The kidneys are important organs that help remove
toxins, waste material and surplus fluids from the body.
It also plays a critical role in regulating the blood
chemicals and blood pressure, keeping the bones healthy,
and stimulating red blood cells production.
When our kidneys fail to function correctly, it affects
the body's muscles, nerves, and other tissues.
What’s the difference between chronic kidney
disease (CKD) and kidney failure?
Chronic kidney disease (CKD) is a condition whereby the
kidneys are damaged and their ability to filter waste
and fluid out of the blood is damaged. This causes waste
to build up in the body.
Kidney failure or end-stage renal disease (ESRD) is a
condition whereby the kidneys have stopped working well
enough, so the patient has to go on a dialysis or a
kidney transplant to survive.
What are the symptoms and signs of kidney disease?
The symptoms are not visible at an early stage of kidney
disease; however, visible signs are noticed as time goes
by and the condition worsens. Some of the symptoms
include:
- Tiredness and having less energy
This is one of the common signs of kidney disease.
Dysfunction of the kidneys results in toxic build-up
in the blood. This can cause people to feel fatigued
and make it difficult to concentrate.
- Difficulty falling asleep
Sleep apnoea is common among those with chronic
kidney problems. When the kidneys aren't working
properly, toxins will build up in the blood as they
cannot be eliminated through urine.
- Dry and itchy skin
This is a common symptom if your kidneys are not
working properly. Dryness and itchiness in the skin
can signify bone or mineral disease accompanied by
kidney troubles.
- Muscle cramps
The imbalance of electrolytes is caused due to
impaired kidney function. This causes poor levels of
phosphorus and calcium, resulting in muscle
cramping.
- Poor appetite
This is a general symptom caused as a result of
toxin build-up due to reduced kidney function.
- Swollen feet and ankles
Reduction in kidney function can cause sodium
retention resulting in swelling of ankles and feet.
- Frequent urge to urinate
Feeling an urge to urinate at night could signify
kidney disease. This occurs mainly because the
filters of the kidney get damaged, increasing the
urge to urinate.
- Blood in the urine
Properly functioning kidneys retain the blood cells
while filtering waste materials from the blood.
However, if the kidney filters are not correctly
working, the red blood cells leak out into the
urine.
- Puffiness around the eyes
Damaged kidney filters may leak proteins into the
urine, causing puffiness around the eyes.
- Urine is foamy
Excessive bubbles in the urine indicate that the
proteins are depleted through the urine. This
sometimes may appear like scrambled eggs and require
many flushes to go away.
How is kidney disease diagnosed?
Here are some diagnostic methods for kidney disease:
- Blood test
This is done to determine creatinine levels, a waste
product in your blood.
Your doctor will analyse the results along with
other factors such as:
- Age
- Gender
- Height and weight
- Ethnicity
A specific formula is then applied to take into
account the above factors along with blood creatine
levels to estimate glomerular filtration rate
(eGFR).
Healthy kidneys should be able to filter 90 ml/min.
- Urine test
Urine tests are done to:
- Determine the presence of protein or blood
in the urine
- Check the creatinine and albumin levels in
the urine and albumin: creatinine ratio, or
ACR
- Other tests
Some of the other tests to determine your kidney
health are:
- Kidney biopsy - A sample of
kidney tissue is taken out using a needle
and observed under a microscope to check for
damage
- Imaging systems -
Ultrasound scan, CT scan and MRI scan to see
the inner portion of kidneys
What are the causes of kidney failure?
The two main causes of kidney problems are diabetes and
high blood pressure. Sometimes, the kidneys also fail
due to some other reasons, such as:
- Polycystic kidney disease
- Damage caused due to physical injuries
- Pyelonephritis or recurrent kidney infection
- Prolonged obstruction in the urinary tract, caused
due to cancers, kidney stones or other prostate
issues
- Inflammation in the kidney tubules of related areas
(interstitial nephritis)
- Glomerulonephritis, when there is an inflammation of
the kidney's filtering units
- Vesicoureteral, which is a medical condition that
results in the urine being held back in the kidneys
What are the stages of kidney failure?
In general, there are five stages of kidney failure,
which can be determined through specific tests.
The treatment methodology depends on the patient’s
stage of kidney failure.
