Kidney diseases can be of various types. While some appear acutely, others have a slow onset. Being one of the most vital organs in the body, a malfunctioning kidney can lead to a number of health disorders and irreversible damages. Furthermore, some people are at a higher risk of developing kidney diseases as compared to others. Therefore, early detection of the diseases can prevent its progression into fatal stages. If you happen to notice anything abnormal in the functioning of the kidneys, it is best to consult a physician right away.
What is Chronic Kidney Disease?
Chronic Kidney disease, also known as CKD, is a progressive disease. It takes place over a prolonged period of time, which could be anywhere from a few months to years. The symptoms are hardly noticeable in the beginning. There could even be cases when the patient does not experience any symptoms at all. However, when they do appear, it is usually in the form of restlessness, nausea, lack of appetite, high blood pressure, vomiting, anemia, fatigue, confusion and leg swelling. In severe cases, the person may also develop heart and bone diseases.
There are many factors leading up to chronic kidney disease. This includes high blood pressure, diabetes, polycystic kidney disease and glomerulonephritis. People who have these condition running in the family are at an even higher risk of developing the disease. Diagnosis of CKD is usually made through urine tests and blood tests, which measure the albumin and the glomerular filtration rate respectively. There are also other tests such as kidney biopsy and ultrasound which are conducted in order to identify the exact cause of the disease.
Different Stages of the CKD
During Chronic Kidney Disease, the kidneys do not malfunction all at once. In fact, the disease takes place in a series of stages. The effectiveness of the treatment is decided by the stages at which it is diagnosed. If detected early, treatments can be highly successful in reversing the damage and preventing further complications. There are five different stages of CKD, and each stage is determined by the glomerular filtration rate or the GFR. Factors such as race, age, gender, and serum creatinine also have a role in determining the GFR number. A high glomerular filtration rate is usually indicative of an irregular functioning of the kidneys as the organ fails to eliminate waste matter from the body effectively.
Different Stages of Chronic Kidney Disease
The five different stages of chronic kidney disease can be classified as given below.
- Stage 1
At this stage, the GFR number is quite normal. However, upon diagnosis, a number of evidence indicating CKD can be detected.
- Stage 2
At this stage, the glomerular filtration rate is less than 90ml, and a number of signs of CKD can be detected.
- Stage 3
During this stage, the glomerular filtration rate will have dropped below 60 ml. It indicates that the disease has started to enter a critical phase.
- Stage 4
At this stage, the glomerular filtration rate is lower than 30 ml.
- Stage 5
At this stage, the glomerular filtration rate is less than even 15 milliliters, and plenty of renal damages will have already occurred.
In a large number of cases, the disease is detected quite early. Hence, it rarely passes the 3rd stage. Even till the 3rd stage, improvements can be made with proper treatment methods. Since the disease is quite common among people with diabetes, they are usually advised to go for a kidney test at least once a year. This can help in early detection of the disease and therefore a timely treatment.
Substages of Stage 3 Chronic Kindey Disease
Stage 3 CKD is a phase during which the kidney damage is moderate. This stage can be further divided into two stages as explained below.
- Stage 3a – At this stage, the extent of kidney damage is mild to moderate, and the GFR number varies between 45 and 59.
- Stage 3b – At this stage, the extent of kidney damage is moderate to severe, and the GFR number can vary between 30 and 44.
At this stage, the ability of the kidneys to filter waste products will have declined by a considerable amount, thereby leading to a waste build up within the body. As a result, the person may also develop a condition known as uremia where the waste products start getting accumulated in the blood. Furthermore, the chances of developing additional complexities such as anemia, high blood pressure, and early bone diseases are quite high at this phase.
Symptoms of Stage 3 Chronic Kidney Disease
Even if the patients do not experience any symptoms in stage 1 and 2, they start becoming quite noticeable by the stage 3. The most common symptoms have been mentioned below:
- Lethargy and fatigue
- Retention of fluid leading to swelling
- Shortness of breath
- Abnormal rates of urination, which could be too frequent or less frequent than normal
- Change in the color of urine to brown, dark orange or red. Red color indicates the presence of red blood cells in the urine
- Pain in the kidneys
- Muscular cramps
- Restless legs
- Difficulty in sleeping
Whom to Consult for Diagnosis of Stage 3 CKD?
