Understanding the 5 stages of Chronic Kidney Disease

We do not have to stress out or even define what CKD is because we have discussed it in this blog in several articles and we already know what it is all about.

Instead today we are going to take a deep look at the 5 stages of Chronic Kidney Disease that were developed or designed by the National Kidney Foundation (NKF) in order to understand better Kidney diseases and to give doctors  some sort of guideline that will help them identify the evolution of the kidney disease and know how to give the patient the best care possible for each stage.

FIVE_5 stages of Chronic Kidney Disease

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Let’s take a look at those 5 stages.

Stage 1 and 2:

Somebody that is in stage 1 or 2 of CKD has a small kidney damage and his or her glomerular filtration rate (GFR) is normal or a bit higher than 90 ml/min. in this stage, symptoms are not common and the kidneys are still working normally. If the person is to find out he or she is on stage 1 CKD it is because the person was being tested for other things and the results came out with certain amount of creatinine levels or they discovered blood or protein in the urine or there was an imaging test and the results said there was a kidney damage.

For people that are in this stage the treatment only focuses on a healthy diet including whole grains, fresh fruits and vegetables, no fats or low fat diets, control the intake of sugar and sodium, have a good weight and exercise very regularly, take vitamins recommended by doctors and definitively stop smoking and having bad habits for the body.

When it comes to stage 2, the description is just the same with the disease having no symptoms and the kidney working at a very good level. The only difference here is that the kidney already has a mild damage and it is getting a bit late to discover it or to treat it and the glomerular filtration rate is around 60-89 ml/min.

Stage 3:

Here the person has already a moderate kidney damage. This stage has two parts which are called A and B. in stage 3A the glomerular filtration rate is 45-59 mL/min, and in stage 3B the glomerular filtration rate is 30-44 mL/min.  Here the disease is already noticeable and patients start to feel the symptoms. A condition called uremia appears and secondary complications such as high blood pressure, anemia and bone disease start to appear as well.

The symptoms for this stage are the feeling of being tired all the time, high retention of fluids, extremities start to swell and the patient starts feeling that his or her breath is just not enough, urine changes color to a more reddish, brownish color or it even contains blood which will make it red, lower back pain, problems with sleep and muscle cramps.

In this stage, the kidney is working at a 50% performance and the idea is to help the patient keep their kidneys working as long as possible.

In this stage, a very controlled diet and medications are essential to make the kidney live longer. When it comes to medications ( the diet is very important even since stage 1) in this stage they become essential to control glucose levels and have a very good blood pressure in order to maintain the kidney working for as long as possible. The medications doctors prescribe in this stage are ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers).

Stage 4:

Here the patient has a real problem that needs to be tackled as soon as possible and with the correct treatment. Their glomerular filtration rate is 15-30 ml/min. and treatments are now very viable options. Unfortunately, a patient with stage 4 CKD will have to get a kidney transplant in the near future. In this stage conditions like anemia, uremia, bone disease, high blood pressure, heart complications and cardiovascular diseases start to become present.

The symptoms in this stage are fatigue, hard kidney pain in the lower back, sleeping problems, nausea, vomiting, a  metallic taste in their mouth, bad breath, loss of appetite due to the flavor in their mouth, difficulty in concentrating and numbness or tingling in the toes or fingers.

In this stage, there are 3 different types of treatments which are Hemodialysis, Peritoneal dialysis and, Kidney transplant

Stage 5:

Unfortunately, at this stage, the person has no options and it is a terminal disease called end-stage renal disease (ESRD) that has a glomerular filtration rate of 15 ml/min or less. In this stage, the kidneys no longer work and don’t have the ability to do anything at all. In this stage dialysis or a kidney transplant will be needed to survive.  

It is very important to understand these five stages so patients and doctors can find out about the disease in the early stages and give patients the option of having a very good quality of life.

Be sure to also read this post about how to choose the right treatment in case of renal failure?

