What is Chronic Kidney Disease?

Chronic Kidney Disease (also known as Chronic Renal Failure) is the progressive loss of kidney function occurring over a span of several months to several years and is characterised by the replacement of kidney architecture with interstitial fibrosis.

Chronic kidney disease is classified into five stages on the basis or proteinuria (presence of protein in large amounts in the urine) or Glomerular Filtration Rate (GFR) - 1 being the mildest with no distinct symptoms and 5 being end stage renal failure.

Causes and Risk Factors of Chronic Kidney Disease-

The various reasons (called risk factors) that can increase chances of Chronic Kidney Diseases are:

Diabetes mellitus, hyperlipidemia (excess fat proteins in the blood)
Hypertension

Family history heritable renal disease

Older age, smoking

Autoimmune disease

Past episodes of acute renal disease

The direct causes of Chronic Kidney Diseases are-

Diabetic nephropathy (leading cause)

Hypertensive nephropathy

Glomerulonephritis (swelling of the glomerulus in the kidneys)

Reno-vascular disease (ischemic nephropathy)

Polycystic kidney disease

HIV-associated nephropathy

Transplant allograft failure

Exposure to drugs and toxins

Diet that you must maintain in Chronic Kidney Disease-

It is essential to make dietary as well as lifestyle amends once you are diagnosed with CKD. The main purpose of this diet is to maintain the levels of carbohydrates, fluids and minerals. This is done to prevent the buildup of waste products in the body as the kidneys are unable to fulfil its function properly.

It is recommended to refer a dietician who can make you a diet chart that helps you adhere to your diet.

Here is a list of food items that you may avoid or may consume if you are suffering from Chronic Kidney Disease:

Carbohydrates : Carbohydrates are a good source of energy. If the intake of protein has been restricted, then it is recommended to replace that with carbohydrates as a source of energy. Fruits, vegetables, grains and bread can be consumed as they are rich source of fibres, minerals and various types of vitamins. You can indulge in some hard candies or sweets as well.

Fats: Fats can provide a good amount of calories as well. Ensure that you only stick to healthy fats such as the monounsaturated and polyunsaturated fats that are good for your cardiac health. 

Reduce your phosphorus intake: A diet with no more than 800 mg of phosphorus can help reduce the risk of too much phosphorus building up in your blood.  Limit intake of foods with high levels of phosphate or phosphate additives such as organ meats, whole grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products and chocolate. Many beverages and processed foods have these additives. Other high-phosphorus foods to limit include: 

Cheese
Chocolate
Ice cream
Legumes
Milk
Nuts
Seeds
Yogurt
Monitor your potassium levels: Usually, potassium is not restricted in stage 3 CKD unless lab tests show potassium is too high. Your doctor may make medication changes or prescribe a low-potassium diet. Reduce an elevated potassium level by limiting some high-potassium foods and potassium chloride (found in salt substitute and many low-sodium processed foods), such as avocado, bananas, cantaloupe, honeydew, legumes, milk, nuts, potatoes, seeds, tomato products and yogurt. Some high-potassium foods to limit or avoid include: 
Avocado
Bananas
Cantaloupe and honeydew melon
Dried fruit
Legumes
Milk
Nuts and seeds
Oranges and orange juice
Potatoes
Pumpkin and winter squash
Tomato products (juices, sauces, paste)
Yogurt
Proteins: Usually, before undergoing dialysis, it is recommended to adhere to a low-protein intake diet. However when you are undergoing dialysis, it is necessary to consume a certain amount of protein. This detailed information can be obtained from your dietician.
Fluids: In the early stages of CKD, your fluid intake is not monitored. But as the disease progresses, you need to check your intake of fluids as too much fluids may accumulate in your body and create pressure on your kidneys.

Sodium Or Salt Intake: Keeping a check on your salt intake reduces the risks of high blood pressure. Also, having food low on salt can reduce your thirst and prevent fluid retention in your body.

Diet In Chronic Kidney Disease

A dialysis diet is a special diet that is customized for patients who are or will be starting dialysis within a short period of time. Such a diet is prepared to reduce the waste and fluid levels that keep on accumulating between the dialysis sessions so that the patient remains healthy for the process to be carried out seamlessly.

What can you eat?
Eat foods which are rich in high-quality proteins (poultry, fish, lean meat and egg whites).

What can t you eat?
Eat less of foods which are rich in sodium and phosphorus.

Foods high in Sodium
1. Use minimum salt in preparing the dishes; this helps control BP and probable weight gain that might happen between the dialysis sessions.
2. Make use of spices, herbs and other salt-flavored enhancers.

Meat
1. Patients on dialysis need to include more of high-quality protein foods in their diet. This will help regulate blood protein levels. Eat about 10 ounces of foods rich in high-quality protein every day.
2. 1 egg,   cup of ricotta cheese,   cup of tuna.

