In part two of our focus on the kidneys, we look at the diseases that can affect these vital organs
To see part one click here.
In the same theme as our last health article about the kidneys, this month we move on to learning a little bit more about chronic kidney disease (CKD). I think this is an important topic to cover because, as a GP, I find that my patients may or may not have either been told they have it or understand what it means. GPs deal with a lot of blood results for lots of different conditions, and we are always looking at kidney function and monitoring it for any changes in patients who may be at risk of developing CKD. CKD is a common condition, and it can happen naturally as you get older and affect anyone. However, it is more common in people with south Asian origins, or who are black. Having CKD increases your risk of developing cardiovascular disease (including heart attacks and stroke).
Chronic kidney disease is measured by checking how well the kidneys are working over the long term. This is normally done using blood and urine tests over time. There are different levels of CKD and they are split into different stages (1-5) based on the test results. Stages 1 and 2 are considered normal kidney function. At stage 3, we start to recognise that someone has CKD; this is important to detect so steps can be taken to find a reason for the kidneys to be working less well and try to fix it.
CKD can have many causes. As I previously mentioned, getting older may simply be one of them! However, the common conditions we mention all the time are most likely to cause problems with the kidneys: high blood pressure, diabetes and raised cholesterol. This is another reason why controlling these conditions if you have them is so important and is how CKD can be managed. Other causes of CKD include, recurrent kidney infections, inflammation of the kidney (called glomerulonephritis), polycystic kidney disease (an inherited genetic condition) and long term use of anti-inflammatory medicines like ibuprofen.
If you have CKD stage 3, your kidney function will be monitored. Often, the kidneys will stay working at this level for a long time and you won’t have any symptoms. It is important to know this as for CKD stages 3, 4 and 5 your doctor may need to change doses of medications you are on, or some medications might not be suitable for you to have at all. This is because the body uses the kidneys to get rid of medication from the system. If they don’t work as well, your body cannot get rid of the waste products.
At CKD stages 4 and 5, the kidney function has reduced a lot. At this stage, your GP might refer you to the kidney specialists. There may still be no symptoms, however if the CKD advances symptoms such as tiredness, feeling sick, swelling in your feet, ankles or hands, feeling short of breath and passing blood in the urine may develop. If you notice these symptoms, it is important you contact your GP.
According to Kidney Care UK, 10 per cent of people with CKD will reach a stage known as renal failure. At this stage, the kidneys no longer work well enough to keep you alive and healthy. This is when treatments such as dialysis or kidney transplants may be considered by the kidney specialists.
Most people with CKD will never reach a stage where they need to see a specialist doctor. CKD can be managed by the GP with regular reviews and with focus on controlling blood pressure, cholesterol, and diabetes to stop it getting worse.
If you would like further information about CKD, please visit kidneycareuk.org