 1/10th population in America are affected by CKD. Mostly, CKD is caused due to Diabetes and Hypertension.
Q. What are the Symptoms of Chronic Kidney Disease in a Person?
A. Some of the major and most common symptoms of chronic kidney disease include:
- Bilateral swelling of legs and face
- Difficulty in breathing
- Severe Abdominal pain
- Loss of Appetite
- Itching
- Non-specific body pains
- Increased urination during the night
- Vomitings
Q. How to Diagnose Chronic Kidney Disease?
A. Some of the investigations to diagnose this Chronic Kidney disease include:
- Blood Chemistry
- Blood Urea
Kidney Function Marker: It is otherwise called as serum creatinine. It is usually excreted through the kidney. When there is an impairment to this kidney, it indicates that there is an accumulation of creatinine in the body. This particular investigation is used to diagnose chronic kidney disease.
Urine Examination: It is done to find out the leakage of protein in the urine.
Ultrasound: To know the morphology of the kidneys, this particular test is done. The normal size of a healthy kidney in a person 9 to 11 cm of length and 3 to 5 cm of breadth. If the upper and lower boundaries are beyond the normal limits then, it indicates that the person is suffering from chronic kidney disease.
Q. How the patients with CKD are treated?
A. In general, the doctors treat the patients with CKD depending on the categorization of the disease. Usually, CKD is categorized into 5 stages. Based on the stage of CKD, the patients are treated. To find out the stage of the disease, the doctors perform eGFR [Estimated Glomerular Filtration Rate Test]. It is meant to calculate the filtration capacity of the kidney. It is calculated with the help of an equation given by the National Kidney Foundation.
Stage 1 – 90ml GFR
Stage 2 – 60ml to 90ml GFR
Stage 3 – 30ml to 60ml GFR
Stage 4 – 15ml to 30ml GFR
Stage 5 – Less than 15ml GFR
People with less than 15ml GFR is said to have an advanced stage of kidney disease.
Q. How to treat patients with CKD?
A. Once the patient consults a doctor, they need to find out whether the patient has Diabetes and Hypertension. People with these two health issues have a high incidence of CKD. In such a case, doctors suggest them to follow a few things:
- Avoid Alcohol
- Control Sugar Level
- Regular Exercise
- Stop Smoking
- Control of Hypertension
- Avoid the usage of over the counter medications or drugs
In terms of food diet, people with CKD must follow the diet that comprises:
- Include Foods with low phosphorous and low potassium in your diet
- Avoid Non-Vegetarian food
- Avoid fruits which have high potassium
- Stop eating cakes, egg yolk that has high phosphorous
The treatment can be given to the patients through medications only if they have CKD between stage 1 to stage 4.
Q. What happens if the patient has stage 5 or end-stage CKD?
A. The main problem arises when the patient has stage chronic kidney disease. Sometimes, the patient may not notice the symptoms until he or she lands in the final stage. When the patient lands in the final stage, they need to undergo renal replacement therapy apart from the medical treatment.
Q. What are the common therapies to treat stage 5 CKD?
A. The most commonly used therapies to treat stage 5 chronic disease include Dialysis and Renal Transplantation. These two are the available renal replacement therapies.
Hemodialysis
It is an artificial or man-made machine used for simulating and for the filtration of the kidney. In this therapy, the blood is pumped using a special machine and it filters and eliminates the toxic material out of the body. Usually, this therapy is done at home or in the hospital. In general, Hemodialysis is performed twice a week. Sometimes, it is also done thrice a week based on body weight.
Peritoneal Dialysis
This type of dialysis is done through a peritoneum membrane. This membrane lines the abdominal wall in the kidneys.
These are the common forms of Dialysis done to treat or administer in patients with CKD.
Renal Transplantation
Renal transplantation is otherwise known as kidney transplantation. In this process, the person with stage 5 CKD will get kidney transplantation.
Q. What are the common causes of Kidney disease?
A. Diabetes is the major cause of Kidney disease followed by Hypertension. These two causes contribute almost 70 percent to the cause of kidney disease. Besides these two causes, some other causes include renal calculus disease, congenital kidney diseases, Glomerulonephritis cases, drug induced kidney disease and more.
Q. What are the common myths and facts about Kidney diseases?
A. Some of them ask the doctor whether a single kidney or both the kidneys are failed. If the patient has the aforementioned symptoms then, it is because of the failure of both kidneys.
Myth: If we start dialysis, should we endure life long?
Fact: The answer is actually no. There are some conditions such as acute kidney injury. It is totally different from chronic kidney disease. People might get acute kidney injury when there is a sudden fall in the kidney function. An acute kidney injury might be caused because of fever, vomitings, diarrhea, over the counter medications and other causes.
In such a case, the patients might require only 3 to 4 sessions of Hemodialysis. After the dialysis, the kidney will function as before. In some cases, dialysis is required for a lifetime in chronic kidney disease patients. For some other kidney problems, dialysis might be for a short period.
