Kidneys are the filters in the human body and are crucial to our overall health. They filter extra water and waste products out of the body in the form of urine and perform many other functions, including the production of Vitamin D to regulate calcium that is vital for strong bones. Kidneys also regulate blood pressure and influence the release of a hormone that produces red blood cells from the bone.
Unfortunately, sometimes this filtration process starts to break down. This process can be slow, occurring over a period of several months to years, and is known as chronic kidney disease. It can also be sudden, occurring over days or weeks, known as acute kidney injury.
More than 10 percent of adults worldwide suffer from CKD. In the United States, more than 20 million Americans have varying stages of the disease, with many cases undiagnosed. This undiagnosed population does not have any signs or symptoms of poor kidney function, with symptoms arising only after CKD has progressed into kidney failure. There are very few helpful treatments available to reverse the process in the late stages.
When CKD reaches an advanced stage, symptoms include edema, or swelling of the legs, nausea, vomiting, loss of appetite, fatigue, anemia, changes in urine output, cramps, itching, sleep changes and confusion. This is due to a dangerous level of fluid, electrolytes and waste products that have accumulated in the body. The treatment options for end-stage renal disease are dialysis and kidney transplant.
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A screening program for CKD, led by the National Kidney Foundation, known as the Kidney Early Evaluation Program, uses targeted screening for those at high risk for CKD. Targeted screening provides an important opportunity for early intervention to reverse or slow the progression of the disease.
Two major risk factors for CKD include diabetes and high blood pressure. Other risk factors include cardiovascular disease, obesity, recurrent kidney stones, smoking, and a family history of kidney disease. Those ages 65 and older, blacks and Asian-Americans are also at increased risk.
The National Kidney Foundation strongly endorses evidenced-based targeted screening to reduce the burden of CKD on the at-risk population and to reduce health care costs. To detect early kidney disease, two tests are often required. A blood test that measures glomerular filtration rate (GFR) determines how well your kidneys are functioning, and a urine test can detect blood or protein.
Your doctor may also order an ultrasound to assess the kidneys for size and structure, diagnose polycystic kidney disease, kidney stones, obstruction and some cancers. A doctor may consider a kidney tissue biopsy to find or confirm a diagnosis.
If you have a condition that increases your risk for chronic kidney disease and you haven’t been screened, talk with your family doctor about blood and urine screening tests and routine monitoring of blood pressure.
Dr. Khalil Rahman is with Nephrology Associates of Lexington PSC and nephrology medical staff chair for Saint Joseph Hospital.