all about chronic kidney disease fact sheet mar 2012_web

7/29/2019 All About Chronic Kidney Disease Fact Sheet MAR 2012_WEB

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ALL ABOUT CHRONIC

KIDNEY DISEASE

KidneyHealthAustralia page1/5

WHY DO KIDNEYS FAIL?Insideeachkidneythereareaboutonemilliontinyunitscallednephrons.Thenephrons

arethepartofthekidney,whichfiltertheblood.Eachnephronismadeupofaverysmall

filtercalledaglomerulus. Asbloodpassesthroughthenephron,waterandwaste

productsareremoved.Mostofthewaterreturnstothebloodandthewasteproducts

collectinthebladderthenleavethebodyasurine(wee).Mostkidneydiseasesattack

thenephrons.

Sometimeskidneyfailurecanhappenquickly.Forexample,kidneyfailurecanbecaused

byasuddenlossoflargeamountsofbloodorbyanaccident.Asuddendropinkidney

functioniscalledAcuteKidneyFailureandisoftenshortlivedbutcanoccasionallyleadto

lastingkidneydamage

Moreoftenkidneyfunctionworsensoveranumberofyears.Thisisgoodnewsbecauseif

kidneydiseaseisfoundearly,medication,dietaryandlifestylechangescanincreasethelife

ofyourkidneysandkeepyoufeelingyourbestforaslongaspossible.

SometimeskidneydiseaseleadstoKidneyFailure,whichrequiresdialysisorakidney

transplanttokeepyoualive.

InsideaNephronLocationoftheKidneysandBladder

WHAT ARE THE SIGNS OF CHRONIC KIDNEYDISEASE?Kidneydiseaseiscalledasilentdiseaseasthereareoftennowarnings.Itisnotuncommon

forpeopletoloseupto90%oftheirkidneyfunctionbeforegettinganysymptoms.Thefirst

signsmaybegeneralandinclude:

Highbloodpressure Changesintheamountandnumberoftimesurineispassed,e.g.atnight Changesintheappearanceofurine Bloodintheurine Puffinesse.g.legsandankles Paininthekidneyarea Tiredness


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Lossofappetite Difficultysleeping Headaches Lackofconcentration Itching Shortnessofbreath Nauseaandvomiting Badbreathandametallictasteinthemouth

HOW IS CHRONIC KIDNEY DISEASE DIAGNOSED?Ifkidneydiseaseissuspected,youwillhavesomekidney

functionteststomeasurehowwellyourkidneysareworking

andhelpplanyourtreatment,including:

Testsforalbumin/proteinand/orbloodinyoururine. Abloodtesttofindoutthelevelofwasteproductsin

thebloodandcalculateyourglomerularfiltrationrate(GFR seebelow).

Abloodpressuretestaskidneydiseasecauseshighbloodpressure,whichcandamagethesmallblood

vesselsinthekidneys.Highbloodpressurecanalso

causekidneydisease. AnultrasoundorComputedTomographyscan(CTscan)totakeapictureofyourkidneys

andurinarytract. Thesetestsshowthesizeofyourkidneys,locatekidneystonesor

tumoursandfindanyproblemsinthestructureofyourkidneysandurinarytract.

Youmayalsovisitakidneyspecialist(calledanephrologist)tohelpmanageyourcareand

decideifakidneybiopsyisneeded.Duringakidneybiopsyasmallpieceofkidneytissueisremovedandlookedatunderamicroscopetofindoutthetypeofkidneydiseaseandcheck

ifthekidneysaredamaged.

WHAT DO KIDNEY TEST RESULTS MEAN?Thefollowingbloodandurinetestsarecommonlyperformedtoassesskidneyfunction.

Glomerularfiltrationrate(GFR)isthebestmeasureofyourkidneyfunctionandhelpsdecidethestageofkidneydisease. Itshowshowwellyourkidneysarecleaningtheblood.YourGFR

isusuallyestimated(eGFR)fromtheresultsofthecreatininebloodtest.eGFRisreportedin

millilitresperminuteper1.73m2

(mL/min/1.73m2

).

YoureGFRcanalsobeusedtoworkoutyourpercentofkidneyfunction.Thisisanestimateofthelevelthateachkidneyisworking.AGFRof100mL/min/1.73m

2isinthe

normalrangesoitisusefultosaythat100mL/min/1.73m2

isaboutequalto100%kidneyfunction.AGFRof50

mL/min/1.73m2couldbecalled50%kidneyfunctionand

aGFRof30mL/min/1.73m2couldbecalled30%kidney

function.SeetheeGFRfactsheetformoreinformation.

