Chronic Kidney Disease


Chronic renal disease or chronic kidney disease, is a result of slow progressive loss of kidney function over a period of numerous years ultimately leading to irreparable kidney failure. Chronic kidney disease is much more widespread than people think and in most cases it goes undetected and undiagnosed until the disease attains a well advanced stage and kidney failure is comparatively imminent. People usually do not realize that they have chronic kidney failure only until their kidney function is drops to 25 percent of normal.

The kidneys perform many vital functions to promote overall health of the body. Each kidney contains millions of tiny vessels called nephrons that function as filters for the blood. In every thirty minutes complete blood supply passes through the kidneys and on everyday basis, over two quarts of waste are filtered out to the bladder to be excreted as urine. If the kidney will not function properly then the waste would accumulate within the bloodstream and speedily cause damage to the other organs, leading to a condition called Uremia.

During this cleaning process the kidneys also regulate the mineral composition of the body. When blood is sent through the kidneys, vital chemicals (sodium, phosphorus and potassium) such as that are needed by the body are removed from the waste and sent back into the bloodstream for use.

The kidneys perform the function of regulating the acid-alkaline balance in the body by maintaining a proper pH level of 7.4. Any imbalance will either make the body alkaline (If the pH level exceeds 7.4) or acidic (if the level drops below 7.4). The body must uphold a proper acid-alkaline equilibrium to function at optimal levels. In America major problem faced today is Acidosis which is the most likely cause of several age-related diseases such as heart disease and diabetes.

Finally, the kidneys perform the vital functions of regulating the fluid levels of the body. They also aid in releasing three important hormones into the body - erythropoietin, which stimulates the bone marrow to build red blood cells; rennin, which regulates the blood pressure; and calcitriol, the active form of vitamin D which aids in maintaining calcium for bones and for maintaining normal chemical balance in the body.

The renal function is regarded to be 100 percent when both the kidneys are performing properly. Even though a human body has two kidneys, the body requires the presence of only one fully functioning kidney to perform its job effectively. When renal function reduces to 25 percent or less, which implies less than half of one kidney is functioning properly, grave health problems will start to take place. A person whose renal function percentage drops below 15 percent can die unless dialysis or a transplant is performed.

There are three grades of kidney disease: Acute Renal Failure, Chronic Kidney Disease and End Stage Renal Disease. Acute Renal Failure (ARF) is illustrated by an abrupt decline in kidney function, normally occurs due to an accident that injures the kidneys, a sudden loss of blood or a poisonous toxin such as drugs. Permanent loss of kidney function can occur in this case if ARF is not treated immediately. However if the kidneys are not severely damaged, the renal failure may be reversed. Chronic Kidney Disease (CKD) is the slow loss of kidney function and the most widespread form of kidney disease today. If not treated on time, CKD will result into permanent kidney failure and people suffering from the disease are at a great threat of dying from a heart attack or stroke. End Stage Renal Disease (ESRD) is the entire or almost entire loss of kidney function. On reaching this stage, the damage to the kidneys has become permanent and hence irreversible. Those detected with ESRD will have to undergo dialysis on a regular basis or undergo a kidney transplant in order to stay alive.

If the disease is detected in early stages, there are chances of slowing down the progression of the disease. Since high blood pressure and diabetes are the two main causes of kidney disease, controlling the blood pressure and blood glucose levels can be solution to prolonging health. People with kidney disease are recommended to follow a low protein diet and uphold their levels of cholesterol as high cholesterol can cause high blood pressure. Moreover, preserving a fit health and quitting smoking are both primary measures to slow down the progression of the disease.

According to the statistics of National Kidney Foundation, roughly 20 million Americans, that is, 1 in 9 adults have the disease and another 20 million are at threat for it. Kidney disease is often a silent attacker and most people are unaware of its existence in their body until the disease has progressed to a life-threatening stage.

