Patient Education - Chronic Kidney Disease

What and where are the kidneys?

"Bones can break, muscles can atrophy, glands can load, even the brain can go to sleep without immediate danger to survival. But should the kidneys fail, neither bones, muscles, glands nor brain could carry on."

- Dr. Homer W. Smith, From Fish to Philosopher.

You have two kidneys, each the size of a fist, located at the lower back end of your ribcage. Each kidney contains up to a million units called nephrons [nfrns]. The kidneys consists of two major compartments, the blood compartment which is basically a very small blood vessels and the urine compartment which consists of tubules [tbyls]. In the tubules chemicals and water or removed based on the body’s needs. The urine from the tubules eventually drains into the middle of the kidney. From here each kidney drains the urine into the bladder where it sits until it is excreted from your body.

What is Chronic Kidney Disease?

Chronic kidney disease includes any condition that damages your kidneys and decreases their ability to keep you healthy by doing the jobs listed. The way your kidney doctor knows if you have kidney disease and the extent of your kidney disease is by doing blood tests, urine tests, and by doing a kidney ultrasound. As kidney disease progresses toxic wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease.

The primary functions of the kidneys are to:

Remove waste products from the body.

Balance the body's fluids.

Release hormones which regulate blood pressure.

Synthesize the vitamins which control growth.

Control the production of red blood cells

What are the symptoms of Chronic Kidney Disease?

Unlike heart disease which causes chest pain or gastrointestinal disease which causes belly pain, kidney disease may not cause any symptoms until advanced. Once the kidney disease progresses and wastes begin to build in your blood stream, the following symptoms may occur:

Often no symptoms in the earlier stages (I-III)

Feeling tired or weak

Headaches

Itching

Nausea and Vomiting

Loss of appetite

Swelling

Shortness of Breath

A metallic taste in your mouth

Darkening of the skin

Trouble concentrating

Change in urination

What increases the risk of having chronic kidney disease?

Diabetes Mellitus

Hypertension

Race: African-American, Hispanic, Pacific Islander, and Native Americans
Age > 65

Relative with CKD

How can the progression of kidney disease be delayed or prevented?

Keeping blood pressure under control: that is < 130/80 or 125/75 if you have diabetes or protein in urine.

Taking certain types of medication called ACE-Inhibitors or Angiotensin Receptor Blockers.

For Diabetics, keeping blood sugars under control with HbAIc less than 6.0. This requires frequent monitoring of your blood sugars.

Avoiding medication that will damage your kidneys such as non-steroidal anti-inflammatory drugs (NSAIDS). Examples are ibuprofin, Advil, Motrin, Aleve, Celebrex and Naprosyn.

Avoid Fleets® Phospho-soda and Fleets® Enema.

Avoiding, if possible, IV Contrast used for CT scans and Heart Catheterizations.

Controlling your cholesterol.

Quit smoking.

If overweight, losing weight.

Treating Anemia, if present.

Advanced Renal Care Chronic Kidney Disease Clinic

Chronic Kidney Disease (CKD) means that the kidneys have become damaged. Common causes of CKD are diabetes mellitus [sugar diabetes], hypertension [high blood pressure], inherited diseases [i.e. polycystic kidney disease], kidney stones, polycystic, obstructions [caused by kidney stones, prostate enlargement, or tumor], repeated urinary tract infections, and glomerulonephritis.

The aim of our CKD Program is to slow the progression of damage to the kidneys and to treat its associated complications such as hypertension, anemia, and bone disease. If we are unable to arrest the disease process and the kidney damage progresses to end state renal disease (ESRD), our plan is to manage these complications while preparing the patient for renal (kidney) replacement therapy. With each patient, our goal is to formulate an individualized ‘life-plan’ for renal replacement therapy. We will take in partnership with the patient their age, other medical problems, projected survival and come up with a ‘life-plan’ which harnesses the maximal yield of each modality of renal replacement therapy: hemodialysis, peritoneal dialysis, home hemodialysis, and renal transplantation.

Managing these complications and preparing patients for renal replacement therapy is a complex process of visits, treatment, and teaching sessions. Our team consists of a nephrologist, a registered nurse, a social worker, and a renal dietician.

As kidney disease progresses through its five stages (based on the degree of damage to the kidneys), different diagnostic studies, treatments, and teaching sessions will take place.

We hope that you will fully participate in this effort by keeping appointments and following treatment recommendations. Please assist us by bringing your medications, a record of your blood pressure and questions on each visit.

Thank you,
Dr. Ahmed and Dr. Rauf
Advanced Renal Care, Ltd