Chronic Kidney Disease
Chronic kidney disease is when the kidneys stop working as well as they should. When they are working normally, the kidneys filter the blood and remove waste and excess salt and water. They also assist with management of bone, mineral and vascular health as well as red blood cell production.
In people with chronic kidney disease, the kidneys slowly lose the ability to filter the blood. In time, the kidneys can stop working completely. That is why it is so important to keep chronic kidney disease from getting worse.
People with diabetes, hypertension, and atherosclerotic vascular disease are at the greatest risk of developing chronic kidney disease. In addition, patients with Lupus, acute kidney injury, glomerulonephritis and other primary kidney diseases may develop chronic kidney disease as well.
At first, chronic kidney disease causes no symptoms. As the disease gets worse, it can:
- Make your feet, ankles, or legs swell (doctors call this “edema”)
- Give you high blood pressure
- Make you very tired
- Damage your bones
- Cause loss of appetite, bitter foul taste, and nausea.
On your initial visit to REHC, our Nephrologists review your medical history and recent blood and urine tests. We examine you and assess your risks for chronic kidney disease. We stage your kidney function and evaluate for reversible causes of kidney disease. We also assess the potential effects of your loss of kidney function on your body.
- We may order additional blood testing
- We may order urine testing, including a 24 hour urine collection
- We may order imaging, such as a renal ultrasound
- We will perform a physical exam, including blood pressure reading
- We will discuss our findings and outline a specific plan for you that may include prescribing medications, altering your diet, and strategy for monitoring progress of your kidney health.
- Taking blood pressure and other medicines every day, if your doctor or nurse prescribes them to you
- Keeping your blood sugar in a healthy range, if you have diabetes
- Changing your diet, if your doctor or nurse says you should
- Avoiding medicines known as “nonsteroidal antiinflammatory drugs,” or NSAIDs. These medicines include ibuprofen (sold as Advil® or Motrin®) and naproxen (sold as Aleve®). Check with your doctor, nurse, or kidney specialist before starting any new medicines — even over-the-counter ones.
Most common questions our patients ask:
Question 1: What are the treatments for chronic kidney disease?
People in the early stages of chronic kidney disease can take medicines to keep the disease from getting worse. For example, many people with chronic kidney disease should take medicines known as “ACE inhibitors” or “angiotensin receptor blockers.” If your doctor or nurse prescribes these medicines, it is very important that you take them every day as directed.
Question 2: What happens if my kidneys stop working completely?
If your kidneys stop working completely, you can choose between three different treatments to take over the job of your kidneys. Your choices are described below.
- You can have kidney transplant surgery. That way, the new kidney can do the job of your own kidneys. If you have a kidney transplant, you will need to take medicines for the rest of your life to keep your body from reacting badly to the new kidney. (You only need one kidney to live.)
- You can have your blood filtered by a machine. This treatment is called “hemodialysis,” but many people call it just “dialysis.” If you choose this approach, you will need to be hooked up to the machine at least 3 times a week for a few hours for the rest of your life. Before you start, you will also need to have surgery to prepare a blood vessel for attachment to the machine.
- You can learn to use a special fluid that has to be piped in and out of your belly every day. This treatment is called “peritoneal dialysis.” If you choose this type of dialysis, you will need surgery to have a tube implanted in your belly. Then you will have to learn how to pipe the fluid in and out through that tube.
Question 3: How do I choose between the different treatment options?
You and your doctor will need to work together to find a treatment that’s right for you. Kidney transplant surgery is usually the best option for most people. But often there are no kidneys available for transplant. The doctors of REHC will guide through you the process if and when the time comes.