850 MILLION PEOPLE WORLDWIDE are now estimated to have kidney diseases from various causes. Chronic kidney disease (CKD), causes at least 2.4 million deaths per year and we are now the 6th fastest-growing cause of death.
Your kidneys are one of the most important organs in your body. They are essential in the regulation of your blood: blood volume, blood pressure, and blood PH. They are also responsible for filtering your blood and excreting waste in the form of urine.
What is Chronic Kidney Disease (CKD)
Chronic kidney disease (CKD) is a progressive loss in kidney function over a period of months or years. Each of your kidneys has about a million tiny filters, called nephrons. If nephrons are damaged, they stop working. For a while, healthy nephrons can take on the extra work. But if the damage continues, more and more nephrons shut down. After a certain point, the nephrons that are left cannot filter your blood well enough to keep you healthy.
When kidney function falls below a certain point, it is called kidney failure. Kidney failure affects your whole body and can make you feel very ill. Untreated kidney failure can be life-threatening.
What you should not forget:
Early chronic kidney disease has no signs or symptoms.
Chronic kidney disease usually does not go away.
Kidney disease can be treated. The earlier you know you have it, the better your chances of receiving effective treatment.
Blood and urine tests are used to check for kidney disease.
Kidney disease can progress to kidney failure.
How is kidney function measured?
The main indicator of kidney function is your blood level of creatinine, a waste product of the body produced by muscles and excreted by the kidneys. If kidney function is reduced, creatinine accumulates in the blood leading to an elevated level when a blood test is checked.
Kidney function is best measured by an indicator called GFR (Glomerular Filtration Rate) which measures the blood filtration rate by kidneys. This indicator allows doctors to determine if the kidney function is normal, and if not, to what level the reduced kidney function has deteriorated.
Causes of CKD
High blood pressure (hypertension) and diabetes are the most common causes of kidney disease. High blood pressure causes just over a quarter of all cases of kidney failure. Diabetes has been established as the cause of around one-third of all cases and is the commonest cause of ESRD in most developed countries.
Other less common conditions include inflammation (glomerulonephritis) or infections (pyelonephritis). Sometimes CKD is inherited (such as polycystic disease) or the result of a longstanding blockage to the urinary system (such as enlarged prostate or kidney stones).
Some drugs can cause CKD, especially some pain-killing drugs (analgesics) if taken over a long time. Often doctors cannot determine what caused the problem.
Symptoms of CKD
A person can lose up to 90% of their kidney functions before experiencing any symptoms.
Most people have no symptoms until CKD is advanced. Signs of advancing CKD include swollen ankles, fatigue, difficulty concentrating, decreased appetite, blood in the urine, and foamy urine.
Kidney Transplantation
A kidney transplant is an operation to place a healthy (donor) kidney in your body to perform the functions your own diseased kidneys can no longer perform.
Kidney transplantation is considered the best treatment for many people with severe CKD because the quality of life and survival are often better than in people who use dialysis. However, there is a shortage of organs available for donation. Many people who are candidates for kidney transplantation are put on a transplant waiting list and require dialysis until an organ is available.
A kidney can come from a living relative, a living unrelated person, or from a person who has died (deceased or cadaver donor); only one kidney is required to survive. In general, organs from living donors function better and for longer periods of time than those from donors who are deceased.
Overall, transplant success rates are very good. Transplants from deceased donors have an 85 to 90% success rate for the first year. That means that after one year, 85 to 90 out of every 100 transplanted kidneys are still functioning. Live donor transplants have a 90 to 95% success rate. Long-term success is good for people of all ages.
Symptoms of CKD
Healthy kidneys clean blood and remove extra fluid in the form of urine. They also make substances that keep our bodies healthy. Dialysis replaces the blood cleaning functions when kidneys no longer work.
There are two types of dialysis: hemodialysis and peritoneal dialysis.
In hemodialysis, your blood is pumped through a dialysis machine to remove waste products and excess fluids. You are connected to the dialysis machine through a needle in a vein that is surgically enlarged (vascular access) or through a temporary plastic catheter placed in a vein. This allows blood to be removed from the body, circulate through the dialysis machine for cleansing, and then return to the body. Hemodialysis can be done at a dialysis center or at home. When done in a center, it is generally done three times a week and takes between three and five hours per session. Home dialysis is generally done three to seven times per week and takes between three and ten hours per session (often while sleeping).
Peritoneal dialysis is another form of dialysis used to remove waste products and excess water. It works on the same principle as hemodialysis, but your blood is cleaned while still inside your body rather than in a machine by adding clean fluid to your abdomen, letting it accumulate waste products from the blood, and then draining it out. It is typically done at home. Some patients can perform peritoneal dialysis continuously while going about normal daily activities (continuous ambulatory peritoneal dialysis, CAPD)
Cost of CKD
The prevalence of kidney disease is increasing dramatically and the cost of treating this growing epidemic represents an enormous burden on healthcare systems worldwide. Even in high-income countries, the very high cost of long-term dialysis for increasing numbers of people is a problem. In low and middle-income countries long-term dialysis is unaffordable. The best hope for reducing the human and economic costs of chronic kidney disease and end-stage renal disease, therefore, lies in prevention, for the following reasons:
Chronic kidney diseases are not curable and can cause people to need care for the rest of their lives.
If CKD is not detected early enough, the patient may progress to kidney failure which requires Renal Replacement Therapy (dialysis or transplantation) which is extremely costly and weighs heavily on healthcare budgets.
Chronic Kidney Diseases trigger other healthcare issues like cardiovascular diseases (heart attack and stroke), which will lead to premature death or disability and multiply the amount of money needed for the healthcare of a patient.
In developed countries, ESRD is a major cost driver for patients, their families, and the taxpayer. Patients with ESRD require dialysis or kidney transplantation, which is highly costly and consume a sizeable portion of the health budget.
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