Chronic Kidney Disease.

Over the last several years, the medical community and indeed the third party payers including Health and Human services have come to realize the increasing  number and cost of caring for individuals with chronic kidney disease.

So it is important to understand first and foremost the role of the kidneys in our day to day life.

The kidneys regulate the body fluid levels, filters waste products and toxins from the blood, keep the blood electrolytes(sodium, potassium, phosphorus etc) in balance, release a hormone that is essential in regulating blood pressure, activate vitamin D to maintain healthy bones and release erthropoetin which is needed for production of red blood cells.

The main risk factors for chronic kidney disease in the society include a personal or family history of diabetes mellitus, hypertension, cardiovascular disease as well as a family history of renal diseases. Racial differences however exist.

Additional risk factors include the prolonged and unsupervised use of non-steroidal agents, nephrolithiasis(kidney stones), obesity and autoimmune disorders such as lupus etc.

Most people with chronic kidney disease have no symptoms early in the course of the disease so some of the signs one should watch out for include fatigue and weakness, foamy urination which may indicate excess amount of protein in the urine, blood in the urine or dark urine, puffy eyes and swelling of the face, hands,ankles and feet. Of course a decrease in urination should immediately demand a medical check up.

Increased thirst and increase need to urinate at night should warrant the need to be tested for diabetes mellitus.

It is important to know if you have chronic kidney disease because of the potential problems that it could lead to if undetected. These include Heart attack and stroke, difficult to control blood pressure, anemia, weak bones, nerve damage(neuropathy) and of course end stage renal disease.

End stage renal disease is best managed by the many modalities of renal replacement therapy available. The mainstay of management of end stage renal disease is dialysis or tranplantation. Dialysis could be  in-center or home hemodialysis, chronic ambulatory peritoneal dialysis and cycler assisted peritoneal dialysis. There are also other variations of the above modalities depending on the preference of the patient and the family.

It is much better to find out earlier about the risk of developing chronic kidney disease before reaching  end stage renal disease. This way one can prevent or slow the progression to end stage renal disease and continue to lead a healthy and productive life.