Chronic Kidney Disease: A Doctor Explains Causes, Diagnosis & Care If You're In Early Stages

Chronic kidney disease is a significant cause of morbidity and mortality. It also has a substantial financial burden on the family. It is essential to identify the causes and risks for kidney diseases in an individual. Early diagnosis and effective management at an early stage prevent or delay the progression of kidney disease to an advanced stage.

Causes of kidney damage

There are several causes of kidney disease. Some of them are:

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Diabetes: High blood sugar in the blood may cause damage to the filters of kidneys. Persistently elevated blood sugar levels damage the kidneys to such an extent that they cannot filter the blood sufficiently. Both type 1 and type 2 diabetes can cause kidney damage, the earliest sign of kidney damage in diabetes is presence of micro albumin in urine which is detected by lab test

Hypertension: High blood pressure causes damage to the blood vessels of the kidneys. Damaged blood vessels in kidneys reduce kidney function

Genetic diseases: Several inherited kidney diseases result in progressive loss of kidney function. These diseases result in polycystic kidney disease, nephronophthisis, the two common diseases which are present by birth but manifest later ages of life and collagen-related kidney diseases.

Glomerulonephritis: It involves the inflammation of the glomerulus. Glomeruli are small filters present in the kidneys. It can be acute or chronic. Usually present with swelling of legs , protein and blood in urine and many times high blood pressure

Urinary tract obstruction: Blockage may result in the development of kidney stones, recurrent infections, and kidney damage. Some of the causes of kidney obstructions are urethral defects in new born and early child hood and urinary bladder dysfunction in children and adults

Recurrent kidney infection: Repeated kidney infections or severe infection may result in kidney damage. It is also possible that the infection may spread to the bloodstream that may be life-threatening.

Vesicoureteral reflux: The urine flow in the kidney is unidirectional, from kidneys to urethra. However, in some cases, the urine flows backwards, resulting in kidney infection and scarring later kidney dysfunction

Interstitial nephritis: It involves inflammation of the kidney tubules. Acute nephritis may result in renal failure due to immune-mediated injury and side effect of some medications use

Metal poisoning: Several heavy metals affect the functioning of the kidney as they are the organs responsible for excreting heavy metals from the body. Heavy metals with potential for kidney damage are barium, cadmium, arsenic, cobalt, lithium, and mercury. These heavy metals cause slow damage to the kidneys

Autoimmune diseases: Autoimmune diseases also cause kidney diseases. Such autoimmune diseases include anti-glomerular basement membrane (anti-GBM) disease, lupus nephritis and ANCA-associated vasculitis and glomerulonephritis.

Medications: Consuming a large amount of over-the-counter drugs may also cause kidney diseases. Such medicines include naproxen, ibuprofen, and aspirin and some antibiotics

Diagnosis of kidney diseases in early stages

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Most people with kidney disease do not experience any symptoms in the early stage. The condition may be diagnosed while investigating some other illness. Diagnosis of the early stages of kidney disease may involve the following techniques:

Identifying early signs: Patients should not ignore the early symptoms of kidney disease. Often swelling of legs or face , some times fatigue, alteration in urination (high or low frequency) especially at night times, foamy urine, nausea and vomiting, and lower back pain, skin itching and discoloration

Blood test: The doctor may recommend blood tests to determine the levels of such certain chemicals in your blood, such as urea and creatinine.

Urine test: Analysis of the urine helps determine the abnormality in kidney function. The urine tests assess the presence of protein, white blood cells, crystals, and red blood cells

Sonography: A radiological scan of abdomen to look at size and appearance of the kidneys

Caring kidneys in early stages

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Caring kidneys in the early stages of the disease may delay or prevent disease progression in advanced stages. Some of the measures include:

- Restriction of dietary protein reduces the rise of glomerular pressure and delays renal disease progression. This delay in the progression of kidney disease is independent of blood pressure management.

- Keep your blood pressure under optimal limits by salt restriction and medications

- If you have diabetes, take medicine regularly to prevent elevated blood sugar levels.

- Get treatment of anaemia as hypoxia due to this condition may further deteriorate kidney function and also improve exercise tolerance

- Manage underlying specific medical conditions such as lupus nephritis, benign prostatic hyperplasia, kidney stones, and other anatomical obstructions.

- Regular exercise, weight management, dietary salt reduction, and quitting smoking prevent kidney disease progression.

- If you are at increased risk for developing kidney disease, undergo routine kidney examination at regular intervals like an annual health check up

- Consult with your doctor if you have symptoms of kidney infections. Early diagnosis and management of kidney infection reduce the risk of kidney damage.

- Undergo genetic testing if any of your family members suffers from hereditary kidney disease.

Dr. Ravi Shankar B, Consultant - Nephrology, Manipal Hospital Whitefield