At stage 3 CKD, patients should consult a nephrologist. Nephrologists are doctors specializing in the treatment of the kidneys and the renal system. The patients will first go through some basic examinations. This will be flowed by comprehensive lab testing of the samples taken from the patients. You will also be required to hand in your entire medical history and answer questions put forward by the nephrologist. This will help them in making an accurate diagnosis and choosing a suitable approach for the treatment. The main aim of the treatment will be to reverse the kidney damage and keep them functioning efficiently.
Diagnosis and Assessment of Patients with Stage 3 CKD
For a proper diagnosis of the disease, the doctors perform a detailed clinical assessment which also reveals other underlying conditions present in the body. They will go through your medical history to check if you have/had been using any drugs with negative side effects on the kidneys. An imaging test is conducted in order to check if there is any kind of obstruction within the urinary system. Also, a urine test is conducted to rule or detect hematuria and proteinuria.
Initially, the assessments are made in primary settings of health care. This is sufficient to identify if the person is at risk of CKD. If the results are positive, the patient is then referred to more elaborate settings for further tests. Out of the initial assessments, the measurement of serum creatinine level is very important as it helps in determining the stability of the renal functioning. Frequent assessments are made if the person appears to be at a higher risk of the disease.
The clinical assessment can be broken down into the following;
- Imaging tests to look for obstructions within the urinary tract
- Review of the medicines that were previously used by the patient
- Urine tests to determine proteinuria and hematuria
- Looking for underlying conditions that may have led up to the disease.
Treatment and Management of Stage 3 CKD
A large number of patients suffering from CKD also have high blood pressure and diabetes. Therefore, maintaining healthy blood pressure and blood glucose is essential for an effective treatment of the disease. Therefore, it is very likely that the doctors will also prescribe medicines for these conditions together with the medicines for CKD. ARBs or angiotensin receptor blockers and ACE or angiotensin-converting enzyme are known to be effective in slowing down the rate of kidney damage and therefore, popularly used for the treatment. During the treatment process, it is very important that the patients stick to their medicines as prescribed by the doctors. Apart from the medications, a healthy lifestyle change is also an essential part of the treatment. Regular exercise and a healthy diet are recommended. Furthermore, the patients are also advised to quit smoking and alcohol.
Stage 3 CKD life Expectancy
CKD is associated with an increased risk of developing cardiovascular diseases and in some cases, even death. If CKD exists together with proteinuria, the risks are amplified even further. Renal replacement therapy is usually required. However, the risks of a cardiovascular problem are even greater.
Stage 3 CKD in the Elderly
It is very natural for the kidneys to stop functioning efficiently as one grows older. Therefore, the risk of developing CKD is very high among the elderly, especially those who have crossed 65 years of age. Studies have revealed that on an average, 49% of the elderly population have glomerular filtration rate less than 60 ml, which is indicative of stage 3 CKD. A healthy lifestyle, especially regular exercise and a proper meal plan can be helpful in maintaining kidney health. So, even if the functioning of kidneys has decreased sufficiently with age, with proper care and maintenance, it is very unlikely for the disease to progress through the third stage, unless there are underlying conditions taking its toll on the kidneys.
Stage 3 Chronic Kidney Disease Risks
Stage 3 CKD puts the patients at a higher risk of developing other complexities such as cardiovascular events. Therefore, a proper diagnosis is important as it helps in detecting the presence of the potential risk factors. With a comprehensive knowledge, disease management becomes much more effective, and the risk factors are reduced by a great degree. It is important to monitor for hematuria, proteinuria and GFR decline. These are the main factors that indicate a progression of the CKD. By keeping a constant eye on these factors, the progression of the disease into further stages can be prevented or at least slowed down.