Albuminuriacanmeanthatyourkidneysaredamagedsoalbumin,akindofprotein,leaksintotheurine.Asmallormicroamountofalbuminintheurineiscalledmicroalbuminuria,anda

largermacroamountiscalledmacroalbuminuria.Albuminuriaisoftenanearlywarningof

kidneydiseasebutcanalsobepresentforotherreasons.Albuminuriacanbedetectedbya


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specialurinetestcalledaurine:creatinineratio(ACR). AnACRisperformedonasinglesample

ofurine.SeetheAlbuminuria/Proteinuriafactsheetformoreinformation.

Haematuriaorbloodintheurineoccurswhenredbloodcellsleakintotheurine.Itcanturnurinearedordarkcolacolour.Sometimesthebloodintheurineisnotvisibletotheeye,butmaybe

foundonaurinetest.Thisiscalledmicroscopichaematuria. Bloodintheurineisacommonsign

ofurinarytractinfectionsbutcanalsobethefirstsignofaproblemwiththekidneysorthebladder.

Creatinineisawasteproductmadebythemuscles.Itisusuallyremovedfromthebloodbythe

kidneysandpassesoutintheurine.Whenthekidneysarentworkingwell,creatininestaysinthe

blood.Abloodtesthelpstoworkouthowquicklyyourkidneysremoveorclearcreatininefrom

theblood.Creatinineisagoodmeasureofkidneyfunctionasitdoesnotchangewithdiet.

Howeveritdoesvarywithage,genderandbodyweightsoisnotanaccuratewayofmeasuring

overallkidneyfunction.

Ureaisawasteproductmadebythebodyasitusesproteinfromthefoodyoueat.Ifyouhavelostsomekidneyfunction,yourkidneysmaynotbeabletoremovealltheureafromyourblood.

Potassiumisamineralfoundinmanyfoods.Ifyourkidneysarehealthy,theyremoveextrapotassiumfromtheblood.Ifyourkidneysaredamaged,thepotassiumlevelcanriseandaffect

yourheart.Aloworhighpotassiumlevelcancauseanirregularheartbeat.

WHAT IS THE DEFINITION OF CHRONIC KIDNEYDISEASE?TobediagnosedwithchronickidneydiseaseyoumusthaveaGFRlessthan60mL/min/1.73m

2

formorethanthreemonths

OREvidenceofkidneydamageformorethanthreemonths,regardlessofyourGFR.

Kidneydamagecanbeanyofthefollowing:

albuminuria haematuria pathologicalabnormalities(suchasanabnormalkidneybiopsyresult) structuralabnormalities(suchasanabnormalkidneyultrasoundresult)

WHAT ARE THE STAGES OF CHRONIC KIDNEYDISEASE?KidneyfunctioncanbeclassifiedintostagesdependingonyoureGFR.

Stage1: AnormalGFRgreaterthanorequalto90mL/min/1.73m2Stage2: SlightlydecreasedGFRbetween6089mL/min/1.73m

2

Ifyourkidneyfunctionisatstage1or2,youonlyhaveCKDifyouhavealbuminuria, haematuria,apathologicalabnormalityorastructuralabnormality.

Stage3a: MildmoderatedecreaseinGFRbetween4559mL/min/1.73m2Stage3b: ModerateseveredecreaseinGFRbetween3044mL/min/1.73m2Stage4: SeveredecreaseinGFRbetween1529mL/min/1.73m2Stage5: KidneyfailureasGFRdecreasestolessthan15mL/min/1.73m2ordialysisisstarted


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YoureGFRandalbuminuriaresultsarecombinedtoprovideanoverallpictureofhowwellyour

kidneysareworking.Yourdoctorusesthisinformationtodecidewhichtreatmentisbestfor

you.Treatmentalsodependsonthecauseofyourkidneydamage.Controllingdiabetesand

highbloodpressurecanhelptosloworpreventfurtherkidneydamage.Italsoreducestherisk

ofotherhealthproblems,suchasheartattacksandstrokes.

Manyfactorsaffecttheprogressofkidneyfailureandthesearenotcompletelyunderstood.Ifyouhavekidneydisease,itisimportanttoworkwithyourhealthcareteamandfollowtheir

advicetoslowdownitsprogress.