Stage | Description |
---|
Stage 1 - Healthy kidney function | This stage does not show any damage or problem with the kidneys. The eGFR value is 90 or more. The symptoms are mild, and tests might indicate the presence of protein in the urine. |
Stage 2 - Mild decline in kidney function | Here, the damages are mild, and the eGFR values are between 60 and 89. The kidney will still be functioning as normal, but tests might show the presence of protein in the urine. |
Stage 3 - Moderate decline in function | From this stage onwards, waste starts to build up in the blood as the kidneys are not properly filtering out waste and extra fluid in the blood. This may cause other health problems such as tiredness, bone diseases, and high blood pressure. Additional symptoms such as excessive tiredness and swelling in hands and feet may also appear. The eGFR value will be between 30 and 59. |
Stage 4 - Severe decline in kidney functionality | At this stage, more toxins and fluid build-up in the blood. As a result, the patient faces health problems such as heart and bone diseases, and high blood pressure. In this stage, the eGFR value drops between 15 and 29. Additional symptoms such as swelling in the feet, lower back and hands may occur. The patient might need to undergo dialysis at this stage. |
Stage 5 - Complete failure of the kidneys | This is a life-threatening stage in which the toxins in the blood build up excessively. As a result, the patient gets very sick and might need dialysis or a kidney transplant for survival. The eGFR value will be 15 or lower, indicating the stoppage of kidney function. Some of the symptoms include excessive tiredness, nausea, vomiting, and swelling in the feet. |
What are the treatment methods for kidney failure?
The two commonly used treatment options for kidney
failure are:
Kidney transplant
It is a surgical method in which a damaged kidney is
removed and replaced with a healthy one. A live donor
with a matching blood type is required in this case.
After a successful transplant, the patient can avoid
undergoing dialysis. However, he will need to take
anti-rejection medication for the rest of his life.
Dialysis
This is the immediate option to save a patient's life
when his kidney fails. In this method, the body's toxic
waste and excess fluids are artificially removed.
Dialysis is generally of two types.
- Haemodialysis - In this procedure,
two needles are placed in the arm, which will be
attached to the haemodialysis. The toxic blood is
pumped into the dialyser, filtered, and returned to
the body. This process is continued three times a
week.
- Peritoneal dialysis - In this
method, a catheter (soft plastic tube) is placed
into the stomach by surgery. Through the catheter, a
sterile cleansing fluid is pumped into the abdomen.
Once the filtering process is completed, the fluid
leaves the body through the catheter.
What is the life expectancy in people with chronic
kidney problems?
It depends on three key factors:
- The stage at which the person has been diagnosed
- Age of the person
- Gender of the person
A person in stages 1, 2 and 3 has a longer lifespan than
a person in the 4th or 5th stage.
A 40-year-old woman diagnosed with a stage 2 chronic
kidney disease can live for another 34 years, while a
40-year-old man can only expect to live for another 30
years.
However, if the kidney problem is detected at an early
stage, there are multiple advanced treatments available,
and the person is expected to live longer.
The life expectancy of a person with stage 4 kidney
problems
Research indicates, that with efficient treatment, a
person in stage 4 kidney failure may live another 14.5
years to 16.5 years.
The life expectancy of a person with stage 5 kidney
problems
Data published by the National Kidney Foundation
indicates that a person is stage 5 kidney disease may
live up to another 5 to 10 years.
Another research shows that patients whose eGFR value is
between 15-29mL may live for another 9-10 years.
Book an appointment at Pantai Hospital
In a nutshell, chronic kidney disease has no cure, but
early detection, a healthy lifestyle, and proper
treatment may prolong your life once diagnosed.
If you or a loved one is at risk of chronic kidney
disease, contact us for an appointment with a
Nephrology specialist
at your nearest Pantai Hospital.
Pantai Hospitals have been accredited by the
Malaysian Society for Quality in Health (MSQH) for
its commitment to patient safety and service
quality.
References
- Teresa K. Chen,Daphne H. Knicely and Morgan E. Grams
(1 Oct 2019) Chronic Kidney Disease Diagnosis and
Management at
https://jamanetwork.com/journals/jama/article-abstract/2752067
[Accessed 11 Mar 2022]
- Robert Thomas,Abbas Kanso and John R. Sedor (2 June
2008) Chronic Kidney Disease and Its Complications
at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474786/
[Accessed 11 Mar 2022]
- Simon DS Fraser and Tom Blakeman (1 June 2016)
Chronic kidney disease: identification and
management in primary care at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5087766/
[Accessed 11 Mar 2022]
- National Kidney foundation at:
https://www.kidney.org/news/newsroom/fsindex
[Accessed 11 Mar 2022]
- WHO article on kidney disease
https://www.who.int/bulletin/volumes/96/6/17-206441.pdf
[Accessed 11 Mar 2022]
- Life expectancy with chronic kidney disease: an
educational review, Available at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5203814/
[Accessed 11 March 2022]
- Chronic kidney disease and life expectancy,
Available at
https://pubmed.ncbi.nlm.nih.gov/22442392/
[Accessed 11 March 2022]
- Dialysis, Available at
https://www.kidney.org/atoz/content/dialysisinfo
[Accessed 11 March 2022]