Kidney Disease Basics
Kidney disease also known as renal disease affects millions of Americans. The progression of kidney disease can be altered if caught early. The key is early detection. Questions to ask include: how does one know if they have kidney disease? How does one know what stage of kidney disease they have? How does one know what to do next?
Why is the kidney Important?
Lets start by looking at the kidney. They are two organs about the size of a fist located in the lower back region in the left and right side of the body. They are made up of millions of filters called nephrons. They help filter your blood and remove toxins. They work around the clock making urine and removing unwanted water and waste from the body. They release hormones to help regulate blood pressure. They release protein to help your body make red blood cells. They help balance minerals for proper bone management.
How does one know if they have kidney disease?
Symptoms may not be present for some, while others experience tiredness, difficulty concentrating, poor appetite, swelling, problems urinating, dry and itchy skin, foamy or discolored urine, dark skin, back pains or muscle cramps. Your doctor will test the urine for blood, protein, glucose, and white blood cells. He/she will perform blood tests that will measure creatinine, BUN, protein, and GFR. Creatinine is a form of waste made when muscle breaks down; when the kidneys cannot remove enough indicates there may be a problem. BUN, blood urea nitrogen, is another waste product that the kidney removes; when the kidney cannot remove enough indicates there may be problem. GFR stands for glomerular filtration rate, which is an approximation of kidney function. For example, GFR of 100 represents 100% kidney function while a GFR of 50 represents 50% kidney function. It is calculated using ones race, gender, age, creatinine, protein and BUN level. If your doctor suspects kidney disease, you will be referred to a nephrologist, which is a kidney specialist.
How did the disease start?
When the kidneys are said to be damaged there could be various causes such as kidney stone, an infection, tumor, or cyst. The nephrologist may order additional tests such as an ultrasound, CT scan or kidney biopsy. They also may order urine and blood tests to determine the cause of kidney disease. Diabetes and high blood pressure are the leading causes of kidney disease. Another leading cause is inflammation of kidney filters known as glomerulonephritis. Having a family history of kidney disease, a history of kidney stones, or a history of kidney infection can lead to kidney disease. There are others who may have a genetic disease, autoimmune disease, or birth defect that may be the cause of kidney disease. The nephrologist will share their findings and determine your stage of kidney disease.
What are these stages?
There are five stages of kidney disease based on your glomerular filtration rate (an approximation of kidney function). Normal GFR range is between 90-120. Stage one is GFR above 90, known as minimal kidney damage with normal GFR. Stage two is GFR between 90 and 60, considered mild decrease. Stage three is GFR between 60 and 30, considered moderate decrease. Stage four is GFR between 30 and 15, considered severe decrease. Stage five is GFR below 15, known as kidney failure or end stage renal disease.
What happens next?
Your nephrologist works in collaboration with a dietitian and nurse practitioner. Their goal is to help manage kidney disease and alter the progression of the disease. There is emphasis to improve quality of life and improve overall health by minimizing complications. These complications include anemia, electrolyte imbalance and bone disease. They will meet with you on a one on one basis so that you will understand your kidney disease and plan lifestyle changes to support optimal health.
Consult with your nephrology team for reliable information sources.
Reliable Internet resources are:
- National Kidney Foundation at www.kidney.org
- U.S. National Library of Medicine NIH National Institute of Health at http://www.nlm.nih.gov/medlineplus/kidneydiseases.html
- Davita at http://www.davita.com/kidney-disease