EARLY STAGESIntheearlystagesofkidneydisease,thereisonlyasmallamountofdamagetothekidneys.The

earlystagesofkidneydiseasecancausescarringandblockagesthatchangebloodflowtoparts

ofthekidneyssotheyarenotworkingaswellastheyshould.Evenintheearlystagesofchronic

kidneydiseasetheriskofcardiovasculardisease(suchasaheartattackorstroke)hasbeenshown

toincrease,someasurestoreducethisriskareessential.

Intheearlystagesyoumayhavenosymptomsandbloodtestscanbenormal.Howeveryoucan

beatmoreriskofdehydrationandhaveahighersensitivitytomedications.Itisveryimportant

totalktoyourdoctorbeforestartinganynewmedications.Maintainingagoodbloodpressure

andfollowinganysuggesteddietarychanges,maydelayorpreventprogresstothenextstage.

MIDDLE STAGESInthemiddlestagesofkidneydiseasesymptomsmaybeginto

appearasthelevelofwasteproductsinthebloodrises.Youmay

begintofeelunwellandnoticechangesinthenumberoftimesyou

wee.Asthekidneysslowdown,bloodpressurerises.Highblood

pressurecanincreasetheriskofcardiovasculardisease.Earlysigns

ofbonediseasemayalsobepresent.Itisveryimportanttowork

withyourhealthcareteamtotreattheseconditionsandprevent

otherproblemsdevelopinglateron.

Anaemiacanalsoappearduringthesestages.Anaemiaiscausedwhentherearenotenoughred

bloodcellsintheblood.Redbloodcellscarryoxygensoanaemiamakesyoufeelweak,tiredand

shortofbreath.Anaemiacanbetreatedwitherythropoietin (EPO)whichisabodychemical

(hormone)mainlymadebythekidneysthattellsthebonemarrowtomakeredbloodcells.See

theAnaemiafactsheetformoreinformation.

LATER STAGESInthelaterstagesofCKDyouwillstarttonoticechangesintheamountofurineyoupassand

highbloodpressurealmostalwaysoccurs.Theamountofalbuminintheurineincreases,asdo

thelevelsofcreatinineandureaintheblood.Youmayneedtomakedietarychangesincluding

limitingyouruseofsaltorreducingtheamountofpotassiumorphosphorusinyourdiet.

EndstagekidneydiseaseisthelaststageofCKD.Thekidneysareonlyfunctioningat1015%

andareunabletoproperlyfilterwasteproducts,removeextrawaterfromthebodyandhelp

tomaintainthebloodschemicalbalance.Nowit'stimetobeginpreparingfordialysisora

kidneytransplant.


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WHO IS MORE AT RISK OF CHRONIC KIDNEYDISEASE?Youareatincreasedriskofchronickidneydiseaseifyou:

are60yearsorolder areofAboriginalorTorresStraitIslanderorigin havediabetes haveafamilyhistoryofkidneydisease haveestablishedheartproblems(heartfailureorpastheartattack)and/or

hadastroke

havehighbloodpressure areobese(Bodymassindex 30) areasmoker

Formoreinformationaboutkidneyshealthorthistopic,pleasecontactKidneyHealthAustralia:KidneyInformationLine(freecall)on18004KIDNEY(18004543639)orvisitwebsitewww.kidney.org.au

Thisisintendedasageneralintroductiontothistopicandisnotmeanttosubstituteforyourdoctor'sorHealth

Professional'sadvice. Allcareistakentoensurethattheinformationisrelevanttothereaderandapplicableto

eachstateinAustralia. ItshouldbenotedthatKidneyHealthAustraliarecognises thateachperson'sexperience

isindividualandthatvariationsdooccurintreatmentandmanagementduetopersonalcircumstances,thehealth

professionalandthestateonelivesin. Shouldyourequirefurtherinformationalwaysconsultyourdoctororhealth

professional.

RevisedMarch2012Ifyouaredeaf,orhaveahearingimpairmentorspeechimpairment,contacttheNationalRelayService

www.relayservice.com.au:

TTYusersphone1800555677thenaskfor1800454363 SpeakandListenusersphone1800555727thenaskfor1800454363 Internetrelayusers www.relayservice.com.au Makeaninternetrelaycallnowthenaskfor1800454363
http://kha.local/Sue%20Bruveris/Local%20Settings/Temp/www.kidney.org.auhttp://kha.local/Sue%20Bruveris/Local%20Settings/Temp/www.kidney.org.auhttp://www.relayservice.com.au/http://www.relayservice.com.au/http://www.relayservice.com.au/http://www.relayservice.com.au/http://kha.local/Sue%20Bruveris/Local%20Settings/Temp/www.kidney.org.au

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