Reversing Stage 3 Chronic Kidney Disease
If there have been no visible symptoms of the disease, it is very likely that the disease is still in its initial stages and therefore, entirely treatable. With proper treatment and management, it is also very unlikely that it will lead to further complexities. The rate of progression is different for each patient. Therefore, it is very important to consult all your concerns with the doctor who is treating you. Listed below are the various factors that should be regularly checked in order to ensure the stable health of the kidneys:
- Blood Pressure
High blood pressure leads to CKD and is further amplified by the disease. An increase in blood pressure tends to slow down the functioning of the kidneys. One way to way to take care of this is by maintaining a healthy diet. It is especially important to limit the intake of sodium as it becomes increasingly difficult for the kidneys to filter it out from the body, thereby leading to increased blood pressure. It is recommended that people suffering from CKD should not take any more than 2300 mg of sodium on a per day basis.
- Protein Intake
It is also very important for people suffering from CKD to limit the intake of proteins. This is because an increase in the protein intake directly leads to a decline in the functioning of the kidneys. It has been recommended that the daily protein intake should not go anywhere beyond 0.6 gram for every lb of the body weight. However, it is alright to consume it at the rate of 0.36 gram for every lb of the body weight. In fact, this can lead to better health and also prevent the progression of the disease into its latter stages. Limiting the daily protein intake is especially very important for people suffering from diabetes.
- Blood sugar control
If neglected, abnormal blood sugar even tends to cause organ damage. Since diabetes is usually present together with CKD, it becomes even more important to maintain a healthy blood sugar level. Normal levels of blood glucose prevent decline in kidney function and also slows down complications such as cardiovascular diseases. Optimum blood glucose levels can be easily achieved by taking the help of a nutritionist.
- Individual nutrition intakes
Nutrition requirements may vary from person to person. Therefore, it is very important to keep track of what you are eating and what you should be eating. So, scan your diet and work it out with a nutritionist to see if any changes need to be made. While charting out a diet plan, it is also important to consider other underlying conditions within the body. At the same time, you should also be aware of the various medications that have been prescribed to you.
When the health of your kidneys is on a decline, it means that it is no longer capable of filtering out the wastes as effectively as it used to. Therefore, you should have a good idea about the things that you can eat and the things that you cannot eat. The patients are advised to limit the intake of phosphorus, potassium, and fluids and familiarize themselves with food items that are helpful in treating the condition. Given below is a food guide applicable to patients suffering from CKD:
- High protein foods should be avoided
- You should limit the foods that act as potassium sources
- It is healthier to add variety to diet in the form of legumes, whole grains, vegetables and fruits
- Limiting the intake of phosphorus is essential in order to prevent the decline of kidney health and bone diseases
- Carbohydrates should be balanced, especially if the person is suffering from diabetes
- The intake of saturated fats should be reduced in order to maintain healthy cholesterol levels
- Too much calcium should be avoided
- Patients should consider taking water-soluble vitamins such as vitamin B complex and vitamin C
- Over-the-counter health supplements should be avoided
- There are registered specialists known as a renal dietician. Devising a meal plan together with them can be helpful for the patients.
Prevention of Stage 3 CKD
Prevention of stage 3 CKD can basically be broken down into three basic things – a proper diet, plenty of exercises and sticking to the prescribed medicines. Also, if you are in the habit of smoking, it should be immediately stopped. You should be aware of the total calories you are consuming on a per day basis. Foods such as cheese, milk, ice cream, seeds, and chocolate should be avoided as it becomes increasingly difficult for the body to process these. Maintaining a healthy weight is also important for the prevention of stage 3 CKD. At the same time, it is also important to consider your sources of nutrition. For example, there can be huge differences between the protein coming from plants and animals. You should also control your portions. It is best to eat small portions spread into 5 or 6 meals rather than stuff it all in 3 meals. As for the exercise, find activities you enjoy, such as swimming, jogging, games, and so on. This way, you will be getting your dose of recreation as well as exercise.
There is no cure for CKD. However, with proper treatment, the condition can be kept under control. It is also possible to slow down its progression and reverse the damages. A healthy lifestyle and proper treatment are all that is required in order to keep your kidneys working efficiently.
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