Chronic kidney disease is progressive and a slow reduction in the function of the kidney, which is over months or years, and it reduces the ability of the kidney to filter metabolic wastes from the blood.
Causes of Chronic Kidney Diseases
The leading causes of chronic kidney disease are:
- The leading causes are Diabetes mellitus
- High blood pressure (hypertension)
- Due to high blood acidity, anemia, nerve damage, and risk of bone tissue deterioration arise, and the probability of atherosclerosis also increases.
- Glomerulonephritis which is inflammation or damage to kidney filter units also causes chronic kidney disease.
- Symptoms of chronic kidney disease may include urination at night, fatigue, nausea, tickling, muscle spasms, cramps, muscle stiffness, loss of appetite, confusion, breathlessness, swelling of the body (usually of the legs).
- Urinary tract obstructions
- Specific kidney changes (such as polycystic kidney disease)
- Autoimmune disorders (such as systemic lupus erythematosus) in which antibodies damage tiny blood vessels (glomeruli)
- Thin kidney tubes (tubules).
- Chronic kidney disease is diagnosed by blood and urine tests.
Treatment of chronic kidney disease
Treatment aims to limit the consumption of fluids, sodium, and potassium in the diet, by administering drugs to correct other diseases (diabetes, high blood pressure, anemia, and electrolyte imbalances) and, if necessary, by resorting to dialysis or kidney transplantation.
Acute kidney injury becomes chronic kidney disease if renal function is not recovered after treatment and persists for more than three months. Hence, any condition that induces acute kidney failure can also cause chronic kidney disease.
- Treatment of conditions, which worsen kidney function
- Proper diet and medications
- Dialysis or kidney transplant
Purpose of treatment
The purpose of treatment is to slow the decline in kidney function. Conditions that can cause or worsen chronic kidney disease and that can adversely affect overall health need to be addressed promptly, such as:
- diabetes
- High blood pressure (hypertension)
- Obstruction of the urinary tract
- Infections
- use of certain medications
For example by controlling the glucose level in blood and hypertension in people with diabetes significantly slows the deterioration of kidney function. Besides, drugs called angiotensin-converting enzymes (ACEs) and angiotensin II receptor blockers (ARBs), which help lower blood pressure, can reduce the rate of blood pressure decline in kidney function in some people with chronic kidney disease. The doctor avoids prescribing drugs excreted by the kidney or prescribes them by decreasing the dose.
Many other medications may need to be avoided. For example
- taking ACE inhibitors,
- angiotensin II receptor blockers,
- some diuretics (such as spironolactone, amiloride, and triamterenemay need to be stopped in people with chronic kidney disease and high blood potassium levels, as these drugs can increase blood potassium levels.
How CKD can be controlled by taking a proper diet?
To slow the progression of chronic kidney disease, it is necessary to follow a correct diet and take certain medications.
1. Protein restriction
You can slightly slow the decay of the kidney by reducing the daily consumption of protein. The subject must consume carbohydrates in sufficient quantities to counterbalance the reduction in protein. Suppose your dietary protein intake is significantly reduced,in that case, it will be good to have the supervision of a dietician to make sure you are getting an adequate amount of amino acids.
2. Control of acidosis
Sometimes, you can control mild acidosis by increasing fruit and vegetable consumption and reducing animal protein intake. However, moderate or severe acidosis may require treatment with antacid drugs (e.g., sodium bicarbonate and sodium citrate).
3. Reduction of triglyceride levels
The patient can control blood triglyceride and cholesterol levels by limiting the intake of dietary fat. To reduce triglyceride and cholesterol levels, the patient may need medications such as statins, ezetimibe, or both.
4. Limitation of sodium and potassium intake
Limiting salt consumption (sodium) is usually helpful, particularly if the person has heart failure.
Patients must restrict fluid intake to prevent excessive lowering of sodium concentrations in the blood. In addition, foods extremely rich in potassium, such as salt substitutes, should be avoided.
Patients should not consume moderately potassium-rich foods such as dates and figs and many other fruits in excess.
High levels of potassium in the blood increase the risk of heart rhythm disturbances and cardiac arrest. In cases where potassium levels are excessively high, potassium-lowering drugs (for example, sodium polystyrene, sulfonate, and zirconium cyclosilicate) may be effective, but emergency dialysis is usually required.
5. Control of phosphorus levels
Increased phosphorus levels in the blood can cause calcium and phosphorus deposits to form in tissues, including blood vessels. Limiting the consumption of foods with high phosphorus content, such as dairy products, liver, legumes, nuts, and many soft drinks, decreases the concentration of phosphates in the blood. Besides, drugs that bind phosphates, such as calcium carbonate, calcium acetate, sevelamer, and iron citrate are taken by mouth, can also reduce phosphorus levels in the blood. Kidney patients must avoid calcium citrate. Vitamin D and similar medications are often taken orally to lower parathyroid hormone levels.
Treatment of advanced chronic kidney disease
When chronic kidney disease treatments are no longer effective, the only long-term alternatives are
- Dialysis
- Kidney transplantation.
Both options reduce symptoms and prolong life. If the person is eligible, a kidney transplant is an optimal option. For people who choose not to undergo dialysis, terminal care (also called care in hospice, a type of palliative care) is essential.
