Written by Kidney failure also known as chronic kidney disease (CKD) is a condition in which the kidneys lose function over a period of months to years. At first, there are usually no symptoms; but as the disease progresses, people may experience fatigue, nausea, vomiting, and weight loss. This article explains the stages of kidney failur: diagnosis, symptoms and treatment.
There are several stages of kidney failure (CKD). Most people with CKD are asymptomatic (show no symptoms) until the late stages of the disease, when the symptoms become more pronounced. In advanced stages of CKD, people may experience abdominal swelling and pain, slow urine flow, and decreased urine production.
According to Wikipedia, 753 million people worldwide were affected by chronic kidney disease in 2016: 417 million women and 336 million men. There were 1.2 million deaths in 2015, an increase from 409,000 deaths in 1990. High blood pressure, diabetes, and glomerulonephritis account for the greatest number of deaths (550,000, 418,000, and 238,000, respectively).
Diagnosis of kidney failure
The kidneys are one of the major organs in your body. They perform many essential functions, including filtering your blood, removing waste and excess fluids, and regulating the amount of fluids your body needs. They also regulate your blood pressure, keeping it within a normal range. The kidneys are found under the ribcage on either side of your spine. They’re about the size of a fist and are composed of two lobes, or halves, connected by a narrow tube called a renal artery.
Most people with chronic kidney disease have no symptoms until the disease is advanced enough to cause significant damage and are only diagnosed after routine blood work reveals an increase in their serum creatinine or a rise in the protein content of their urine.
- The glomerular filtration rate (GFR) measures the kidney function and estimates how much fluid is filtered by the kidneys into the blood. A normal GFR is 60 mL/min/1.73 m2 of body surface area. GFR also identifies the presence of kidney damage.
- Urine test such as albumin-creatinine ratio (ACR) is also used to screen for kidney damage. This test measures the amount of protein and creatinine in your urine. The higher your ACR, the lower your kidney function. Normal ranges for the ACR vary among laboratories, but a ratio of less than 1.0 is considered abnormal while values higher than 2.0 are typically associated with kidney disease.
- Kidney ultrasound is used to diagnose and monitor kidney problems. The images produced by this test allow your doctor to determine the size and structure of your kidneys and may highlight kidney diseases or problems in their development. Kidney ultrasound can also be used to evaluate other parts of your body that have a connection to your kidneys, including the ureters, bladder, and prostate.
Stages and Symptoms of kidney failure
Stage 1: In stage 1 kidney disease, the kidneys are still functioning normally, but there is some damage to the organ. The kidneys can usually compensate for the damage, allowing the person to keep performing at 90% or better. This is the earliest form of the disease, and it often has no symptoms. That means it’s often discovered by accident while the person is having bloodwork done for something else. GFR is normal or high (> 90 mL/min).
Stage 2: there’s kidney damage with a mild decrease in their glomerular filtration rate (GFR). There are usually no symptoms to indicate the onset of CKD, so it usually occurs without the person being aware. As the disease progresses, however, many people experience symptoms such as excessive tiredness, weight gain, and nocturia (passing urine at night). The treatment for CKD varies from person to person, but the most important step is to manage the disease and prevent further kidney damage. GFR is between 60 and 89 mL/min.
Stage 3: The kidneys are moderately damaged in stage 3 chronic kidney disease (CKD). This stage is divided into two (3A and 3B): a decrease in glomerular filtration rate (GFR) for Stage 3A ranges between 45 and 59 mL/min and a decrease in GFR for Stage 3B ranges between 30-44 mL/min.
A condition called “uraemia” occurs when waste products build up in the blood as kidney function declines. Uraemia causes an increase in the amount of protein in the urine, which can lead to several complications, including kidney damage and kidney failure. Uraemia also decreases the amount of urine that is produced, which means that the kidneys must work harder to get rid of waste and can lead to kidney damage and kidney failure.
At stage 3 Chronic Kidney Disease, patients may experience symptoms of: decreased urine output, small urine volume, dark urine, and dehydration. Some may experience symptoms of excessive thirst, increased urination, leg swelling, and abdominal swelling. Signs of stage 3 CKD may include: increased weight, decreased appetite, and fatigue.
Stage 4: Stage 4 chronic kidney disease (CKD) is marked by extensive kidney damage and a severe decline in glomerular filtration rate (GFR) between 15 to 30 ml/min. People with stage 4 kidney disease are more likely to suffer complications such as high blood pressure, anaemia (deficiency of red blood cells), heart disease, bone disease, and cardiovascular problems. Patients at this stage will require more advanced treatments, such as dialysis or kidney transplantation, to stay healthy.
Symptoms of stage 4 kidney disease include: anorexia (due to protein intolerance) and weight loss, nausea, vomiting, abdominal pain, fatigue, low urine output, rapid heart rate, confusion, dark urine, blue or black tinge to the skin and mucous membranes, swelling of the hands, ankles, or feet, easy bruising, easy bleeding, easy tiredness, easy bruising.
Stage 5: this stage of kidney failure is the end stage renal disease (ESRD) with a glomerular filtration rate (GFR) of 15 ml/min or less. At this advanced stage of kidney disease, the kidneys have lost nearly a third of their glomeruli, or filtration units, the small, bean-shaped structures that filter blood and produce urine. As a result of these changes, the kidneys are unable to filter blood to excrete waste and toxins.
Symptoms of stage 5 kidney failure are same with stage 4, however at this stage there is an increased risk of cardiovascular and heart disease.
Treatment of kidney failure
There is no cure for CKD, but the goal of treatment is to slow the progression of the disease and to prevent complications. Treatment is usually targeted at the underlying conditions that led to the kidney damage, such as high blood pressure, high cholesterol, and diabetes. Drugs that reduce inflammation in the body are also proving to be very beneficial in the treatment of CKD. For stage 5 kidney failure, dialysis or kidney transplant is needed.
Lifestyle measures such as eating healthy, dietary salt restriction, regular exercise, smoking cessation and weight control have also been found helpful in managing kidney failure.
Kidney failure cannot be cured, but early treatment can slow down or stop its progression. Addressing the underlying cause is crucial. Follow your physician’s instructions to manage conditions such as diabetes, high blood pressure, or heart disease. The risk of developing CKD increases with age, so it’s important to discuss kidney care with your doctor if you’re over sixty. Additionally, maintaining a healthy diet, exercising regularly, and controlling your weight are essential.
