Updated 19 October 2022 | Approved By Dr. Umberto Russo
What is Chronic Kidney Disease?
Chronic kidney disease (also known as chronic renal disease) is a condition where the kidney(s) begin to work less efficiently. The kidneys are vital organs that help filter waste from the blood. As blood enters the kidneys, the kidneys remove the waste from the blood in the form of urine. According to the Australian Institute of Health and Welfare, approximately 1.7 million Australians over 18 were diagnosed with chronic kidney disease [1]. As 44% of diagnosed Australians were over 75, data shows that older Australians are more likely to develop kidney problems. There are 5 stages of chronic kidney disease which tests referred by your doctor can measure. Often, there are no obvious signs in the earlier stages of the condition. Later stages of chronic kidney disease indicate that the condition is worsening and can even lead to kidney failure.  Chronic Kidney Disease Symptoms
Symptoms of chronic kidney disease may not be noticeable in the earlier stages. People can lose up to 90% of kidney function before feeling more apparent signs. Identifying kidney disease is crucial for receiving the right treatment to slow down or even prevent the condition from progressing. Symptoms to be aware of include [2]:- Changes in urination frequency (especially at night time)
- Swelling around the legs, arms and eyes
- Fatigue
- Lower appetite than usual
- Changes in your urine's appearance (darker and more frothy than usual)
- Weight loss
- Difficulty concentrating
- Dry and itchy skin
- Confusion
- Nausea
- Shortness of breath
- Chest pain
- Vomiting
Chronic Kidney Disease Causes
Kidney disease is characterised by a low estimated glomerular filtration rate (eGFR) of the kidneys. The worse the eGFR, the more severe the condition. The filtration rate shows how the kidneys function by recording how well they can filter waste from the blood. Some several causes and conditions can affect kidney performance and the development of chronic kidney disease, including:- Diabetes (read more about type 2 diabetes here)
- High blood pressure (hypertension)
- Glomerulonephritis (inflammation of the glomeruli)
- Other kidney conditions, such as polycystic kidney disease
- Inflammatory conditions
- Autoimmune disease (e.g. lupus)
Risk Factors for Kidney Disease
Certain risk factors increase the chance of developing kidney disease, which includes [3]:- Living with other conditions, such as diabetes and high blood pressure
- Living with cardiovascular disease (e.g. heart disease, arrhythmias, etc.)
- Being older (particularly over the age of 60)
- Having a family history of kidney failure
- Aboriginal or Torres Strait Islander descent
- Smoking
- Being obese
- Living a sedentary and inactive lifestyle
Chronic Kidney Disease Diagnosis and Tests
Many people with chronic kidney disease may not notice any symptoms until the late stages of kidney disease. Some people may need to lose 90% of their kidney function before noticting signs [3]. Early detection is an effective strategy for appropriate medical management. Those with risk factors for kidney disease should undergo a Kidney Health Check every 1-2 years.Glomerular Filtration Rate
The glomerular filtration rate is a blood test to examine the function of your kidneys. An analysis of the blood sample will measure creatinine levels, which is a substance that comes from the breakdown of muscle tissue and protein in the body. Measurements can be performed to estimate the glomerular filtration rate of the kidneys [3].Urine Albumin / Creatinine Ratio
Urine tests can also be used to compare the amount of albumin and creatinine levels. These levels can determine how the kidney is functioning [3].Imaging Investigations
Imaging investigations, such as ultrasound, MRI and CT scanning, can help create detailed 2D and 3D images of the kidney(s). They can help doctors observe whether there are any abnormal changes in these areas.Kidney Biopsy
A sample of your kidney tissue can also be taken surgically for laboratory analysis. These samples are assessed under a microscope to look for signs of damage which can help with diagnosis.Chronic Kidney Disease Treatment
Treatment recommendations for chronic kidney disease will vary depending on the severity of the condition. Those in the earlier stages can be managed conservatively, while more advanced stages may need more aggressive forms of treatment. While there is no cure for chronic kidney disease, these treatments can help reduce symptoms and control disease progression.Lifestyle Changes
Making positive changes to your daily habits can help control the symptoms and progression of chronic kidney disease. Your doctor may ask you about certain practices contributing to kidney disease and recommend strategies to manage them. Fundamental changes that should be made include [3]:- Having a healthy weight (especially if you're overweight and/or obese)
- Stop smoking
- Being more physically active
- Reducing alcohol
- Having a healthy diet
Medication
Your doctor can prescribe medication to manage contributing conditions, such as high blood pressure (hypertension) and cholesterol levels (dyslipidaemia). These medications can complement other treatments, such as lifestyle changes.Dialysis
Dialysis is usually required during the later stages of chronic kidney disease. As the kidneys begin to stop functioning normally, waste can build up in the bloodstream. A dialysis machine is connected to the body through attachments to help fill the blood.Kidney Transplant
A kidney transplant from a donor may be necessary in extreme advanced conditions.  Recovery
There is no cure for kidney disease. However, treatment can help slow down the condition's progress and manage symptoms. If left untreated, chronic kidney disease can progress to kidney failure, which can potentially become fatal.  Complications
Complications of chronic kidney disease include [4]:- Weakening of the bones (read about osteoporosis here)
- Increasing the risk of cardiovascular disease (e.g. heart failure, diabetes, etc.)
- Kidney failure
- Dyslipidaemia
- Poor nutrition
Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.
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   References
- https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease/contents/summary
- https://kidney.org.au/your-kidneys/what-is-kidney-disease/symptoms-of-kidney-disease
- https://kidney.org.au/uploads/resources/CKD-Management-in-Primary-Care_handbook_2020.1.pdf
- Thomas, R., Kanso, A., & Sedor, J. R. (2008). Chronic kidney disease and its complications. Primary care: Clinics in office practice, 35(2), 329-344.