Chronic kidney disease is a long-term medical condition that affects around 1 in 8 people. It means that your kidneys don't function exactly as they should. Cases can range from very mild, where you can usually manage your symptoms with your GP, to severe, where hospital treatment is necessary.
Today, we're taking a closer look at chronic kidney disease, including the causes, symptoms, and stages of the condition. We'll also explore the different treatments that are available.
What is Chronic Kidney Disease?
Chronic kidney disease is a common medical condition affecting lots of older people. According to Kidney Care UK, around 50% of people over 75 have some degree of kidney disease. People of African and Asian origin are more likely to develop the condition at a younger age.
The kidneys play a very important role in the body. They filter the blood, removing toxins from the bloodstream and converting the waste into urine. They also produce some important hormones which regulate blood pressure and the production of vital red blood cells. Therefore, poor kidney function can lead to high blood pressure and anaemia, as well as other complications.
"Right now, around 63,000 people in the UK are being treated for kidney failure (also known as stage 5 CKD, where kidney function is less than 15%)."
At its most severe, chronic kidney disease can lead to kidney failure (when kidney function is 15% or less). This means the kidneys can no longer function well enough to keep us alive and hospital treatment is needed. The NHS estimates that there are up to 45,000 premature deaths related to chronic kidney disease every year.
Symptoms of Chronic Kidney Disease
In the early stages of chronic kidney disease, there usually aren't any symptoms. In fact, it may only be picked up if blood or urine tests detect a possible problem with your kidneys.
As CKD progresses, symptoms can include:
- Shortness of breath
- Feeling sick
- Blood in your urine
- Swollen ankles, feet or hands
- Muscle cramps
The most advanced stage of chronic kidney disease is known as kidney failure, end-stage renal disease, or established renal failure. If you suffer from any of the symptoms above or notice any other worrying changes to your body, you should see your GP as soon as possible.
Diagnosing Chronic Kidney Disease
As previously mentioned, chronic kidney disease can be diagnosed with blood and urine tests. Since symptoms are so rare in the early stages, it is commonly discovered during routine check-ups. Those who may be at a higher risk should have tests on a regular basis. High-risk groups include people with high blood pressure or diabetes, older people, and people of African or Asian origin. If you have a family history of kidney disease, you should also have regular check-ups.
A blood test will measure the levels of a waste product known as creatinine in your blood. According to the NHS:
"Using this result, a calculation that takes into account your age, gender and ethnic group is then done to work out how many millilitres of waste your kidneys are able to filter in a minute. This measurement is known as your estimated glomerular filtration rate (eGFR)."
Healthy kidneys should be able to filter more than 90ml per minute. Any lower and you may have kidney disease.
Urine tests will check the level of creatinine and albumin in your urine, which is known as the albumin:creatinine ratio, or ACR. This test also checks for any blood or protein in your urine, and can also give an accurate picture of how well your kidneys are working.
Other tests that can assess the level of damage to your kidneys include:
- Ultrasound Scan
- MRI Scan
- CT Scan
These tests will be able to provide an image of what your kidneys look like and whether there are any blockages. A kidney biopsy may also be helpful. This is where a small sample of kidney tissue is removed and examined.
Stages of Chronic Kidney Disease
Your test results can determine how damaged your kidneys are and will therefore show which stage of the condition you are at. Your doctor will then be able to advise you about the best course of treatment and how often you should have tests to monitor your condition.
Chronic kidney disease has five stages. Your stage essentially depends on how much blood your kidneys can filter per minute. The normal rate is around 100ml per minute. At stage 1, it will be 90ml per minute or more but with other signs of damage to the kidneys. At stage 5, the most severe, the rate is less than 15ml per minute.
Causes of Chronic Kidney Disease
In most cases, chronic kidney disease is caused by other medical conditions which put a strain on the kidneys. These conditions include:
- Kidney infections
- High cholesterol
- High blood pressure
- Kidney inflammation
- Blockages in the flow of urine
- Long-term use of medicines such as lithium and non-steroidal, anti-inflammatory drugs
Although there is no cure for CKD, there are several treatments that can help relieve the symptoms and prevent it from getting any worse. The treatment available will depend on how severe your condition is.
