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Chronic Kidney Disease

  

When your kidneys stop working

If your kidneys are damaged in some way, or are affected by disease, they may be unable to maintain their vital functions that keep you well.

 

Often the onset of disease is gradual and symptoms can be vague and dismissed. However, over time, as the kidneys are unable to efficiently remove water and waste products from the blood, patients may complain of a number of symptoms.

 

 

 

Common symptoms of kidney failure:

•    Fatigue

•    Nausea and vomiting

•    Breathing difficulty

•    Difficulty falling asleep

•    Swelling of the face, hands, and feet

•    Loss of appetite

•    Itching

•    High blood pressure (hypertension)

 

As the kidneys progressively fail to filter the blood efficiently, they do not do their job of removing excess water, waste products, and toxins. The levels of these substances in your body increase, making you feel unwell. The condition is called uremia.

 

In the first instance, patients who have early stage Chronic Kidney Disease (CKD) with mild uremia may be treated with drugs and diet management.

 

For many patients this is enough to keep them feeling well indefinitely. For others, despite management with diet and drugs, more kidney function is lost over time. If uremia becomes severe, it reaches end stage renal failure (ESRD), and you must begin dialysis to replace the job of your kidneys.

 

Causes of Chronic Kidney Disease

There are many causes of CKD, but the most common are diabetes and high blood pressure.

 

Diabetes

The UAE has one of the world's highest incidences of diabetes. Diabetes is a main cause of ESRD for over 50% of patients on dialysis.

 

Diabetes is a chronic disease of another important organ in your body: the pancreas. One of the main functions of the pancreas is to release a hormone called insulin, which regulates the sugar in your blood within safe limits. When insulin production fails, blood sugar levels rise to dangerous levels. High sugar levels in the blood are extremely damaging to the very tiny and delicate filters or nephrons in the kidney.

 

Some people develop diabetes early in life. Their pancreas is unable to produce insulin at all and they must give themselves insulin injections regularly. This is known as Type 1 diabetes or insulin-dependent diabetes.

 

Others who continue to produce some insulin, but cannot regulate their sugar levels within safe limits, suffer from Type 2 diabetes or non insulin-dependent diabetes. This is usually managed with drugs and diet. Type 2 diabetes is linked to obesity. People with Type 2 diabetes can achieve significant improvements in their blood sugar management by losing weight, eating healthily, and doing regular exercise. People with diabetes often also suffer from high blood pressure.

 

High blood pressure

High blood pressure or hypertension can cause kidney damage and lead to CKD, but it can also be caused by CKD. High blood pressure raises the pressure of the blood within the arteries and causes damage to many organs including the kidneys. If you have high blood pressure, you are prescribed drugs to try to reduce it. It is important to keep the blood pressure within safe limits as high blood pressure not only damages the tiny blood vessels in the kidneys, the eyes and the nervous system: it is a major cause of heart attacks and strokes.

 

Glomerulonephritis

This term covers a wide range of diseases that result in inflammation within the kidney, causing damage to the tiny filters.

 

Genetic or Inherited diseases

Many genetic conditions may affect the kidneys. Some patients may be aware that a genetic condition exists within their family, while for others it is a complete shock. A few examples of these conditions are adult polycystic kidney disease (APKD), Alport syndrome, Fabry's disease, cystinosis, and Bader-Biedle syndrome.

 

Congenital urinary reflux

Some babies are born with this condition. It is caused by a malformation of the ureters (tubes which take urine from the kidney to the bladder). Urine flows backwards from the bladder to the kidney, causing repeated infections that can damage the kidneys.

 

Obstruction

Kidney stones may develop inside the kidney or tumors may develop inside or outside the kidney, causing obstruction to the flow of urine. One of the commonest causes of obstruction is enlargement of the prostate gland, a very common problem in elderly men. This often results in difficulty in passing urine or the need to get up several times at night to pass urine.

 

Drugs

Some drugs are toxic to the kidneys and can cause irreversible damage.

 

Autoimmune disease

Many different autoimmune conditions may cause damage to the kidneys, such as: systemic lupus, scleroderma, and Wegener's granulomatosis. The cause of these conditions is unknown, but for some reason our immune system starts to attack organs and tissues including the kidneys.