Let’s start with the basics!
In the following text, you will learn how your kidneys work in general, how to best prevent them from potential damage and what to do if your kidney function is already impaired. Hopefully, learning about the basics will make the kidneys a bit easier to understand and will enable you to have a confident discussion about disease-related topics with your physician.
Chronic kidney disease is defined as abnormalities of kidney structure or function, present for more than 3 months, with implications for health.
Perhaps you have already noticed physical changes yourself: Do you often feel tired and powerless? Do you have less appetite than usual? Are you having trouble falling asleep or are you unable to concentrate? Do you often experience nausea? These signs could indicate the gradual loss of kidney function.
With appropriate treatment, your physician can find ways to relieve these symptoms. Having an open discussion with your physician about how you’re feeling is crucial. Learn how to cope with your illness while still enjoying life.
Diagnosis of chronic kidney disease
Your general practitioner or a medical specialist, the nephrologist, will carry out various tests to determine whether you have chronic kidney disease. Blood will be drawn so that the nephrologist can check certain laboratory values. In addition, usually a urine test is carried out. This examines which substances are excreted into the urine and the level of excretion.
Protein in the urine
The question of whether there is protein (albumin, a certain protein) in the urine plays a crucial role. If there is a sustained increased amount of albumin in the urine, this could indicate that the kidneys’ filter function has deteriorated, which is also known as proteinuria (or albuminuria).
Determining the GFR
CKD stage 1 describes a slightly reduced function of the kidneys and CKD stage 5 is the terminal stage. Your physician calculates the glomerular filtration rate (GFR) for classification. It indicates how well the kidneys cleanse the blood of toxins and excrete those into the urine. The GFR is expressed in milliliters per minute. The lower the GFR, the worse your kidneys are functioning.
For example, a GFR between 60 and 89 indicates slightly decreased kidney functioning. This corresponds to CKD stage 2. A GFR between 15 and 29 suggests severely impaired kidney function with CKD stage 4.
If the GFR is lower than 15, kidney replacement therapy becomes more and more likely due to inadequate kidney function. At this stage, you and your physician will decide on when is the most ideal time to start a replacement therapy.
Establishing a treatment plan
If you have been diagnosed with chronic kidney disease, the second step is to develop a treatment plan that suits your personal situation. It aims to slow down the progression of the disease and to alleviate any symptoms and reduce complications. Your treatment can target problems, such as:
- High blood pressure (hypertension): Checking whether the blood pressure is in the normal range
- Kidney-related anemia (kidney anemia): Checking whether there are enough red blood cells in your blood and if the electrolyte and acid metabolism which are responsible for the transport of oxygen to the organs are in balance
- Diabetes: Checking blood sugar levels
We are aware that there’s currently a lot going on in your head.
If you have unpleasant thoughts, stick to the following principles:
- I am not alone!
My physician, my family and my care team are at my side
- All the necessary steps can be learned!
Others did it, so I can do it, too
- My symptoms can be alleviated!
With the right therapy, I'll feel better
Be brave and believe in your strength! Being open about your problems to the physician will help you find the treatment that suits your situation best. Let loved ones engage in conversations, too. Address your fears and worries openly.
Find out how your kidneys work in the next section