I'm Dr. Andrew Bentall, a
kidney doctor at Mayo Clinic.
I look after patients with kidney disease,
either in the early stages,
or with more advanced kidney disease
considering dialysis and
transplantation as treatment options.
In this video, we'll cover
the basics of chronic kidney disease.
What is it? Who gets it?
The symptoms, diagnosis and treatment.
Whether you are looking for answers for
yourself or for someone you love,
we're here to give you
the best information available.
Chronic kidney disease is
a disease characterized by
progressive damage and loss
of function in the kidneys.
It's estimated that chronic kidney disease
affects about one in seven American adults.
And most of those don't know they have it.
Before we get into the disease itself,
let's talk a little bit about
the kidneys and what they do.
Or kidneys play many important roles
keeping our bodies in balance.
They remove waste and toxins,
excess water from the bloodstream,
which is carried out of the body in urine.
They helped to make hormones
to produce red blood cells,
and they turn vitamin D into
its active form, so it's usable in the body.
There are quite a few things
that can cause or
put you at higher risk for
chronic kidney disease.
Some of them are not
things that can be avoided.
Your risk is simply higher if you have
a family history of
certain genetic conditions like
polycystic kidney disease or
some autoimmune diseases like lupus or
IgA nephropathy. Defects in
the kidney structure can
also cause your kidneys to fail,
and you have an increased risk
as you get older.
Sometimes, other common medical conditions
can increase your risk.
Diabetes is the most
common cause of kidney disease.
Both type 1 and type 2 diabetes.
But also heart disease and obesity can
contribute to the damage
that causes kidneys to fail.
Urinary tract issues and
inflammation in different parts of
the kidney can also lead
to long-term functional decline.
There are things that are more under our control:
Heavy or long-term use of certain medications,
even those that are common over-the-counter.
Smoking can also be
a contributing factor
to chronic kidney disease.
Often there are no outward signs in
the earlier stages of
chronic kidney disease,
which is grouped into stages
1 through 5
Generally, earlier stages
are known as 1 to 3.
And as kidney disease progresses,
you may notice the following symptoms.
Nausea and vomiting, muscle cramps,
loss of appetite, swelling
via feet and ankles,
dry, itchy skin, shortness of breath,
trouble sleeping, urinating either
too much or too little.
However, these are usually in the later stages,
but they can also happen in other disorders.
So don't automatically interpret
this as having kidney disease.
But if you're experiencing
anything that concerns you,
you should make
an appointment with your doctor.
Even before any symptoms appear,
routine blood work can
indicate that you might be in
the early stages of chronic kidney disease.
And the earlier it's detected,
the easier it is to treat.
This is why regular checkups
with your doctor are important.
If your doctor suspects
the onset of chronic kidney disease,
they may schedule a variety of other tests.
They may also refer you to
a kidney specialist, a
nephrologist like myself.
Urine tests can reveal
abnormalities and give clues
to the underlying cause of
the chronic kidney disease.
And this can also help to
determine the underlying issues.
Various imaging tests like ultrasounds or CT
scans can be done to
help your doctor assess the size,
the structure, as well
as evaluate the visible damage,
inflammation or stones of your kidneys.
And in some cases, a kidney biopsy
may be necessary.
And a small amount of tissue is taken with
a needle and sent to
the pathologist for further analysis.
Treatment is determined by what is
causing your kidneys to
not function normally.
Treating the cause is key,
leading to reduced complications
and slowing progression of kidney disease.
For example, getting
better blood pressure control,
improved sugar control and diabetes,
and reducing weight are
often key interventions.
However, existing damage
is not usually reversible.
In some conditions, treatment
can reverse the cause of the disease.
So seeking medical review
is really important.
Individual complications vary, but
treatment might include
high blood pressure medication,
diuretics to reduce fluid and swelling,
supplements to relieve anemia,
statins to lower cholesterol,
or medications to protect your bones
and prevent blood vessel calcification.
A lower-protein diet
may also be recommended. It
reduces the amount of waste
your kidneys need to filter from your blood.
These can not only slow the damage of
kidney disease, but make
you feel better as well.
When the damage has progressed to
the point that 85 to 90 percent
of your kidney function is gone, and they no
longer work well enough to keep you alive,
it's called end-stage kidney failure.
But there are still options. There's dialysis,
which uses a machine to filter
the toxins and remove water
from your body as your kidneys are no
longer able to do this. Where possible,
the preferred therapy is a kidney transplant.
While an organ transplant can sound
daunting, it's
actually often the better alternative,
and the closest thing to a cure,
if you qualify for a kidney transplant.
If you have kidney disease,
there are lifestyle choices.
Namely quit smoking.
Consuming alcohol in moderation.
If you're overweight or obese,
then try to lose weight.
Staying active and getting exercise can help
not only with your weight,
but fatigue and stress.
If your conditional allows,
keep up with your routine,
whether that's working, hobbies,
social activities, or other things you enjoy.
It can be helpful to talk
to someone you trust,
a friend or relative who's good at listening.
Or your doctor could also refer you to
a therapist or social worker.
It can also be helpful to find
a support group and connect
with people going through the same thing.
Learning you have
chronic kidney disease and learning
how to live with it can be a challenge.
But there are lots of ways to
help you to be more
comfortable for longer before
more drastic measures are needed.
And even then, there is plenty of hope.
If you'd like to learn even more
about chronic kidney disease,
watch our other related videos or visit
Mayo Clinic.org. We wish you well.