Chronic kidney disease is the description given for the kidneys not functioning normally, or having abnormal structure to the kidneys. It can be detected by a blood test, by an ultrasound of your kidneys, or by finding something abnormal such as blood or protein in the urine. Chronic kidney disease is a descriptive term and doesn't give the diagnosis of why the kidney function may be abnormal. Leading consultant nephrologist, Professor Liz Lightstone discusses chronic kidney disease, the different possible causes, and how it can be managed.
How common is chronic kidney disease?
Chronic kidney disease is more common in people who have high blood pressure, and in people who have diabetes. However, many people who have chronic kidney disease have no idea they have it.
You may have no symptoms at all until your kidney function is only about 10% of normal. Some people may notice that their ankles and their legs are swelling, or they may wake up with a swollen face in the morning, which are symptoms of leaking a lot protein into their urine.
Sometimes, if the kidney function is not very good, it can cause anaemia and can lead to you feeling tired and under the weather. But actually, most patients with chronic kidney disease do not know they have a problem with their kidneys and will only find out with a routine blood test or urine test.
What causes chronic kidney disease?
There are some general diseases that can cause kidney disease, and you might have symptoms from them such as a condition called vasculitis, where you may get a rash, pains in your joints, and a fever.
There’s also quite a common condition affecting young women called lupus, which can also affect your kidneys. Lupus causes a different type rash to vasculitis and also causes swelling, fatigue, and hair loss in some cases. There are many symptoms you can get that may seem to have nothing to do with your kidneys, but actual chronic kidney disease needs tests to make the diagnosis.
How is chronic kidney disease treated?
There are two aspects to treating chronic kidney disease. But first, the most important part is actually to make the diagnosis, as the symptoms are often assumed to be due to other things, which may not always be the case.
Sometimes, specific blood tests are needed, where other times it may be necessary to take a sample of your kidney tissue, known as a kidney biopsy. The tissue will be investigated under microscope and a specific diagnosis made.
Treatment would need to be given for that condition, such as lupus or vasculitis. If you’ve had diabetes for many years, it can also lead to chronic kidney disease.
The second aspect to treatment of chronic kidney disease is not just the treatment of the specific underlying disease and to treat the diabetes, but also to look after your kidneys in the long term.
Keeping your kidneys as healthy as possible
The key ways to look after your kidneys in the long term, and to prevent chronic kidney disease getting worse, is to have a tight control of blood pressure.
To achieve this, specific blood pressure tablets are used that not only reduce the blood pressure, but reduce any protein leak you might have from your kidneys.
The next most important thing is to avoid tablets that might upset your kidneys. The biggest group we always warn people about are anti-inflammatories such as ibuprofen.
Anti-inflammatories can be really damaging to the kidneys in someone who already has chronic kidney disease. Patients should stick to paracetamol or other types of codeine-based treatments for pain, rather than anti-inflammatories.
Something you can do quite easily is to think about the amount of salt in your diet. Reducing salt definitely reduces blood pressure. The recommended total daily intake of salt is only 6 grams a day, and there’s an enormous amount of hidden salt especially in processed foods. So reducing that would help treat your blood pressure. However, you need to be careful what you use as a salt supplement because some supplements contain a high amount of potassium and sometimes people with kidney disease have real problems with their potassium levels.
The other very important general factor is to stop smoking. Of course, that’s terribly important for your lungs and heart, but kidneys don't like smoking either and people who smoke, tend to have their kidney disease progress more rapidly.
The other foods and drinks that help to keep your kidneys healthy are those that are very high in what we call antioxidants. These are very good for blood vessels and tend to keep your blood pressure lower. Research is being done into the benefits of beetroot juice, which contains a lot of a substance called nitrous oxide. This dilates your blood vessels and will reduce your blood pressure. But otherwise, eat sensibly and avoid a high protein diet.
If you are concerned about chronic kidney disease, and would like to make an appointment with a specialist in chronic kidney disease, you can do so here.