Chronic Kidney Disease is a long-term medical condition which is commonly associated with the ageing process. The condition means that your kidneys aren’t working as they should and over time they may stop working altogether, although this is quite rare.
In today’s blog post we take a closer look at chronic kidney disease, including the causes, symptoms, stages and the treatment that is available. For other medical conditions, please have a read of our in-depth guide.
What is Chronic Kidney Disease?
Chronic kidney disease is a common medical condition which can affect anybody, however it is more common in older people, black people and people of south Asian origin. Kidney disease is caused by other conditions that put strain on your kidneys. It’s often a result of a combination of other medical problems and will cause your kidneys to stop functioning correctly.
Around one in every eight people in the UK will develop chronic kidney disease (CKD). Right now, around 64,000 people in the UK are being treated for kidney failure (also known as stage 5 CKD, where kidney function is less than 15%).”
They also state that there are between 40-45,000 premature deaths in the UK every year due to chronic kidney disease, and that 19 people in the UK will develop kidney failure every day.
For those of you who may be unaware, your kidneys filter around 180 litres of blood every day, control the production of red blood cells and release hormones that regulate your blood pressure. Alongside this, your kidneys also produce urine by removing waste products from your body. Other functions include keeping your bones strong and healthy by helping to produce an active form of vitamin D.
Commonly, there aren’t any symptoms of kidney disease in the early stages. In fact, it may only be picked up if blood or urine tests carried out for other medical reasons detect a possible problem with your kidneys.
At an advanced stage, symptoms of the condition can include:
- Shortness of breath.
- Feeling sick.
- Blood in your urine.
- Swollen ankles, feet or hands.
- Muscle cramps.
The 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.
As previously mentioned, chronic kidney disease can be diagnosed with blood and urine tests, and is commonly only discovered during routine check-ups. Those who may be at a higher risk should have tests on a regular basis.
Regular tests are recommended if you have any of the following:
- High blood pressure.
- Acute kidney injury.
- Cardiovascular disease.
- Kidney stones.
- Enlarged prostate.
- A family history of the condition.
A blood test will measure the levels of a waste product known as creatinine in your blood. The NHS explain further:
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 be carried out to 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, where a small sample of kidney tissue is removed and examined, may also be suggested.
Stages of Chronic Kidney Disease
Your test results can be used to determine how damaged your kidneys are and will therefore show which stage of the condition you are at. This will allow your doctor to decide the best possible treatment and how often you should have tests to monitor your condition.
Your eGFR result is given as a stage from one to five:
- Stage 1 (G1) – A normal eGFR (above 90ml/min), but other tests have detected signs of kidney damage.
- Stage 2 (G2) – A slightly reduced eGFR (60-89ml/min), with other signs of kidney damage.
- Stage 3a (G3a) – an eGFR of 45-59ml/min.
- Stage 3b (G3b) – an eGFR of 30-44ml/min.
- Stage 4 (G4) – an eGFR of 15-29ml/min.
- Stage 5 (G5) – an eGFR below 15ml/min, meaning the kidneys have lost almost all of their function.
Your ACR result is given as a stage from one to three:
- A1 – An ACR of less than 3mg/mmol.
- A2 – An ACR of 3-30mg/mmol.
- A3 – An ACR of more than 30mg/mmol.
In both cases, the higher the stage means the more severe form of chronic kidney disease you have.
Chronic kidney disease is commonly caused by other medical conditions which place strain on your kidneys, and can be a result of a combination of different problems. Some of the most common causes 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.
As with most conditions, you can lower your risk by make healthy lifestyle changes such as cutting down on alcohol, sticking to a balanced diet and by stopping smoking. You should also ensure that any underlying conditions are under control.
Although there is no cure, there are treatment methods available which 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 to take part in regular exercise sessions. 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 will need to have dialysis. This involves the removal of waste products and excess fluid from your blood. There are two different types of this procedure:
- Haemodialysis – Diverting blood into an external machine, where it’s filtered and then returned to the body. This is usually done around three times a week, in hospital or at home.
- Peritoneal dialysis – Pumping fluid into the space inside your tummy to draw out waste products from the blood passing through vessels inside the lining of your tummy. This procedure is usually done at home, several times a day, or overnight.
Dialysis will be a lifelong form of treatment unless you have a kidney transplant.
For those with severely reduced kidney function, a kidney transplant is the most effective treatment. However this is a major surgical procedure and will involve you taking medications afterwards to prevent your body from attacking the donor organ.
You can live with one kidney, which means donor kidneys can come from recently deceased or living donors, however there is a still a shortage of donors, with patients having to wait months or even years for a transplant.
From April 2014 to April 2015, around 3,000 kidney transplants were carried out in the UK, but there were still more than 5,000 people on the waiting list for a kidney by the end of this period.” – NHS
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. In the UK, consent is required before organs can be donated. A person can give their consent to become an organ donor after death by joining the NHS Organ Donor Register or by discussing their wishes with loved ones.
Living with Chronic Kidney Disease
Most people are able to live quite a normal life with chronic kidney disease, but of course you will need to take extra care of yourself in order to prevent your condition from getting worse. You should follow the lifestyle advice shared in this blog post and ensure that you take and understand your prescribed medication.
You will also need to ensure that you have the annual flu jab and the one-off pneumococcal vaccination as your body will be more vulnerable to infections.
At work, it’s important that you talk to your manager as soon as you feel that your condition is have an affect on your ability to do your job. This way a solution can be found that works for both parties. Remember, the Disability Discrimination Act 1995 requires employers to make reasonable adjustments to working practices or premises to help a person with a disability. If you have to stop working or cut-down on the amount of hours you work, you may be entitled to some financial benefits.
You’ll need to stay in close contact with your specialist care team and seek as much support and advice from the people around you. Working through your condition together is the best way of living with chronic kidney disease.
Chronic kidney disease is a condition which qualifies you for VAT Exemption when you order a personal alarm system from Lifeline24. HMRC state that a product which has been “designed or adapted for a disability” qualifies for VAT exemption.
For a person to qualify they must meet certain criteria set by HMRC. This criteria says that the customer must have a long-term illness, a terminal illness or a disability in order to qualify.
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