How is chronic kidney disease (CKD) detected?

Simple tests can be done to detect early kidney disease, including:

• Blood pressure measurement
• A test for protein in the urine, which will be confirmed by your doctor over several weeks (one positive result could be due to fever or heavy exercise).
• A test for blood creatinine. The results should be used along with age, race, gender, and other factors to calculate the glomerular filtration rate (GFR), which tells how much kidney function is present.

What happens if my test results show I may have chronic kidney disease?

Your doctor will want to pinpoint the diagnosis and check your kidney function to help create a treatment plan. The doctor may:

• Calculate the Glomerular Filtration Rate (GFR), which is the best way to tell how much kidney function you have. The GFR illustrates the stage of kidney disease and allows the doctor to plan treatment.
• Perform an ultrasound or CT scan to get a picture of your kidneys and urinary tract. These procedures can show your doctor if your kidneys are too large or too small, whether you have a problem like a kidney stone or tumor, and whether there are any problems in the structure of your kidneys and urinary tract.
• Perform a kidney biopsy, which is done in some cases to check for a specific type of kidney disease, see how much kidney damage has already occurred, and to help plan treatment. In a biopsy, the doctor removes small pieces of kidney tissue and inspects them under a microscope.

Your doctor may also ask you to see a kidney specialist who will consult on your case and help manage your care.

Can kidney disease be successfully treated?

Careful control of conditions like diabetes and high blood pressure can help prevent kidney disease or keep it from getting worse. Treating high blood pressure with medications called angiotensin converting enzyme (ACE) inhibitors often helps slow the progression of chronic kidney disease. Moreover, many kidney diseases – like kidney stones and urinary tract infections – can be treated successfully. Unfortunately, the exact causes of some kidney diseases are still unknown, so specific treatments are not yet available for them. Sometimes, chronic kidney disease can progress to kidney failure, which requires dialysis or kidney transplantation. Today, a great deal of research is being performed to find more effective treatment for all conditions that can cause chronic kidney disease.

How is kidney failure treated?

Kidney failure can be treated with hemodialysis, peritoneal dialysis, or a kidney transplant. Hemodialysis (treatment with an artificial kidney) can be performed at a dialysis unit or at home. The treatments are usually performed three times a week. On the other hand, peritoneal dialysis is generally done daily at home. Continuous Cycling Peritoneal Dialysis requires the use of a machine while Continuous Ambulatory Peritoneal Dialysis does not. Finally, kidney transplants have high success rates. The kidney may come from someone who has passed away or from a living donor who may be a relative, friend, or possibly a stranger, who donates a kidney to anyone in need of a transplant.

How long does dialysis take?

Hemodialysis treatments usually last three to five hours. Continuous cycling peritoneal dialysis (CCPD) takes longer and continuous ambulatory peritoneal dialysis (CAPD) involves shorter but more frequent treatments. However, the length of each person’s dialyses varies and depends on how many hours of treatment the doctor ordered.

What does dialysis feel like?

Hemodialysis patients with a fistula or graft may feel a sting or pressure as staff insert the needles, but should not feel the needles once they are in place. Some patients have other symptoms during dialysis, including upset stomach, vomiting, dizziness, sweating, chills, shortness of breath, muscle cramps, headache, restlessness, or itching. Patients on peritoneal dialysis may feel pressure or coolness as the dialysis fluid enters their body. In addition, they may feel a fullness in the abdomen, restlessness, or cramping.

Why should I not skip a treatment?

Skipping a treatment will increase waste products and fluid build up in your blood.

What happens if I gain excess weight between treatments?

Gaining excess weight will increase fluid in your blood that will lead to shortness of breathe, edema, and increase work load on your heart.

Can I eat before dialysis?

At least two or three hours before you dialyze, you may want to eat a snack or light meal. Eating a large meal may make you feel ill or even vomit as more blood will flow to your stomach while it is simultaneously going through a dialysis machine.

What should I wear to my dialysis appointment?

Wear comfortable, washable clothes without buckles, and avoid tops with buttons down the back. Loose or short sleeves are best because nurses take your blood pressure multiple times. Many people feel chilly while on dialysis, so you may want to wear something warm and comfortable.

Source: National Kidney Foundation http://www.kidney.org/, Northwest Kidney Centers http://nwkidney.org/