Chronic Kidney Disease

Many people with chronic kidney disease don't have symptoms. If your kidneys get worse and start to fail, you may:

• Have swelling and weight gain. This is from the extra fluid in your tissues. It is called edema.
• Often feel sick to your stomach (nauseated) or vomit.
• Have trouble sleeping.
• Urinate less than normal.
• Have trouble thinking clearly.
• Feel very tired.

Chronic kidney disease can cause problems throughout your body.

• Anemia. You may feel weak, have pale skin and feel tired because the kidneys can't produce enough of the hormones needed to make red blood cells.
• Electrolyte imbalance. When the kidneys can't filter out certain chemicals, you may have an irregular heartbeat, muscle weakness or other problems.
• Uremic syndrome. You may be tired, have nausea and vomiting, not have an appetite or be unable to sleep when substances build up in your blood. The substances can be poisonous if they reach high levels.
• Heart disease. Chronic kidney disease speeds up hardening of the arteries and increases the risk of stroke, heart attack, heart failure and death.
• Bone disease. Abnormal levels of substances, such as calcium and phosphate, can lead to this.
• Fluid buildup. As kidney function gets worse, fluids build up in the body. This can lead to heart failure and pulmonary edema.

Chronic kidney disease is caused by damage to the kidneys. The most common causes of this damage are:

• Diabetes. High blood sugar levels caused by diabetes can damage blood vessels in the kidneys. If blood sugar stays high over many years, this damage slowly reduces kidney function.
• High blood pressure. If it isn't treated, high blood pressure can damage blood vessels, which can lead to damage in the kidneys. Blood pressure often rises with chronic kidney disease.

Other things that can lead to chronic kidney disease include:

• Kidney diseases you were born with, such as polycystic kidney disease.
• Kidney infections.
• A narrowed or blocked renal artery. This artery carries blood to the kidneys.
• Long-term use of medicines that can damage the kidneys, such as ibuprofen and some antibiotics.

Chronic kidney disease may sometimes be prevented by controlling other diseases or factors that can contribute to kidney disease. People who have already developed kidney failure also need to focus on these things to prevent the complications of the disease.

• Manage your blood pressure. Work with your doctor to keep your blood pressure under control. Learn to check your blood pressure at home.
• Manage your blood sugar. If you have diabetes, keep your blood sugar within a target range. Talk with your doctor about how often to check your blood sugar.
• Stay at a healthy weight. This can help you prevent other diseases, such as diabetes, high blood pressure, and heart disease.
• Control your cholesterol levels.
• Don't smoke or use other tobacco products. Smoking can lead to atherosclerosis, which reduces blood flow to the kidneys.

Your doctor will ask you about past kidney problems. You will be asked if you have a family history of kidney disease. Your doctor will also want to know what medicines you take. This includes prescription and over-the-counter medicines.

Your doctor will do blood and urine tests to check how well your kidneys are working. This will help your doctor see how well your kidneys filter your blood.

You may have a test, such as an ultrasound or CT scan. These tests let your doctor look at a picture of your kidneys. This can help your doctor measure the size of your kidneys and see if anything is blocking your urine flow.

In some cases, your doctor may take a tiny sample of kidney tissue. This is called a biopsy. It helps the doctor find out what caused the kidney disease.

The first step is to treat the disease that's causing kidney damage. In most cases, this is diabetes or high blood pressure. Managing your blood pressure and blood sugar may slow the damage to your kidneys.

You'll probably need to take medicine. Take it as prescribed.

Lifestyle changes can help slow kidney disease or improve other problems that make kidney disease worse.

• Follow a diet that's easy on your kidneys. You may need to limit salt (sodium) and protein and watch your fluid intake.
• Be active.
• Don’t smoke or use tobacco.
• Limit alcohol and avoid illegal drugs.
• Avoid medicines that can harm your kidneys. Let your doctor know all of the prescription and over-the-counter medicines, vitamins and herbs you take. Talk with your doctor before taking anything new.