Chronic Kidney Disease (CKD) - Symptoms and Treatment

This article looks at some common problems relating to kidney disease, the symptoms, when concerns should be expressed to patients and what can be done.

Knowledge is power, and the main criticism that I see of GP's is their failure to spot signs, monitor the problem, and most importantly tell the patient when there is an issue, that then becomes a real issue. Prevention is better than a cure. These cases can often involve a lack of information and appropriate referral by a number of doctors over many years.

How do you test for Chronic Kidney Disease (CKD)?

A routine blood to measure your filtration rate (eFGR) or a urine test to measure albumin and creatinine (ACR). This may lead to ultrasound, MRI or CT scan for blockages and a kidney biopsy.

What do the tests do?

Allow you to stage the severity of the CKD.

What are the symptoms of Chronic Kidney Disease?

Quite often you may have no persistent symptoms , particularly in the early stages, but symptoms may include;

• shortness of breath

• weight loss or poor appetite

• swollen ankles, feet or hands

• tiredness

• blood in urine

• Needing to urinate more regularly, particularly at night

Who is at particular risk and requires regular testing?

If you take long term medicines that can affect the kidneys, such as lithium, omeprazole or non-steroidal anti-inflammatory drugs (NSAIDs), you should be tested. Also, if you suffer with any of the following problems;

• diabetes

• high blood pressure

• acute kidney injury - sudden damage to the kidneys that causes them to stop working properly

• cardiovascular disease

• Conditions that can affect the kidneys. This might include kidney stones or an enlarged prostate, or lupus

• Family history of advanced CKD or another kidney disease

• protein or blood in your urine where there's no known cause.

People taking long-term medicines that can affect the kidneys, such as lithium, omeprazole or non-steroidal anti-inflammatory drugs (NSAIDs), should also be tested regularly.

How do you treat Chronic Kidney Disease?

It depends on the stage. It can be improved and monitored with diet and exercise.

End -stage kidney failure is treated with dialysis. This is associated with significantly increased risk of morbidity, mortality and diminished quality of life compared to age-matched individuals according to UK Renal Registry data.

Patient survival for people with kidney failure is better if they receive a kidney transplant compared to remaining on dialysis (although both remain inferior to a similar aged person who does not have kidney failure).

Most people with chronic kidney disease do not reach kidney failure and the kidney failure population is a small proportion (68,249 in the latest UK Renal Registry report) of the overall chronic kidney disease population.

In the absence of negligence it is an issue that should be managed and in many cases prevented. Inadequate, diagnosis , monitoring, education, referral and treatment can impact significantly on quality of life and life expectancy as we have seen in recent cases.