Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure
Chronic kidney disease is the slow loss of kidney function over time. The main function of the kidneys is to remove wastes and excess water from the body.
Chronic kidney disease (CKD) slowly gets worse over time. In the early stages, there may be no symptoms. The loss of function usually takes months or years to occur. It may be so slow that symptoms do not occur until kidney function is less than one-tenth of normal.
Chronic kidney disease and ESRD affect more than 2 out of every 1,000 people in the United States.
Many other diseases and conditions can damage the kidneys, including:
Chronic kidney disease leads to a buildup of fluid and waste products in the body. This condition affects most body systems and functions, including red blood cell production, blood pressure control, and vitamin D and bone health.
The early symptoms of chronic kidney disease often occur with other illnesses, as well. These symptoms may be the only signs of kidney disease until the condition is more advanced.
Symptoms may include:
Other symptoms that may develop, especially when kidney function has worsened:
High blood pressure is almost always present during all stages of chronic kidney disease. A neurologic examination may show signs of nerve damage. The health care provider may hear abnormal heart or lung sounds with a stethoscope.
Tests that check how well the kidneys are working include:
Chronic kidney disease changes the results of several other tests. Every patient needs to have the following checked regularly, as often as every 2 - 3 months when kidney disease gets worse:
Causes of chronic kidney disease may be seen on:
This disease may also change the results of the following tests:
Controlling blood pressure is the key to delaying further kidney damage.
Other tips for protecting the kdineys and preventing heart disease and stroke:
Always talk to your kidney doctor before taking any over-the-counter medicine, vitamin, or herbal supplement. Make sure all of the doctors you visit know you have chronic kidney disease.
Other treatments may include:
You may need to make changes in your diet. See: Diet for chronic kidney disease for more details.
Different treatments are available for problems with sleep or restless leg syndrome.
Everyone with chronic kidney disease should be up-to-date on important vaccinations, including:
When loss of kidney function becomes more severe, you will need to prepare for dialysis or a kidney transplant.
Many people are not diagnosed with chronic kidney disease until they have lost much of their kidney function.
There is no cure for chronic kidney disease. Untreated, it usually progresses to end-stage renal disease. Lifelong treatment may control the symptoms of chronic kidney disease.
Treating the condition that is causing the problem may help prevent or delay chronic kidney disease. People who have diabetes should control their blood sugar and blood pressure levels and should not smoke.
Tolkoff-Rubin N. Treatment of irreversible renal failure. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 133.
Mitch WE. Chronic kidney disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 131.
KDOQI. KDOQI Clinical Practice Guideline and Clinical Practice Recommendations for anemia in chronic kidney disease: 2007 update of hemoglobin target. Am J Kidney Dis. 2007; 50:471-530.
KDOQI; National Kidney Foundation II. Clinical practice guidlines and clinical practice recommendations for anemia in chronic kidney disease in adults. Am J Kidney Dis. 2006;47(5 Suppl 3):S16-S85.
Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004; 43(5 Suppl 1):S1-S290.
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