Chronic kidney disease (CKD) occurs when kidneys are no longer able to clean toxins and waste product from the blood and perform their functions to full capacity. This can happen suddenly or over time.

One of the first things that you should know is that kidney disease has stages. Knowing your chronic kidney disease (CKD) stage is important for determining your treatment. CKD has five stages, ranging from nearly normal kidney function (stage 1) to kidney failure or end stage renal disease (ESRD), which requires dialysis or a transplant (stage 5). At stage 5, kidneys function below 10–15 percent of their normal capacity. Understanding which stage you are at will help you learn how to appropriately manage your kidney disease.

In most cases, ESRD (stage 5) occurs after years of living with kidney disease. Less common is acute kidney failure, which is a sudden compromise of kidney function. Whichever the case may be, when you are diagnosed with ESRD it is necessary to receive dialysis or a transplant to maintain your good health. DaVita offers many services that can suit your lifestyle.

There are various options to treat ESRD (stage 5). The most common treatment is dialysis. If you and your nephrologist agree on a kidney transplant as a treatment option, you might require dialysis while waiting for the right kidney donation.

 

Understanding Your Kidneys

Understanding how kidneys work is the first step in taking control of your health. Following a suitable diet for your kidneys, not smoking, and managing diabetes, hypertension (high blood pressure) and other health conditions may help your kidneys function better and longer, even when you have kidney disease. Your kidneys play a very important role in regulating your overall health. They make up your body’s filtration system, cleaning waste and eliminating excess fluids from your body as well as producing a series of chemical substances that are necessary for your
body to function.

 

Could You or Someone You Care About Be at Risk for CKD?

Risk factors include the following:

  • Diabetes
  • High blood pressure
  • Cardiovascular disease
  • Family history of kidney disease
  • Age of 55 or greater

If you may be at risk for kidney disease, consider scheduling a kidney screening with your general practitioner as part of your next checkup.

What Are the Symptoms of Kidney Disease?

Knowing the symptoms of kidney disease can help people detect it early enough to get treatment. Symptoms can include the following:

  • Changes in urination—Urinating in bigger or smaller amounts than usual, feeling pressure when urinating, changes in the color of urine, foamy or bubbly urine or having to get up at night to urinate.
  • Swelling of the feet, ankles, hands or face—Liquids the kidneys can't remove may accumulate in the tissues.
  • Fatigue or weakness—A buildup of toxins or a shortage of red blood cells (anemia) can cause these problems when the kidneys begin to fail.
  • Shortness of breath—Kidney failure is sometimes confused with asthma or heart failure because fluid can build up in the lungs.
  • Ammonia breath or an ammonia or metal taste in the mouth—Waste buildup in the body can cause bad breath, changes in taste or an aversion to protein-rich foods such as meat.
  • Back or side pain—The kidneys are located on either side of the spine, in the back.
  • Itching—Waste buildup in the body can cause severe itching, especially of the legs.
  • Loss of appetite.
  • Nausea and vomiting.

If you have any of these symptoms, talk to your doctor about your concerns. This is especially important if you have diabetes or high blood pressure, which are the main causes of kidney failure, or even if you have a close family member who has kidney disease.

How Can I Find Out If I Have Kidney Disease?

Kidney disease can be found or confirmed through lab tests. High blood levels of creatinine and urea or high levels of protein in your urine suggest kidney disease. Diabetics should have a yearly urine test for the presence of micro albumin, small amounts of protein that do not show up on standard urine protein test.

 

If I Have Signs of Kidney Disease, What Should I Do?

After you have basic screening tests done, if you have signs of kidney disease, you should ask for a referral to a nephrologist, a specialist in treating kidney disease. A nephrologist will perform an evaluation then suggest medications or lifestyle changes to help slow the progression of kidney disease.

 

Stages with kidney disease

With chronic kidney disease (CKD) the kidneys usually do not fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, medicines and lifestyle changes may help slow its progress and keep you feeling your best for as long as possible. Kidney disease is divided into five stages, each of which calls for different tests and treatments.

What are the 5 stages of kidney disease?

There are five stages of chronic kidney disease. Stage 1 is the closest to healthy kidney function and Stage 5 requires dialysis or a kidney transplant.