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How To Spot The Symptoms Of Kidney Disease

The kidneys have a very important and busy role when it comes to their functions in the overall working of the human body. These organs are charged with filtering out toxins that exist in your bloodstream and depositing those toxins into the bladder. The bladder empties the urine and so that residue leaves your body in a safe and expedient manner. The problem arises when the kidneys are unable to properly filter the waste components of your bloodstream and thus begin what we commonly know as kidney failure. In addition to that, they kidneys are also able to regulate the PH of plasma in the blood just like the lungs are constantly doing, but in some instances when the lungs are suffering and exchanging gases improperly, they kidneys pick up the slack and compensate through a slower, but more efficient process, and help the body reach the optimal acidity levels it should have.

Being such a busy organ, the kidneys may start to fail for many different reasons such as exposure to toxic environmental pollutants, severe dehydration, local trauma and certain types of acute and chronic diseases that may affect the normal functions. In some cases, people who suffer a heart attack, heart disease, a severe burn, a major infection or a severe allergic reaction have a high propensity to suffer from kidney failure because all of the former conditions may affect the amount of blood that flows to the kidneys.

Another factor that may cause renal problems is the inability of the kidneys to properly eliminate urine. This can happen due to obstructions in the urinary tract caused by kidney stones, some forms of cancer and in male patients mostly, enlarged prostate due to inflammation. When the kidneys are unable to send toxins to the bladder, they overload and begin damaging the organs.

The signs and symptoms of kidney failure are many and sometimes they are not even present in the earlier stages of the condition because the organs own resilience makes it difficult to detect before the situation is quite advanced. However, paying attention to these symptoms and getting tested can make a big difference in your own fight against the disease. Getting a urinalysis and a blood test is the best way to accurately predict if you, in fact, are prone or currently suffering from kidney disease that may eventually become kidney failure.

unidentified-structures-in-urine_urinalysis

Image courtesy of Ed Uthman at Flickr.com

Fatigue is one of the most common symptoms of kidney disease. When your kidneys are healthy, they secrete a hormone called erythropoietin that regulates the production of red blood cells. When your kidneys are failing, the creation of this hormone is affected, thus making your blood’s oxygen level drop, something that causes fatigue and shortness of breath. Feeling like that can cause difficulty sleeping and a feeling like you are drowning when you can’t breathe.

The aforementioned anemia can also leave the brain oxygen-starved, something that causes dizziness, weakness and even the possibility of fainting. Something else that comes along is the difficulty to think clearly. This leads to memory problems and trouble with concentration. Patients often report that they forget the simplest task of having difficulty solving simply problems and concentrating on their reading.

Another common symptom is that of feeling extremely cold even when the room is warm. This is another side effect of the anemia caused by kidney failure.

Patients sometimes report itching all over the body. This happens because of the buildup of excess waste material in the bloodstream. Toxic waste in the blood causes severe itching all over the body, something that can become a real problem if the patient scratches constantly and breaks the skin.

Swelling in the hands, feet or even the face are not uncommon symptoms of kidney failure. This happens because they kidneys are not eliminating enough fluid out of the body and that remaining fluid can cause your joints and extremities to swell to the point of impairing mobility and causing a lot of pain and fatigue.

When your body is retaining waste that should have been eliminated, you may experience of a condition called uremia. Uremia may cause food to taste differently and cause bad breath with the smell of ammonia. Patients often say their food tastes like metal and stop eating meat altogether because they can’t stand the taste of it. This may cause a rapid and unhealthy weight loss. Uremia can also cause upset stomach, nausea, and vomiting.

Finally, one of the most important symptoms to consider and that sometimes gets ignored is the increased urge to urinate. People often don’t pay attention to these symptoms because they are commonly associated with other issues. Patients with kidney failure may notice they urinate more often than usual and with a strange pale color in their urine that is foamier than usual.How To Spot The Symptoms Of Kidney Disease

For more great information about dialysis, renal compensation and kidney disease in general, check out our other articles available in Joe Cosgrove’s Blog today.