Myth: Can a Kidney donor live with a single kidney?
Fact: Yes, a donor can live with a single kidney and it is enough to sustain for a lifetime. There won’t be any problem even if they have a single kidney.
Myth: Should the kidney donor take lifetime medication?
Fact: The kidney donor doesn’t require intake of any sort of medication or treatment post-renal transplant.
Q. Is Dialysis better than a kidney transplant?
A. Kidney transplantation is better than dialysis. There won’t be any sort of diet restrictions if a patient prefer kidney transplantation. Moreover, the transplant doesn’t have symptoms and they can lead to a good quality of life. On the other hand, dialysis patients must and should go to the hospital or dialysis center twice or thrice a week. They need to spend at least 4 hours of time for the dialysis procedure during each session.
During the session, the dialysis patients will have some complaints as well. Some of the complaints include breathing problems, loss of appetite, short breath and more. So, transplant is better than dialysis.
Q. Will the patient with Kidney problems need to urinate frequently?
A. Yes, it is actually an early sign of chronic kidney disease. Besides this sign, there are many other signs like urinary tract infection, diabetes and others. The patient must consult a doctor or physician in order to find out the exact problem.
Q. What is the follow up for kidney stones?
A. The major cause of kidney stones is etiology. If etiology is cured, the patient doesn’t have any recurrence to the kidney disease. For instance, if the patient works in a hot summer and doesn’t take enough fluids then, the patient might get a recurrence stone. By maintaining the body with proper hydration, there won’t be any chance of recurrence stones. There are some instances to get recurrence stones due to infections and abnormal tracts.
Q. Is it possible to cure Kidney Stone Prognosis?
A. If it is detected at an early stage, it is possible to cure it without getting any damage to the kidney.
Q. Is renal disease hereditary?
A. Yes, there are some diseases that run in families. Some of them include Alport syndrome, SLE [Systemic Lupus Erythematosus] and more.
Q. Are there any risk factors in patients with CKD?
A. Yes, if the patient with CKD in stage 5 then, there are lesser chances of survival. In case, if the patient has other problems like renal stones and acute kidney injury [AKI], there is a chance of survival if they are diagnosed and treated in early stages. Chronic kidney disease is truly a complicated kidney problem. By identifying this problem at an early stage, there are maximum chances of survival.
Q. Will kids get kidney stones?
A. In fact, kidney stones are caused because of solute and solvent mixture. Whenever people intake less fluids i.e. if you take a high protein diet and heavy foods, there are higher chances of getting renal stones. Even, the kids and children get kidney stones. In kids, they might have congenital abnormal tracts and abnormal ureter that eventually leads to kidney stones.
Q. What are the causes of kidney stones?
A. Kidney stones are caused due to the high consumption of non-vegetarian food, less intake of water, oxalate diet and other things that can cause kidney stones.
Q. How to prevent people from getting kidney diseases?
A. One must follow some preventive measures from getting a few kidney diseases. Some of them include:
- Follow a healthy lifestyle
- Regular Exercise [30 minutes walk daily]
- Avoid smoking and alcohol
- Control of Hypertension
- Intake of 3 to 4 liters of water on a daily basis
- Controlling blood sugar levels once diagnosed with Diabetes
- Avoid over counter medications
Q. What are the preventive measures to cure Congenital Diseases or Hereditary Kidney Diseases?
A. If the parents have kidney diseases, their children must go for a regular checkup after 30 years of age. Usually, cystic diseases might be caused by some people after 30 years. Some of the kidney function tests to diagnose kidney diseases include urine examination, blood pressure checkup, Creatinine blood test, blood urea and more.
Q. How to prevent kidney stones?
A. When the patient is predisposed to kidney stones, they need to take at least 3 to 4 litres of water frequently on a daily basis. It is essential to prevent consumption of high protein diet, fiber meat and they must avoid oxalate food.
- Intake of adequate fluids
- Avoid Red meat
- Evade Cocoa related products like coffee
Q. What is the normal range of passing urine daily?
A. Generally, the normal attendance to pass urine is 4 to 5 times. If it is beyond that during the daytime then, there could be something wrong with the kidneys. Otherwise, it might be an early sign of the patient having Diabetes.
Q. Will the ideal amount of water differs from person to person?
A. On average, a normal person can take 3 to 4 liters.
Q. What kind of diet a person on dialysis should follow?
A. If the patient is on regular dialysis i.e., twice or thrice a week, they must follow some diet. They can intake a high protein diet like non vegetarian. They must take fluids not more than 750ml.
- High protein diet
- High-Calorie Diet
- Multivitamins Supplements
Q. Can a person without pain have a kidney problem?
A. Kidney diseases cannot be noticed until the final stage of the problem. After 40 years of age, every person must go for a regular checkup at least once a year. They must get a urine examination, blood chemistry and some other essential common tests.
MD, DM (Consultant – Nephrologist)