GFR, which stands for glomerular filtration rate, estimates kidney function. If your GFR is 26, that means your kidneys are working at approximately 26 percent of the normal rate.

 

MILD

STAGE 1 , GFR > 90

STAGE 2, GFR 89-60

  • Kidney damage with mild loss of kidney function
  • Few to no symptoms
  • Manage through healthy diet and blood pressure regulation

 

MODERATE

STAGE 3A, GFR 59-45

STAGE 3B, GFR 44-30

  • Could have fatigue, urination change, sleep problems and kidney pain
  • Speak to your doctor about a kidney-friendly diet, managing high blood pressure and prescription medications that may help

SEVERE

STAGE 4, GFR 29-15

  • May develop high blood pressure, anemia, bone disease or cardiovascular diseases
  • Symptoms include fatigue, nausea, taste changes, nerve issues, difficulty sleeping, and poor appetite and energy
  • See a kidney doctor to manage your disease and ask about kidney transplant
  • A dietitian can help manage your diet

 

END STAGE RENAL DISEASE (ESRD)

STAGE 5, GFR < 15

  • Symptoms include loss of appetite, nausea, itching, swelling, and making little to no urine
  • Treatment options include dialysis or kidney transplant

Your life may be different when you have chronic kidney disease (CKD), but you can still enjoy it. Taking things one step at a time is the best way to tackle any change. Below are few tips to help you enjoy your life:

  • Learn all you can about kidney disease and especially your own condition. Work with your care team to find out how the information applies to you.
  • Know that you can do this! Think of CKD as a challenge to be met head on. There are people and resources to help you become a partner in your care and aid you in living long and well with CKD.
  • Learn about your medications, their proper dosages, and the name and the purpose of each one. Some medications, such as certain classes of blood pressure pills, can slow the progress of kidney disease. Ask your doctor what's right for you.
  • Track your lab-test values over time and learn what they mean. Your healthcare team knows a lot about kidney disease, but you are the expert on you.
  • Take charge and act. If you do not understand something or if something seems wrong, talk to your doctor. Ask questions and find out what you can do to improve your health.
  • Find out the symptoms of CKD and report your symptoms to your doctor. Some problems, such as fatigue, can be treated to help you feel better.
  • Work with your doctor and dietician to determine good kidney-friendly dietary guidelines. Follow them as closely as possible and see how your diet affects your lab-test values.
  • Exercise regularly and sensibly. Talk to your doctor about the right level of exercise for you.
  • Stay employed if possible. Even if you have to take some time off work to adjust to a new situation, try to work part-time or full-time. Keeping a job is a good way to stay active and engaged.
  • Do some research and planning for financial considerations of chronic kidney disease. Resources such as social workers and kidney patient organizations can help.
  • Find out your target blood pressure and work with your doctor to achieve it and keep it there. Research shows this can help slow the progress of kidney disease.
  • If you have diabetes, blood-sugar control can help slow the progress of kidney disease. If you are not sure how to improve your blood-sugar control, ask your doctor for a referral to a diabetes educator.
  • Be aware of the possible complications of kidney disease, including anemia, metabolic acidosis, bone disease, cardiovascular disease, fluid overload and high potassium and phosphorus. Each of these can be detected with the right tests; plus, you can do a lot to avoid complications if you learn what to look for.
  • If your kidney disease is severe, decide whether you want to get on a transplant waiting list, or check out the possibility of a kidney transplant from a willing and suitable living donor.
  • If you are on dialysis, do all the treatments your doctor orders. Work with your care team to feel your best. Monitor your Kt/V or URR (measures of whether your blood is being adequately cleaned) and other lab values over time; find out what to do to improve your test results if they are not satisfactory.
  • If you have a transplant, take all your medications on schedule. Watch for any signs of infection, rejection, or other illness.
  • Pay attention to your emotions. Give yourself time to adjust and feel in control again. You may be dealing with uncertainty about the future or with changes in your lifestyle and relationships. It is normal to go through a period of upheaval.
  • Cultivate your appreciation of life; do the things that are most meaningful and bring you the most joy.