Salads/Vegetables

The potassium content of vegetables can be alarming for a patient on dialysis. Eat 3 servings of vegetables that are low in potassium every day. These include broccoli, cauliflower, cabbage, carrots, garlic, cucumber, eggplant, celery, radishes, etc.
Avoid vegetables such as beets, potatoes (in any form- wafers or wedges), winter squash, cooked spinach, pumpkin, asparagus and avocado.
Note:

Although seeds, nuts, peanut butter, lentils, dried beans and peas are rich in protein, they are generally struck off from the diet plan because of their high phosphorus and potassium content.
You can have moderate amounts of grains, bread and cereals.
Try and not have brown bread and other whole grains as they are loaded with phosphorus.
Usually, 5-10 servings of these are considered sufficient for patients on dialysis.
Also, limit intake of milk and other dairy products.
  cup yoghurt or   a cup of milk is considered safe. Also, remember that all varieties of milk- skim, whole and low fat, have the same amount of phosphorus.
All fruits contain some amount of potassium. However, some of them contain more potassium than the others. Limit your intake of fruit juices.
Avoid or limit fruits like: 
Orange juice and oranges
Kiwis
Prune juice and prunes
Dried fruit and raisins
Melons
Bananas

Dialysis - What To Eat & What To Avoid?

Treatment for Kidney stones varies depending on the size and type of the stone or the symptoms caused by it. In case of small stones, medication and simple changes in lifestyle can be enough to treat it, but surgeries and extensive treatments are required if symptoms are severe. 

Following are treatment options for kidney stones:

Small stones with minimal symptoms 
1. Drinking water
Drinking around 3 liters of water a day will regulate your urinary system and can effectively eliminate small stones. Unless your doctor advices otherwise, drinking ample amount of fluids, usually water, is one of the commonest way to get rid of small kidney stones. 

2. Pain relievers
There might be a considerable amount of pain and discomfort associated with passing the stone through urine. Your doctor may recommend pain killers like Ibuprofen, Naproxen sodium or acetaminophen. 

3. Medical therapy
In order to eliminate the kidney stone, your doctor may administer medical therapy. Medication like alpha blocker helps in passing the kidney stone with least pain and more quickly. It relaxes the muscles in the ureter and makes the process relatively easy. 

Large stones with severe symptoms
 
1. Using sound waves to break up stones 
In this technique, a procedure called Extracorporeal Shock Wave Lithotripsy (ESWL), is employed. ESWL uses the help of sound waves to create vibrations which breaks the stones in smaller pieces. This procedure takes about an hour and can cause mild pain and discomfort. Your doctor may administer sedatives to reduce your sensitivity. ESWL has side effects like blood in urine or bruising in the abdomen. 

2. Surgical removal of kidney stones 
Surgical removal of stones is done with the help of a procedure called nephrolithotomy. It uses small telescopes and other instruments which are inserted in your back through a small incision. It is generally done in case of large stones and when ESWL fails. 

3. Ureteric Calculi (Using a scope to remove stones) 
A thin illuminated tube called ureteroscope is used to remove a comparatively smaller stone in the kidney or ureter. The ureteroscope is equipped with a tiny camera which determines the location of the stone which is then broken into pieces with the help of other instruments. It may require general or regional anesthesia.

Treatments For Kidney Stones

Chronic kidney disease or CKD is the decreased function of the function of the kidney for a minimum of three months or more. In this the end stage renal disease usually refers to the end of the kidney function where the kidneys work for less than 15% of what they are supposed to. The kidneys play a vital role in the human body and if they do not function properly then a person can die. The functioning of many organs depends on the kidneys. However, the main function of the kidneys is to remove the products and regulate blood and water, control blood pressure, promote healthy and strong bones, and produce hormones.

Here are 5 facts about kidney disease you should know about:

1. Causes of the kidney disease: There are two main common causes of the end-stage kidney disease. These are preventable causes. These are diabetes and high blood pressure, but then kidney disease can be caused by other inherited diseases such as infection, trauma or polycystic kidney disease.

2. Serious Stages: The kidney disease has five stages and stage 5 is known as the end stage renal disease; this is the point where patients usually need dialysis or kidney transplant to lead a sane life. The stages of kidney disease are:

Stage 1   Slight kidney disease
Stage 2   Mild decrease in kidney function
Stage 3   Moderate decrease in kidney function
Stage 4   Severe decrease in kidney function
Stage 5   End stage renal disease

3. Detection of the disease: Kidney disease is usually difficult to detect because of the presence of very few symptoms. Age, gender along with the blood test is one way to determine information regarding kidney function. The people who are at a risk of getting kidney disease are:

    Over the age of 55 years
    People who suffer from hypertension and diabetes
    Ethnic groups such as Asians, Africans, Americans, Pacific Islanders and Hispanics

