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Chronic kidney disease: Early diagnosis is key

Although one in nine Americans—more than 20 million people—is living with chronic kidney disease, many don’t know it. Sometimes called “silent” kidney disease, it may remain undetected for years, even decades, until the condition has reached an advanced state.

Understanding the problem

Located in your lower back just behind the rib cage, your kidneys—twin fist-sized organs—serve as the blood’s waste disposal system. They filter toxins from your blood and help regulate blood pressure. They also work to balance certain important nutrients, including potassium and calcium, and regulate your body’s water content.

Blood travels to your kidneys by way of an artery from the heart. Once the blood arrives, millions of tiny units, called nephrons, perform a thorough cleanup and excrete waste and excess fluids as urine into your bladder. The purified blood then passes through your veins back into your circulatory system.

When the kidneys can no longer function properly on their own, toxins and excess fluids build up in your blood. High blood pressure, diabetes and other conditions can cause the kidneys to give out if the disease is not managed properly. You should be on the alert if you suffer from these problems or if you have a family history of kidney disease. Recurring bladder infections can also spread to the kidneys and cause complications. (See “Spotting the Signs.”)

Treating kidney disease

A urine dipstick or 24-hour urine test will alert your physician to excess protein in the urine, a sign of potential trouble, since the kidneys normally separate protein from urine. A blood test can detect toxins and other excess fluids in your blood that your kidneys have failed to filter. Because these are the easiest tests—taking urine samples and blood and sending them to a lab—your healthcare provider will probably do them first if he or she suspects kidney disease.

If the results indicate that your kidneys are not working well, your doctor may recommend that you have further tests, using ultrasound, a computed tomography (CT) scan or magnetic resonance imaging (MRI) to help determine if you have an unusual growth or blockage.

If detected early, even before you experience noticeable symptoms, kidney disease can be treated with medication and lifestyle changes such as controlling high blood pressure and blood sugar, exercising and limiting the amount of protein you eat.

End-stage renal disease

When kidney function reaches less than 10 percent of normal capacity, end-stage renal disease has set in. Dialysis treatments must be performed several times a week.

Reduce your risk

To maintain kidney health, drink plenty of fluids, exercise regularly and maintain a healthy weight. If you smoke, try to stop. Keep diabetes and high blood pressure in check. And ask for a urinalysis test during doctor visits. A urine sample can give your physician valuable information regarding overall kidney health.

Spotting the signs

Few systems in the body are unaffected when you suffer from chronic kidney disease. Although you may not have severe symptoms until the disease gets worse, you may have some of these symptoms:

  • fatigue
  • a poor appetite
  • nausea and vomiting
  • sleeplessness
  • muscle cramping at night
  • swollen feet and ankles
  • dry, itchy skin
  • puffiness around the eyes, especially in the morning
  • a need to urinate more often, especially at night

Chronic vs. acute kidney failure

Chronic renal (kidney) failure is a gradual loss of kidney function as a result of chronic kidney disease. Acute renal failure occurs suddenly and can be caused by an accident that injures the kidneys, a traumatic injury such as a burn, dehydration or severe blood loss. It may also occur in people who have conditions that block the flow of urine, such as kidney stones, tumors or an enlarged or inflamed prostate gland. If your kidneys are not seriously damaged, acute renal failure may be reversed.