chronic kidney disease
FSGS Kidney Disease

The Truth About Chronic Kidney Disease

Your kidneys are two bean-shaped organs about the size of an adult fist located in the middle of your back, with one kidney on either side of your spine.
Their function is to filter water and waste out of your blood and produce urine which disposes of this waste. Every day, your kidneys filter about 120 to 150 quarts of blood to produce urine.
Your kidneys also:
  • Manage electrolyte (salt) concentrations
  • Manage the amount of fluid within the body
  • Help manage blood pressure xHelp maintain acid-base balance
  • Produce hormones that affect blood and bones
It is estimated that kidney disease affects 31 million people in the United States alone, and globally 1 in 10 people have some form of kidney disease. Chronic kidney disease (CKD), also known as renal disease, is the general term for damage that reduces function of the kidney. CKD occurs when kidneys are no longer able to clean toxins and waste products from the blood and perform their functions to full capacity. CKD can happen all of a sudden or over time.
Some Causes of Kidney Disease
Diabetes and high blood pressure are the most common causes of kidney disease, but your doctor will need to perform tests to find out why you have kidney disease. Testing is one of the only known ways to know if you have kidney disease. Get checked if you have a history of kidney disease, high blood pressure, heart disease, or a family history of kidney failure. Work with your doctor to get the proper treatments to manage your disease. Other causes of CKD include:
  • Immune system conditions such as lupus or chronic viral illnesses such as HIV/AIDS, hepatitis B, and hepatitis C.
  • Urinary tract infections that have reached the kidneys can lead to scarring as the infection heals. Multiple episodes can lead to kidney damage.
  • Inflammation in the tiny filters within the kidneys; this can happen after a strep infection and other conditions of unknown cause.
  • A rare kidney disease called focal segmental glomerulosclerosis (FSGS) that disproportionately affects African Americans. It affects the kidney’s filter units which stop filtering the blood properly and protein spills into the urine (called proteinuria). Over time, this may lead to kidney failure.
  • Polycystic kidney disease, in which fluid-filled cysts form in the kidneys over time. This is the most common form of inherited kidney disease.
  • Congenital defects that affect the kidneys often cause urinary tract obstruction or malformation. One of the most common involves a valve-like mechanism between the bladder and urethra.
  • Drugs and toxins, including long-term exposure to some medications and chemicals, such as NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen and naproxen, and use of intravenous “street” drugs.
The National Kidney Foundation created guidelines to help doctors identify each level of kidney disease as seen in the chart below. Having the ability to clearly and accurately identity each stage of CKD helps healthcare providers plan and give the best and most informed care, especially given that each stage of CKD requires different treatment. Many factors go into determining what stage of kidney disease, including age, weight, gender and results of blood and urine tests. Chronic kidney disease (CKD) has five distinct stages.
Stages of Kidney Disease
Stage 1
Stage one still means your kidneys are functioning normally, but urine analysis point to kidney disease. At this stage you are monitored for blood pressure and observed.
Stage 2
This stage has mildly reduced kidney function. Blood pressure is still monitored, and you are simply observed, no radical treatment yet.
Stage 3a
This stage show mild to moderately reduced kidney function. Patient is still monitored and treated for blood pressure issues and observed closely.
Stage 3b
This is closely behind stage 3a but lumped in the same treatment area. Patient is observed, and blood pressure continues to be watched closely.
Stage 4
This stage show severely reduced kidney function, a noticeable jaundice can occur. Yellowing of the whites of the eyes is common. Patient may be feeling quite ill at this stage. Patient is planning for end stage renal failure and dialysis.
Stage 5
At this stage the patient is suffering from kidney failure and possibly waiting for a kidney transplant. Patient is on dialysis at this point.
Chronic kidney disease patients can move back and forth from various stages of the disease. This disease is serious and causes major medical interventions and high costs for most patients.
Treatment
The decision to prescribe a medication is the responsibility of your nephrologist and/or your primary care provider (PCP) based on his/her evaluation of your condition. It’s important to work with your doctor regarding your treatments, including potential clinical trials, and overall health.
Some Tips to Prevent or Slow Down CKD
  • Eat a healthy diet that is low in salt, fat and cholesterol, emphasizing fruits and vegetables. One healthy diet is the DASH Diet, which has been endorsed by leading health organizations. It is rich in fruits, vegetables, low fat dairy products, whole grains, fish, poultry, beans, seeds and nuts. It is low in sodium, added sugars and sweets, fat and red meats.
  • Quit smoking.
  • Maintain an active lifestyle with plenty of exercise. Get at least 150 minutes per week of moderate to high intensity aerobic activity such as walking, bicycling, swimming, dancing, etc. Talk to your doctor before starting any exercise program.
  • Get enough sleep. The typical adult needs 7-9 hours of sleep a night.
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