Monday, June 8, 2015

Chronic Kidney Disease: Symptoms and Treatment

CKD is sometimes called a "silent disease." Patients rarely feel sick until their kidney disease is advanced, according to the NKF, which states that when symptoms do develop, they may include:

  • Fatigue
  • Trouble concentrating
  • Poor appetite
  • Trouble sleeping
  • Muscle cramping at night
  • Swollen feet and ankles
  • Puffiness around eyes, especially in the morning
  • Dry, itchy skin

Need to urinate more often, especially at night
While diabetes and high blood pressure are the leading causes of CKD, natural aging also puts people at an increased risk of developing this chronic disease, according to Vassalotti.

"As we age, we tend to lose kidney function — especially over age 50, and usually in men more so than in women. Also as we age, we're more likely to develop Type 2 diabetes and high blood pressure," Vassolotti said. While aging is not a cause of CKD, doctors consider people over the age of 60 to be at increased risk of developing the disease, he added.

Those with a family history of kidney disease, such as polycystic kidney disease, are also at increased risk of developing CKD. Smoking, obesity and high cholesterol are other risk factors for the disease, according to the Mayo Clinic. African Americans are nearly four times as likely as Caucasians to develop kidney disease, and Hispanics are about 1.5 times more likely than non-Hispanics to be diagnosed with CKD, according to the NIH, which also found that American Indians and Alaska Natives are 1.8 times more likely than Caucasians to develop the disease.

Most kidney diseases do not have a specific drug treatment, according to Vassalotti, who said that the first goal in treating kidney disease is to address the underlying causes of the disease and stop the disease from progressing. This means treating conditions like diabetes and high blood pressure, he said.

here are two different kinds of dialysis treatment, according to the National Kidney Foundation. In hemodialysis, an artificial kidney called a hemodialyzer is used to remove waste and excess chemicals and fluid from the blood. To get blood from a patient's body to the artificial kidney, a doctor performs a minor surgery to connect a blood vessel (usually in the arm or leg) to the artificial kidney.

In peritoneal dialysis, a patient's blood is cleaned inside his or her body instead of by an external hemodialyzer. The doctor first performs a surgery to place a plastic tube, or catheter into the abdomen (also known as the peritoneal cavity). The abdomen is slowly filled with a fluid known as dialysate, which absorbs extra fluids and waste products from the blood located outside the abdomen walls. Once the dialysate has done its job, it travels back outside the body through the catheter. There are two main kinds of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD), which is done without a machine and automated peritoneal dialysis (APD), which requires a special machine called a cycler.

"In 1950, everybody died [of CKD]. Kidney failure was 100 percent fatal. Now, we've saved the lives of over a million people with dialysis in the United States," Vassalotti said.

Finally, kidney transplant is also a treatment option for some patients with CKD, according to Vassalotti, who said that, ideally, some patients choose a kidney transplant as their first treatment option. This is known as preemptive kidney transplantation.

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