4. Signs and Symptoms: CKD is usually considered to be a silent disease and many people don t know that they are suffering from the disease. The signs and symptoms of the disease are:

    Fatigue and weakness
    Nausea, vomiting and loss of appetite
    Dizziness
    Numbness and headaches in hand and feet
    Frequent urination

5. Renal Replacement Treatment: This is the treatment for the end stage of the kidney disease. Dialysis involves the replacement of some part of the lost function of the kidneys and is usually continued throughout life. There are 2 types of dialysis:

    Hemodialysis: This cleans the blood via an artificial kidney which is hooked to the machine
    Peritoneal Dialysis: This removes the excess water and waste products and cleans the blood of the body by using the peritoneal cavity as a filter. 

5 Facts About Kidney Disease You Should Know

3 Causes of Acute Kidney Failure

You're said to suffer from the problem of acute kidney failure if your kidneys suddenly stop working and lose their ability to eliminate waste materials including excess fluids and salts from the blood. The condition usually develops quickly over a few days or even a few hours. When this happens, waste materials accumulate in your blood, disrupting the chemical balance of your bloodstream.

So, what causes this problem?

Acute kidney failure can occur because of any one of these reasons:

1. A drop or slowdown of blood flow to the kidneys - Adequate blood circulation to the kidneys is of great importance as without it the kidneys may end malfunctioning. If blood flow to the kidney is hampered, a part of or the entire kidney may die. You may suffer from acute kidney failure if blood flow to the kidneys gets impaired due to conditions like

-Heavy blood loss
-Sepsis (body's inflammatory reaction to an infection, which can bring about organ failure, tissue damage, and death)
-Injury
-Use of certain drugs
-Dehydration
-Burns
-Heart disease

2. Urinary obstructions - A sudden blockage that hampers your kidney's ability to eliminate urine can also bring about acute kidney failure. When this happens, it leads to a build up of toxins in the body, causing an overload of the kidneys. Conditions that bring about this urinary obstruction include:

-Cervical cancer
-Colon cancer
-Bladder cancer
-Kidney stones
-Enlarged prostate
-Prostate cancer

3. Disease within the kidneys - Even instances of clotting within the blood vessels of the kidneys can lead to acute kidney failure. This is because if the movement of blood cells within the blood vessels gets hampered, kidneys are not able to filter out toxins from the body. The conditions and diseases that may cause clotting, and subsequently damage to the kidneys include:

-Scleroderma (an autoimmune disease that affects connective tissues and skin)
-Build-up of cholesterol deposits
-Glomerulonephritis (an inflammatory condition of the kidney's ball-shaped structures called glomeruli)
-Hemolytic uremic syndrome (a condition that occurs due to untimely death of red blood cells)
-Lupus (a disorder of the body's immune system that brings about damage to the body's own organs and tissues)



3 Causes of Acute Kidney Failure

A kidney transplant is a surgical procedure that patients of kidney disease go through in order to replace a non functioning kidney with a live one that is healthy and functions well. Other methods to treat this disease also include dialysis, which basically is an artificial way of doing what our kidneys are designed to do. When dialysis does not work, many doctors recommend a kidney transplant. A replacement or donated kidney can come from a living donor or a non-living donor. This new kidney will mostly work towards keeping the blood clean, which is a function that stops when the old and diseased kidneys fail.
 
So, here's a list of five essential facts that you need to keep in mind if you are looking at a kidney transplant:

1. Donors: While there are living and non-living donors, the doctor will have to ensure that your donor is someone who has no medical history of complications, kidney disease or any other medical condition like diabetes or hypertension. Also, the donor would have to have two proper functioning kidneys. Further, one of the most important factors is the blood group. The blood group of the donor and the patient must match for the transplant to be possible.

2. Procedure: During the surgery, the patient will be under general anesthesia. The surgeon will make an incision in the lower abdomen area and the blood vessels of the new kidney will be connected surgically with the vein and iliac artery of the patient. Thereafter, any excess fluid will be drained before wrapping up the surgery.

3. Rejection: The patient's body may also reject the kidney. The immune system of the patient may mistake the new kidney as an attacking body and its natural defenses may work against it, which will lead to complications. For this, doctors usually prescribe immunosuppressant medicines that will help in preventing such an eventuality. 

4. Longevity: While a living donor's kidney may last longer, a non-living donor's kidney will not enjoy such a long life. In such cases, a second transplant can be conducted.

5. Diet: After the transplant, the patient will be required to go through a number of measures like coughing to show that the lungs are clear, as well as administration of fluids and some amount of examination and dialysis. Also, the patient will have to have a special diet that includes raw fruits and vegetables, and plenty of non-fat dairy ingredients.

A kidney transplant is a major operation that can change your lifestyle in the long run. 

5 Things You Should Know About Kidney Transplant

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