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Chronic kidney disease is a condition of kidneys being damaged from many potential causes, resulting in gradual and permanent loss of kidney function over time. The main causes of CKD are diabetes, hypertension (high blood pressure) and obesity. Other conditions that can cause chronic kidney disease include glomerulonephritis and genetic disease, e.g. polycystic kidney disease.

If unaware of the disease, kidney disease can gradually worsen over time, as the symptoms are often not noticed until the damage is severe. Early detection and diagnosis play critical roles in delaying further kidney damage that could ultimately cause kidney failure. At late stage, the treatment options are narrowed down to dialysis and kidney transplant.

The risk factors include:

Diabetes
Hypertension or high blood pressure
Family history of CKD
Aging
Obesity
Smoking

Initial screening tests are quite simple:

Blood pressure measurement
Urine test for protein (proteinuria): Protein is very important to body. Normally, kidneys filter wastes out of the blood and retain protein which can be used by the body. When the kidneys’ function is abnormal, blood protein (called albumin) may leak into the urine. The test of urine for protein can be done by several methods. The increased amount of protein the urine is a sign of deteriorating kidney function and chronic kidney disease.
Blood test for creatinine: Creatinine is a waste product in blood created by the breakdown of muscle cells. With the creatinine result from the blood test, doctors can calculate the glomerular filtration rate (GFR) which helps determine the quality of kidney function. The lower GFR signifies that the kidneys are not working well in filtrating wastes out of the body.

The symptoms of CKD can vary greatly since kidneys are associated with many functions of our body. Some people experience mild and unspecific symptoms while many experience no symptom at all. This is why CKD often is left undiagnosed until the late stage. Watch out for the following signs and symptoms:

Fatigue and weakness
Diminished mental ability
Loss of appetite
Sleeplessness
Itchiness and skin irritation
Muscle cramps, especially at night
Swelling of legs and feet
Puffiness around the eyes (especially in the morning)
Frequent urination (especially at night)

You will need to undergo further tests so that doctors can plan the best treatment. The specific tests you can expect include:

A glomerular filtration rate calculation is the best way to measure the kidney function based on creatinine values, age, race and sex. The GFR helps doctors determine the stage of kidney disease and plan the appropriate treatment accordingly.
Ultrasound or CT scanner is used to diagnose certain kidney problems and urinary tracts. The image results allow doctors to examine the kidney’s size and look for possible kidney stones or tumors as well as check for kidneys’ structure and urinary tracts.
A kidney biopsy is required in some cases in which the cause of kidney disease is unclear and doctors need specific information. Kidney tissue samples will be examined under a microscope to determine the seriousness of kidneys damage and plan the best possible treatment.

Stage	Stage Description	GFR
Stage 1	Slight kidney damage (found excessive protein in the urine) with normal GFR rate	90 or higher
Stage 2	Kidney damage with slightly decrease of GFR	60-89
Stage 3	Moderate decrease of GFR	30-59
Stage 4	Severe decrease of GFR	15-29
Stage 5	Kidney failure	Lower than 15

The glomerular filtration rate will let doctors know how well your kidneys are functioning. Usually, the kidney disease is advanced by the time the symptoms appear and the GFR is significantly decreased.

Created When: 五月 15, 2019

Last modify: 十月 28, 2020

Bumrungrad Hospital

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