Risk factors of Chronic Kidney Disease
The conditions or situations those are associated to a higher risk of developing kidney disease are
Kidney disease found in family history
Age factor - Chronic kidney disease is much more widespread in people over 60 years of age
Atherosclerosis
Bladder obstruction
Chronic glomerulonephritis
Inborn or Congenital kidney disease
Diabetes
Hypertension or high blood pressure
Lupus erythematosis
Overexposure to some toxins
Sickle cell disease
Some medications

Signs and Symptoms of Chronic Kidney Disease
Chronic kidney failure, in contrary to acute kidney failure, is a slow and steadily progressive disease. It is not typically until the disease is in reasonably well advanced stage and the condition has become severe that signs and symptoms are evident and most of the damage is irreversible. The most common signs and symptoms of chronic kidney disease are
Anemia
Blood in urine or dark urine or more frequent urination especially at night
Reduced mental alertness
Reduced urine output
Edema - swollen feet, hands and ankles
Fatigue or shortness of breath
Hypertension
Insomnia
Itchy skin, can become persistent
Loss of appetite and abrupt change in bodyweight
Erectile dysfunction
Muscle cramps and twitches
Nausea
Pain on the side or mid to lower back , unexplained headaches
Protein in urine

Causes of Chronic Kidney Disease
The kidneys perform the function of filtration in human body by removing excess waste and fluid material from the blood and excreted from the body. Kidneys get the blood and oxygen supply from the renal arteries and when the blood enters the kidneys it passes through smaller and smaller blood vessels. The smallest ones are the glomeruli and it is in this blood vessel the blood is filtered. Waste, fluids and other substances are taken out and cross into miniscule tubules. Here the bloodstream reabsorbs what the body is able to reuse and the left-over waste which the body cannot reuse is excreted in our urine.

Mostly the kidneys are able to remove all waste materials that are produced by the body. However, problems can occur if the blood flow to the kidneys is affected or the tubules or glomeruli are not functioning properly due to damage or disease, or if urine outflow is hindered. In the bulk of cases progressive kidney damage is based out of a chronic or a long-term disease such as

Diabetes (both Diabetes Types I and II) - If the diabetes is not well controlled, excess sugar or glucose can build-up in the blood causing damage the glomeruli. The danger of chronic kidney failure is more among patients with Diabetes Type I. Kidney disease more commonly occurs between years 15 to 25 after diagnosis of diabetes.
Hypertension or high blood pressure can also damage glomeruli.
Obstructed urine flow can back up the urine into the kidney from the bladder due to vesicoureteral reflux. Blocked urine flow boosts pressure on the kidneys and destabilizes their function. Possible causes of obstruction in urine flow are an enlarged prostate, kidney stones or a tumor.
Kidney diseases such as polycystic kidney disease, pyelonephritis, or glomerulonephritis.
Kidney artery stenosis is the narrowing or blocking of the renal artery before it enters the kidney.
Some toxins such as fuels, solvents (carbon tetrachloride), lead (lead-based paint, pipes and soldering materials) and also some types of jewelry have toxins which can lead to chronic kidney failure.
Fetal developmental problem associated with improper development of kidneys in the unborn baby while it is developing in the womb.
Systemic lupus erythematosis is an autoimmune disease in which immune system starts attacking the kidneys thinking of them to be a foreign tissue.
Malaria and yellow fever
Overuse of some medications for example non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen.
Prohibited drug abuse such as heroin or cocaine.
Injury such as a sharp blow or physical injury to one kidney or both kidneys.

Diagnosis of Chronic Kidney Disease
A doctor will assess the signs and enquire the patient about symptoms. On assessing sings and symptoms the doctor may order further investigation through various tests.
Blood test is done to check the levels of urea and creatinine which determines whether waste substances are being sufficiently filtered out from the body. If levels are persistently high, it is most likely the end-stage kidney disease.
Urine test is done to determine whether there is either blood and/or protein in the urine.
Kidney scans, such as a magnetic resonance imaging (MRI) scan, computed tomography (CT) scan, or an ultrasound scan, are done to find out about any blockages in the urine flow. These scans can also show the size and shape of the kidneys. The kidneys are smaller and have an uneven shape in advanced stages of kidney disease.
In kidney biopsy a small sample of kidney tissue is taken out and investigated for cell damage. An investigation of kidney tissue makes it easier to conclude an exact diagnosis of kidney disease.
Chest X-ray is done with the aim of checking for presence of pulmonary edema, a fluid retained in the lungs.
Glomerular filtration rate (GFR) is a test that compares the levels of waste products in the patient's blood and urine. It measures how many milliliters (ml) of waste are filtered per minute by the kidneys. The individuals with healthy kidneys filtration rate of over 90 ml per minute. Therefore, changes in the GFR rate can measure how advanced the kidney disease is. If GFR rate is lower than 15 ml, it implies that renal failure has occurred.

