What is CKD
Chronic kidney disease is said to occur when impairment of kidney structure or function persists for three months or more. The diagnosis is based on two indicators: the glomerular filtration rate, calculated from blood creatinine, and the presence of protein or albumin in the urine.
The kidneys perform not only an excretory function. They regulate blood pressure, water-salt balance, participate in the formation of red blood cells and the exchange of calcium and phosphorus. Therefore, when they are damaged, the heart, bones and hematopoiesis suffer.
Stages of CKD
- C1 - normal function, but there are signs of kidney damage: protein in the urine, changes on ultrasound
- C2 - slight reduction in filtration
- C3a and C3b - moderate and pronounced decrease; at this stage, the first laboratory abnormalities usually appear - anemia, disorders of phosphorus-calcium metabolism
- C4 - sharply reduced function, preparation for replacement therapy
- C5 - end stage, requiring dialysis or kidney transplantation
Reasons
- Diabetes mellitus is the leading cause worldwide
- Arterial hypertension
- Chronic glomerulonephritis
- Chronic pyelonephritis and recurrent urinary tract infections
- Urolithiasis with long-term obstruction
- Hydronephrosis of any origin
- Prostate adenoma with chronic urinary retention
- Polycystic kidney disease
- Systemic diseases: lupus, vasculitis
- Long-term use of nonsteroidal anti-inflammatory drugs and certain other medications
- Congenital anomalies of the kidneys and urinary tract
Urological causes are important because many of them are reversible. Removing the obstruction to the outflow of urine can stop the progression or even improve kidney function - unlike most nephrological causes.
Symptoms
In the early stages there are no symptoms. As it progresses, nonspecific complaints appear, which can easily be attributed to fatigue or age.
- Fatigue, weakness, decreased performance
- Swelling on the face in the morning and on the legs in the evening
- High blood pressure that is difficult to treat
- Frequent urination at night
- Decreased appetite, nausea, metallic taste
- Itchy skin and dry skin
- Paleness due to anemia
- Muscle cramps
- Dyspnea on exertion and at rest in later stages
- Sleep and concentration problems
Diagnostics
- Blood creatinine with calculation of glomerular filtration rate
- Determination of albumin or protein in urine, albumin/creatinine ratio
- General urine test
- Ultrasound of the kidneys - size, thickness of the parenchyma, presence of stones and dilation of the pelvis
- Complete blood count to detect anemia
- Electrolytes, calcium, phosphorus, parathyroid hormone
- Glucose and glycated hemoglobin
- Lipid profile
- 24-hour blood pressure monitoring
- CT or MRI if obstruction or mass is suspected
- Kidney biopsy - if the cause of the lesion is unclear, according to the decision of the nephrologist
Treatment: What Really Slows Progression
- Strict blood pressure control is the most important factor
- Compensation for diabetes mellitus
- Drugs that reduce protein loss in urine - as prescribed by a doctor
- Elimination of urological causes: stone removal, stenting, nephrostomy, treatment of prostate adenoma
- Limiting salt
- Moderate protein restriction in later stages under medical supervision
- Avoidance of non-steroidal anti-inflammatory drugs without prescription
- Correction of anemia and disorders of phosphorus-calcium metabolism
- Weight control, smoking cessation, sufficient physical activity
- Timely vaccination and infection prevention
- Renal replacement therapy - dialysis or transplantation - in the terminal stage
Who needs to have their kidneys checked regularly?
- For everyone with diabetes - at least once a year
- Everyone with arterial hypertension
- People with urolithiasis and recurrent urinary tract infections
- Men with prostate adenoma and a large volume of residual urine
- Patients with cardiovascular diseases
- People with obesity
- Those who have a family history of kidney disease, including polycystic disease
- Anyone taking painkillers or other potentially nephrotoxic drugs for a long time
- People over 60 years old
The minimum screening kit is simple and accessible: blood creatinine with GFR calculation, general urine test with protein determination and kidney ultrasound.
Where to get examined in Tashkent
The first step when CKD is suspected is to determine whether there is a remediable urological cause: stone, hydronephrosis, prostate adenoma with urinary retention. This is important because such causes are treatable.
In Tashkent, a urological examination for decreased renal function, including ultrasound, assessment of residual urine and, if necessary, kidney drainage, is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
Take all previous creatinine tests with you: the dynamics of the indicator over several years speaks more about the rate of progression than a single value. Clinic contacts are below on the page.