The four main forms of treatment are:
- Medication - To control associated problems such as hypertension and high cholesterol.
- Lifestyle changes - To ensure that your body remains as healthy as possible.
- Dialysis - Replicates some of the kidney's functions, which may be necessary if your condition is at an advanced stage.
- Kidney transplant - May be needed if your condition is at an advanced stage.
In order to remain as healthy as possible, it's important to stop smoking, eat a healthy diet and take part in regular exercise. You will also need to restrict your salt intake to less than 6g per day and moderate your alcohol intake so that it follows the recommended guidelines of no more than 14 units per week.
Should you reach the stage where your kidneys stop working completely, you may need to have dialysis. There are two kinds of dialysis. The more common option (haemodialysis) involves diverting the blood to a machine that filters it, just as the kidneys normally would, before returning it to the body. Another form of dialysis (peritoneal dialysis) uses the peritoneal cavity (a space in your abdomen, containing lots of tiny blood vessels) as a filtering device, instead of a machine.
You may be able to choose which kind of dialysis you'd like to have. Haemodialysis usually happens three times a week in a treatment centre or more often at home. Peritoneal dialysis, on the other hand, needs to happen every day, but can sometimes be done overnight while you sleep.
Dialysis will usually be a lifelong form of treatment unless you have a kidney transplant.
For those with little or no kidney function, a kidney transplant is the most effective treatment for CKD. This is a major surgical procedure, which normally takes around three hours. After a transplant, you'll usually need to take immunosuppressant medication for the rest of your life. This is to prevent your immune system from attacking the new kidney.
You can live with one kidney, which means people can choose to donate a kidney to someone else who needs one. Ideally, the donor should be a close relative in order to reduce the chances of the body rejecting the kidney. Kidney donations from people who have recently died are also possible, although they have a slightly lower success rate in the long term. Survival rates for kidney transplants are extremely good nowadays. About 90% of transplants still function after five years and many work after 10 years or more. However, there is still a shortage of donors, with patients often waiting years for a transplant. As of August 2021, there are currently 3,537 people waiting for a kidney transplant.
Organ donation law in England and Wales has recently changed to an opt-out system. This means that all adults in England and Wales will be considered potential donors unless they opt-out or belong to an excluded group. You can still choose whether or not to donate your organs by registering a decision. Your family will also be asked to give their support.
You can register your decision to donate (or opt-out of donating) your organs after you die on the NHS Organ Donation website. If you've already recorded a decision, you are free to change your mind at any time. You may also choose to donate some but not all of your organs.
Living with Chronic Kidney Disease
Most people are able to carry on living their normal life with chronic kidney disease. The majority of cases just require medication and regular check-ups. Of course, it's even more important for those with kidney disease to try and stay as healthy as possible. Chronic kidney disease increases your risk of cardiovascular disease, which is a leading cause of death in CKD patients.
It's also wise to have the annual flu jab and the one-off pneumococcal vaccination, as your body will be more vulnerable to infections. If you are undergoing dialysis or you have stage 5 kidney disease, you are also advised to get the COVID-19 vaccination. If you've already had both doses, you may be eligible for a third booster jab.
Remember, the Disability Discrimination Act 1995 requires employers to make reasonable adjustments to working practices or premises to help a person with a disability. This could involve flexible working hours to fit with dialysis appointments, for example. If you have to stop working or cut down on the number of hours you work, you may be entitled to some financial benefits.
Chronic kidney disease is a condition that qualifies you for VAT Exemption when you order a personal alarm system from Lifeline24. This means that people with chronic kidney disease will not have to pay any VAT whatsoever on their Lifeline24 alarm system. To find out about other medical conditions that qualify you for VAT exemption, click here.
Personal Alarm Information
The Lifeline24 personal alarm service is ideal for people with long-term medical conditions like chronic kidney disease. Having a personal alarm allows you to carry on living independently at home with total peace of mind. If you ever need to call for help in an emergency, all you need to do is press your pendant button. Our 24/7 Response Team will answer the call and send assistance to your home straight away. For more information about our life-saving personal alarm service, please get in touch with our friendly team on 0800 999 0400. Alternatively, get in touch online and we will get back to you as soon as possible.
Editor's Note: This article was updated on 16th May 2022 to reflect current information.