Basics of Chronic Kidney Disease

By Alyssa Ball

The kidneys help cleanse your blood of waste, toxins, and excess fluid. They also help regulate salt and water levels in the body, maintain blood pH, regulate blood pressure, and more to keep you healthy. But nearly 37 million Americans don’t have full kidney health due to chronic kidney disease (CKD).

Unfortunately, many of these adults may not even realize they have this progressive disease. Learn more about kidney disease so you can get treatment for yourself or a loved one as soon as possible. 

What Is Chronic Kidney Disease? 

Chronic kidney disease, or chronic renal disease, is a progressive condition that causes the kidneys to stop functioning efficiently. Kidneys may become scarred or even shrink as the disease gets worse.

As the kidneys lose their function, seniors can experience muscle weakness, malnutrition, and osteoporosis. This can lead to limited mobility, increased fall risk, and loss of independence. Ultimately, the condition leads to kidney failure, and the damage is irreversible. 

Chronic kidney disease affects 1 in 7 adults in the US. However, 90% of individuals with chronic kidney disease do not even know they have it because the symptoms are undetectable in the early stages.  

Chronic Kidney Disease vs Acute Kidney Failure 

Kidney disease is different from kidney failure. Chronic kidney disease is slow and progressive, causing the kidneys to become less efficient over time until they fail. However, the kidneys may suddenly shut down, resulting in acute kidney failure.  

What Causes Chronic Kidney Disease? 

Chronic kidney disease is most commonly caused by diabetes and high blood pressure. Diabetes leads to the buildup of sugar in the blood, which can damage the kidneys. High blood pressure can cause the kidneys' filtration system to be ineffective. The longer an individual suffers from these health problems, the more likely they are to develop chronic kidney disease.  

However, other risk factors can lead to chronic kidney disease.   

  • Age: You can get chronic kidney disease. However, the older you are, the higher your risk. 
  • Weight: Individuals who are overweight or obese are more likely to develop chronic kidney disease because the kidneys have to work overtime to meet the demands of excess body weight. Plus, weight is a factor in developing high blood pressure or other conditions. 
  • Family history: If your family has a history of kidney disease, you are at a higher risk. 
  • Health conditions: Other health conditions, like lupus, cardiovascular disease, or kidney blockages, can increase your risk of developing chronic kidney disease. 
  • Lifestyle factors: Overusing medications with ibuprofen, acetaminophen, or naproxen can lead to chronic kidney disease. 
  • Ethnicity: African Americans, Hispanics, American Indians, and Pacific Islanders are at a higher risk of developing kidney disease. 

What Are the Symptoms of Chronic Kidney Disease? 

Chronic kidney disease is hard to detect because there aren't any symptoms early in the disease's progression. Additionally, some of the symptoms may seem like the flu or normal signs of aging.  

When symptoms do start to appear, you may notice the following:  

  • Changes in urination: Seniors may experience foamy or bloody urine. They may also urinate less frequently than usual or get up more often at night to use the restroom. 
  • Fatigue: Chronic kidney disease makes you extremely tired and have low energy. 
  • Back pain: The condition may cause pain near the kidneys, which are by the small of your back. This pain will not go away with stretching or movement.  
  • Shortness of breath: You may experience shortness of breath as excess fluid in the body builds up in the lungs. 
  • Itching: The disease leads to waste buildup in the body, which can cause severe itching.  
  • Swelling in extremities: The extra fluid in the body can also cause swelling in the hands or feet. 
  • Difficulty sleeping: You may struggle to fall asleep and stay asleep. 
  • Central nervous system damage: The disease may cause damage to the central nervous system, leading to seizures, personality changes, or difficulty with concentration. 
  • Spike in potassium: Because the kidneys can't filter wastes effectively, you may have increased levels of potassium in the blood, which can damage the heart and lead to abnormal rhythms. 
  • Nausea: Excess waste in the blood and throughout the body can make you feel nauseated and even vomit. It may be difficult for you to keep food down, leading to a loss of appetite. 
  • Decreased immune system: Poor kidney function can lead to a compromised immune system. So seniors are more susceptible to illnesses and other harmful conditions. 

What are the Stages of Chronic Kidney Disease? 

Chronic kidney disease progresses in 5 stages, ranging from mild to severe. These stages are categorized by the estimated glomerular filtration rates (eGFR). This number is based on the amount of waste in the blood.   

 Let's take a look at each stage of renal disease.   

Stage 1 

Stage 1 chronic kidney disease occurs with an eGFR number of 90 or greater. During this stage, individuals have very mild damage to the kidneys. There may be excess protein in the urine, but many individuals won't experience any symptoms.   

Stage 2 

Stage 2 chronic kidney disease occurs with an eGFR number between 60 and 89. During stage 2, the kidneys are still performing well. There may be excess protein in the urine or some physical damage to the kidneys. Individuals in this stage typically do not experience any symptoms.  

Stage 3 

Stage 3 chronic kidney disease occurs with an eGFR number between 30 and 59. At this stage, the kidneys are not working efficiently. Waste begins to build up in the body, and you may experience some mild symptoms, like swelling, back pain, and frequent urination. You may also develop anemia or early bone disease. However, individuals may still not experience any symptoms in Stage 3.   

Stage 4 

Stage 4 chronic kidney disease occurs with an eGFR number between 15 and 29. The kidneys are moderately or severely damaged at Stage 4. This is the last stage before progressing to kidney failure. You may experience swelling, back pain, fatigue, and frequent urinating. Additional complications could include high blood pressure, anemia, and bone disease. Individuals in this stage should prepare for dialysis or kidney transplant.  

Stage 5 

Stage 5 chronic kidney disease occurs with an eGFR number less than 15. At this stage, the kidneys are very close to failure or have already failed. Once the kidneys fail, waste builds up in the body. You may experience itching, cramps, nausea, swelling, back pain, frequent urination, and trouble breathing and sleeping. Ultimately, you will need dialysis or a kidney transplant.   

Usually, individuals will progress slowly through these stages. But, by the time an individual notices symptoms, it can be towards the end of the disease's progression. Why is that?   

The kidneys have a larger capacity to perform than is necessary. Even with decreased efficiency, the kidneys can still perform well above normal. That's why individuals can remain healthy with just a single kidney. By the time the kidneys function poorly enough for symptoms to arise, the damage is moderate to severe.  

How Is Kidney Disease Diagnosed and Treated? 

A doctor can diagnose chronic kidney disease with a blood test and a urine test. They may also request an MRI to see if the kidneys have shrunk in size. The sooner a senior can receive a diagnosis, the faster they can start treatment to help preserve their kidneys and slow the progression of the disease.  

Depending on the progression of the disease, a doctor can implement a number of treatments to help seniors manage the condition.   

  • Medication: Seniors with high blood pressure or diabetes may be prescribed medication to help control those conditions and prevent chronic kidney disease from worsening. Seniors should also avoid any medications that can cause further damage to the organs. 
  • Diet: Seniors may need to restrict their diet to lower their intake of sugar, salt, protein, potassium, and phosphorus.  
  • Transplant: A kidney transplant involves removing the damaged kidney and replacing it with a healthy kidney from a kidney donor.  
  • Dialysis: Dialysis is a treatment that filters the blood outside of the body after the kidneys have stopped working. 

Once chronic kidney disease has reached kidney failure, the condition is fatal without a kidney transplant or dialysis. That’s why seeking a diagnosis and getting treatment as soon as possible is so important.  

Our professional caregivers can help if you or a loved one has chronic kidney disease and needs help implementing your treatment plan and managing day-to-day activities. Reach out to a local office for more information. 

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