Chronic Kidney Disease (Chronic Renal Failure)

In this article, we will discuss chronic kidney disease and the stages involved in kidney failure.

Chronic Kidney Disease

                                            Chronic Kidney Disease is characterized by a gradual, progressive, and irreversible deterioration of kidney functions. It takes about a few months to years for its complete progression and showing its symptoms in the body.

Stages of Kidney Failure

                                           There are five stages of kidney failure corresponding to the GFR (Glomerolous Filteration Rate).

Stage 1

            During stage 1, the kidney performs its normal functions and here the GFR rate is >90ml/min.

Stage 2

            During stage 2, a mild damage/disturbance occurs in the kidney, and the kidney does not perform its normal functions appropriately, and here the GFR rate is 60-89ml/min.

Stage 3

          During Stage 3, a moderate decline in kidney functions occurs, and here the GFR rate is 30-59ml/min.

Stage 4

          During Stage 4, severe damage to kidney functions occurs and the kidney does not perform its normal functions, and here the GFR rate is 15-29ml/min.

Stage 5

          During Stage 5, kidney failure or End-Stage Renal Disease (ESRD) occurs and there is a need for dialysis. Here the GFR rate is <15ml/min.

Causes of Chronic Kidney Disease                                                       

• Diabetic Nephropathy
• Hypertension
• Pyelonephritis
• Glomerulonephritis
• Cystic Kidney Disease
• Obstructions
• Lupus Erythematosus

Symptoms of Chronic Kidney Disease

• Nausea
• Loss of Appetite
• Weight Loss
• Fatigue
• Weakness
• Headache
• Drowsiness
• Muscle Cramps
• Shortness of Breath

Diagnosis

                Following tests are performed for the diagnosis of Chronic Kidney Disease.

1. Kidney Functional Test
2. Blood Test
3. Urine Test
4. Ultrasonography

Management of Chronic Kidney Disease

1. Control of Blood Pressure
2. Maintenance of  HBA1c (<7% in Diabetic Patients)
3. Restriction of Protein Intake (<0.8g/kg/day)
4. Maintenance of LDL (<100mg/dl)
5. Maintainance of Hemoglobin (approximately 11-12g/dl)

Dietary Management Of  CKD

• Protein ( 0.6 g/kg of Body Weight)
• Sodium (Normal unless blood pressure is raised)
• Potassium (Serum Potassium Level is reduced to 30-40mmol)
• Phosphorous (Restricted to less than <700mg)
• Energy (35kcal/kg of Ideal Body Weight)
• Fluid (Reduced to 500ml plus the Previous day's Urine Output)