It is vital for kidney disease to be diagnosed and treated early in order to prevent serious damage. Patients with diabetes should undertake an annual test which measures microalbuminuria, small amounts of protein in urine. This test can identify early diabetic nephropathy or early kidney damage linked to diabetes.

Prevention of chronic kidney failure
People who are suffering from a chronic disease such as diabetes or hypertension, which are directly associated with the risk of chronic kidney failure, can drastically lower their chances of developing kidney disease if they manage their condition. To know more about Diabetes, please click here.

Some of the natural ways of controlling hypertension are meditating, exercising, quit smoking, reduce weight and reduce salt intake.  Coconut water is known for lowering the blood pressure and a study revealed that drinking coconut water regularly was able to significantly lower blood pressure in 71 percent of the participants. To know more about Hypertension, please click here.

Healthy Diet – Following a proper diet is vital to keep the body healthy and to avoid putting excess strain on failing kidneys. The diet of person suffering from chronic kidney disease should not include protein rich foods since when a person eats protein, the body after using up the required amounts, excretes the waste product formed called urea. The kidneys of an affected person cannot filter urea correctly and the waste product accumulates. So it is important to reduce protein intake. In order to get the recommended daily protein, those suffering from kidney failure should get most of their protein from plant sources such as nuts, grains and starches instead of meat and dairy. Specific daily protein recommendations rely on the level of kidney function.

Person suffering from CKD should avoid sodium as it contributes to increased blood pressure and high blood pressure puts excess strain on the kidneys. Foods with the highest levels of sodium are canned foods, processed foods, pickled foods and foods that have been smoked or cured. It is also vital to avoid use of excess salt during cooking and eating. To know more about hazards of Sodium, please click here.

According to the National Kidney Foundation, kidneys of people with chronic kidney disease cannot properly remove phosphorus from the bloodstream and excessive levels of phosphorous in the bloodstream triggers the release of calcium from bones. This results in weakening and porosity of bones which are more prone to breakage. Therefore, it is important to avoid foods such as dairy products, dried beans, peas, nuts, nut butters and beer.

Increased potassium levels in the blood of patients suffering from chronic kidney failure can result in a condition called hyperkalemia, which can further cause irregular heartbeat, abnormal nervous system function and possibly cardiac arrest. Thus, affected people should not eat foods such as bananas, oranges, potatoes, spinach and cantaloupe.

Diet restrictions can frequently cause trouble in meeting calorie needs however it is important for people with chronic kidney disease to intake adequate calories to maintain proper body function and weigh. Excess weight loss can lead to malnutrition and ill health.

Physical activity - Regular physical exercise is best for sustaining healthy blood pressure levels and also to control chronic conditions such as diabetes and heart disease.

Avoid alcohol and drugs intake. Aspirin, Motrin, Advil and Tylenol have been linked to cause kidney damage. Avoid enduring exposure to heavy metals, such as mercury & lead and also to fuels, solvents and other toxic chemicals.

A study published in Clinical Journal of the American Society of Nephrology, has found that Aspartame (artificial sweetener) can cause fast-paced kidney decline.


Please consult your health care provider before starting supplement or herbal treatment
Supplements 
Carnitine (L-Carnitine) - Kidneys make carnitine and kidney disease could lead to low levels of carnitine in the body. If you have kidney disease, your health care provider may prescribe carnitine. To know more about L-Carnitine, please click here.
Eicosapentaenoic Acid (EPA) - Omega-3 fatty acids, including EPA, has manhy positive effects on kidneys.
Zinc - Studies show potential improvement in uremic patients taking zinc supplements. However, zinc supplementation may be recommended only in patients with proven zinc deficiency.
Vitamin D - Studies have found Vitamin D deficiency in majority of the kidney disease patients, plus it is essential to regulate calcium, which is a problem in kidney disease.
Baking Soda - The Journal of the American Society of Nephrology (JASN) has reported that a daily dose of baking soda could prevent kidney damage and chronic kidney disease.

Herbs
Grape Seed - It helps support the filtration function of your kidneys.
Horsetail - Use for horsetail is as a mild diuretic 'water pill' to increase urination and lessen swelling.
Turmeric - Studies have found that Curcumin found in turmeric can effectively treated kidney problems and restored kidney functions.