There are many kinds of kidney diseases, which generally refer to the occurrence of pathological changes or impaired function of the kidneys. Kidney disease generally refers to Chronic Kidney Disease (CKD for short), which is mainly caused by long-term damage to kidney tissue, resulting in a decline in structure or function and failure to function normally.

However, diseases may occur in other components of the kidney, and the treatment and prognosis are also different. The lesions caused by each part of the kidney can also be divided into acute and chronic diseases, and kidney lesions may complicate even systemic diseases. If you suffer from kidney disease, not only the kidney itself has problems, but it can also cause complications, such as hypertension, osteoporosis, and insufficient red blood cells.

The location and structure of the kidneys

The kidneys are located on both sides of the back lumbar spine, about the size of a fist, and are located below the rib edge of the back waist, with one left and one symmetrical to the spine. The basic unit of the kidney is called “nephron”. Each kidney is composed of about 1 million nephrons, and each nephron includes glomeruli and renal tubules.

Kidney function

The main function of the kidney is to remove metabolic waste from the body by filtering blood and producing urine. In addition, the kidney also has important secretory functions, including secreting renin, erythropoietin, and activated vitamin D.

How the Kidneys Make Urine

Urine contains substances that the body needs to excrete, mainly including water, waste after metabolism, excessive electrolytes, drugs and toxins, etc. The amount of substances in the body will affect the content of substances in the urine, and then the kidneys determine the excretion. A healthy kidney can regulate the state of the body by producing “high-quality” urine. When the disease invades both kidneys, it will cause the kidneys not to maintain the quality of urine, and in severe cases, it will cause uremia.

Types of kidney disease

There are many types of kidney disease. In addition to the common types, patients with diabetes, hypertension, and systemic lupus erythematosus are often complicated by kidney disease. The following describes the common types of kidney disease:

1. Congenital kidney disease
2. Chronic kidney disease
3. Acute kidney injury
4. Kidney nephropathy
5. Nephritis
6. Tubulointerstitial nephropathy
7. Renal cyst
8. Glomerular disease
9. Kidney stones
10. Secondary nephropathy (kidney disease arising from other diseases)

Kidney Disease Causes, Risks, and Symptoms

The causes and risks of affecting kidney function are as follows:

Initial causes

1. Ageing
2. Family history
3. Diabetes, hypertension, hyperlipidemia
4. Proteinuria
5. Primary kidney disease
6. Urinary disease
7. Hyperuricemia

Risk of worsening kidney function

1. Proteinuria
2. Hypertension, hyperglycemia, hyperlipidemia
3. Hyperuricemia
4. High protein diet
5. Obesity, smoking
6. Abuse of over-the-counter drugs, herbal remedies, or pain relievers
7. Treatment Interruption or Automatic Discontinuation

High risk group for kidney disease

1. Diabetic
2. Hypertensive patients
3. Gout patient
4. Seniors over 65 years old
5. Drug abuser
6. Those with a family history of kidney disease

Symptoms of Kidney Disease

1. Foamy urine, urine abnormalities such as hematuria, protein foamy urine
2. There is edema in the lower limbs, and the depression produced after pressing cannot be recovered immediately
3. Hypertension
4. Anaemia, pallor
5. Unexplained burnout

In addition, other symptoms, such as loss of appetite, haematuria, painful urination, low back pain, skin lesions, frequent urination or nocturia, polyuria but less urine output, oliguria or anuria, may also be symptoms of kidney disease.

Diagnosis, examination and staging of kidney disease

The reason why kidney disease is scary is that the disease has no obvious symptoms in the early stage. “Early diagnosis and early treatment” is not easy for kidney patients, so it is necessary to observe carefully in daily life to see if there are symptoms of kidney disease. The most important way to early judge whether there is kidney disease is the Urine test. The following are common kidney disease testing items:

1. Urine test: Blood urea nitrogen (BUN for short)
2. Blood test: Serum creatinine
3. X-ray examination
4. Ultrasound examination
5. Kidney Biopsy

High-risk groups should implement the “three-three system of kidney protection checks”, that is, three kinds of kidney protection checks should be carried out every 3 months, including urine test, blood test (creatinine), and blood pressure measurement.

Common test values for kidney disease

The worse the renal function, the higher the blood urea nitrogen and serum creatinine index. The following is a reference of Hospital – the normal value of the commonly used renal function tests, but a single abnormal value does not mean you have kidney disease. For further information, it is recommended to consult a specialist.

Blood urea nitrogen (BUN): 6-24 mg/dl

Creatinine (Cr): 0.5-1.4 mg/dl

Potassium (K): 3.1-5.3 mmol/L

Phosphorus (P): 2.5-4.6 mg/dl

Calcium (CA): 8.5-10 mg/dl

Glomerular Filtration Rate (GFR): >90mL/min/1.73m²

Staging of Chronic Kidney Disease

The glomerular filtration rate of a patient can reflect the degree of kidney damage. According to the USA National Kidney Foundation, chronic kidney disease can be divided into 5 stages.

Stage 1: GFR>90, normal kidney function.

Stage 2: GFR=60~89, with mild kidney damage.

Stage 3: GFR=30~59, kidney function is moderately impaired.

Stage 4: GFR=15~29, kidney function is severely impaired.

Stage 5: GFR<15, the kidneys cannot function normally, and symptoms of uraemia appear, and dialysis treatment (commonly known as kidney dialysis) may be required.

Treatment of Kidney Disease

kidney disease drugs:

Kidney dialysis patients should take the following drugs on time, with the doctor’s prescription, to prevent complications:

1. Phosphorus binder
2. Active Vitamin D3
3. Vitamins
4. Erythropoietin
5. Iron
6. Blood pressure medication
7. Potassium-lowering drugs
8. Anticoagulant
9. Antihistamines
10. NSAIDs, pain relievers

Kidney surgery

Kidney transplantation refers to the replacement of a failed kidney with a healthy one, and the donor can be a fifth-degree relative or an organ donation from a brain-dead patient. The donor needs a blood test to confirm that the kidney is normal and matches the recipient’s tissue before the transplant can be performed.

When a uraemia patient intends to receive a kidney transplant, he must first undergo a detailed physical, psychological and social evaluation at the transplant institute to confirm that he meets the indications and has no contraindications before he can register and wait for donation.

Renal replacement therapy

The most common type of renal replacement therapy is dialysis, which is divided into haemodialysis (commonly known as kidney dialysis) and peritoneal dialysis.

Kidney disease prevention and care.  To prevent, you need to change your lifestyle

1. More fibre, more vegetables, drink more water
2. Less salt, less oil, less sugar
3. No smoking, no holding back urine, no staying up late, and no indiscriminate use of drugs of unknown origin
4. No fatty belly.

Diet for kidney disease

For patients with early renal insufficiency, moderately restricting dietary protein and sodium, phosphorus, and potassium ions can delay renal failure. However, if you are a patient who has started kidney dialysis and the blood phosphorus and potassium are high, you need to limit the intake of phosphorus and potassium in your diet. The dietary principles for kidney disease patients are as follows:

1. Enough calorie
2. Low protein diet
3. Low phosphorus diet
4. Low potassium diet
5. Low sodium diet
6. Limit water intake

In addition to adjusting the diet according to the physical condition, anaemia and amino acid loss are easy to occur during dialysis, so supplement iron, vitamins and protein.

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Reference

Chronic kidney disease – NHS

Chronic Kidney Disease (CKD) – NIH

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