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Dr. Andrew Bentzel, kidney doctor at Mayo Clinic, looks after patients with kidney disease, whether in the early stages or with more advanced kidney disease considering dialysis and transplantation as treatment options. In this video, he covers the basics of chronic kidney disease: what it is, who gets it, the symptoms, diagnosis, and treatment. Whether you are looking for answers for yourself or for someone you love, the goal is to give the best information available.
Chronic kidney disease is a disease characterized by progressive damage and loss of function in the kidneys. It is estimated that chronic kidney disease affects about one in seven American adults, and most of those people do not know they have it.
Before getting into the disease itself, it helps to talk about the kidneys and what they do. The kidneys play many important roles in keeping the body in balance. They remove waste and toxins and excess water from the bloodstream, which is carried out of the body in urine. They help make hormones, produce red blood cells, and turn vitamin D into its active form so it is usable in the body.
Quite a few things can cause or put you at higher risk for chronic kidney disease, and some of them cannot be avoided. Your risk is simply higher if you have a family history of certain genetic conditions, such as polycystic kidney disease, or of some autoimmune diseases, such as lupus or IgA nephropathy. Defects in the kidney structure can also cause the kidneys to fail, and the risk increases as you get older. Sometimes other common medical conditions increase your risk. Diabetes is the most common cause of kidney disease, both type 1 and type 2 diabetes. Heart disease and obesity can also contribute to the damage that causes kidneys to fail. Urinary tract issues and inflammation in different parts of the kidney can also lead to long-term functional decline.
Some risk factors are more under our control. Heavy or long-term use of certain medications, even those that are common over-the-counter, can contribute, and smoking can also be a contributing factor to chronic kidney disease.
Often there are no outward signs in the earlier stages of chronic kidney disease, which is grouped into stages one through five. Generally, the earlier stages are known as one to three. As kidney disease progresses, you may notice the following symptoms: nausea and vomiting, muscle cramps, loss of appetite, swelling of your feet and ankles, dry itchy skin, shortness of breath, trouble sleeping, and urinating either too much or too little. However, these usually appear in the later stages, and they can also happen in other disorders, so do not automatically interpret them as meaning you have kidney disease. If you are experiencing anything that concerns you, you should make an appointment with your doctor, even before any symptoms appear. Routine blood work can indicate that you might be in the early stages of chronic kidney disease, and the earlier it is detected, the easier it is to treat. This is why regular checkups with your doctor are important.
If your doctor suspects the onset of chronic kidney disease, they may schedule a variety of other tests. They may also refer you to a kidney specialist, a nephrologist like Dr. Bentzel. Urine tests can reveal abnormalities and give clues to the underlying cause of chronic kidney disease, which can also help determine the underlying issues. Various imaging tests, like ultrasounds or CT scans, can help your doctor assess the size and structure of the kidneys, as well as evaluate visible damage, inflammation, or stones. In some cases, a kidney biopsy may be necessary, in which a small amount of tissue is taken with a needle and sent to the pathologist for further analysis.
Treatment is determined by what is causing your kidneys to not function normally, and treating the cause is key, leading to reduced complications and slowing progression of kidney disease. For example, getting better blood pressure control, improved sugar control in diabetes, and reducing weight are often key interventions. However, existing damage is usually not reversible. In some conditions, treatment can reverse the cause of the disease, so seeking medical review is really important. Individual complications vary, but treatment might include high blood pressure medication, diuretics to reduce fluid and swelling, supplements to relieve anemia, statins to lower cholesterol, or medications to protect your bones and prevent blood vessel calcification. A lower protein diet may also be recommended, because it reduces the amount of waste your kidneys need to filter from your blood. These measures can not only slow the damage of kidney disease but also make you feel better.
When the damage has progressed to the point that 85 to 90 percent of your kidney function is gone and the kidneys no longer work well enough to keep you alive, it is called end-stage kidney failure, but there are still options. Dialysis uses a machine to filter the toxins and remove water from the body, since the kidneys are no longer able to do this. Where possible, the preferred therapy is a kidney transplant. While an organ transplant can sound daunting, it is often the better alternative and the closest thing to a cure, if you qualify for a kidney transplant.
If you have kidney disease, there are lifestyle choices to consider: quit smoking, consume alcohol in moderation, and if you are overweight or obese, try to lose weight. Staying active and getting exercise can help not only with weight but also with fatigue and stress. If your condition allows, keep up with your routine, whether that means work, hobbies, social activities, or other things you enjoy. It can be helpful to talk to someone you trust, such as a friend or relative who is good at listening, or your doctor may refer you to a therapist or social worker. It can also be helpful to find a support group and connect with people going through the same thing.
Learning you have chronic kidney disease and learning how to live with it can be a challenge, but there are many ways to help you be more comfortable for longer, before more drastic measures are needed. Even then, there is plenty of hope. To learn more about chronic kidney disease, watch the other related videos or visit mayoclinic.org. The speaker wishes viewers well.