Diagnosis of Chronic Kidney Disease
Unfortunately, symptoms may not develop early in the course of the disease. The main tests to diagnose CKD are simple and usually done through blood and urine tests. These include:
Serum creatinine: this is a blood test which helps in determining the extent of the disease and its progression. As already mentioned in the previous blog, it helps in calculating the eGFR.
Urine protein: this report is generated during a routine urine examination, which can give valuable insight into the presence and progression of CKD.
Serum cystatin C: this is a specialized blood test, which may be advised by a Nephrologist to further fine tune the calculation of eGFR and kidney disease extent, in certain situations.
Urine albumin to creatinine ratio (UACR): this is a spot urine report which quantifies with reasonable accuracy, the extent of albumin (protein) loss in the urine.
Various stages of CKD and their natural progression timeline
When detected early, CKD progression can be decreased by managing and controlling the comorbidities like Diabetes mellitus and Hypertension. While reversal is difficult, patients who have acute symptoms or causes for creatinine report worsening are managed by nephrologists by titrating and changing their medicine, volume status, and other interventions based on the clinical status which can differ from patient to patient. The natural timeline of progression of CKD from stage 1 to stage 5 is highly variable and depends on the age, nature of the disease, cause of the CKD to name a few. Hence, it is important to keep close follow up with a nephrologist.
Precautions which can be taken to retard the progression of CKD
As mentioned earlier, regular follow up with the nephrologist is important to ensure close vigilance and regular check-ups are done. Some of the other precautions which can be taken are:
- Eating healthier
- Controlling blood sugar levels
- Keeping the blood pressure in check
- Avoiding smoking and limiting alcohol
- Staying active
- Maintaining a healthy fluid intake
- Avoiding self-medication and over-the-counter medicines
- Regular kidney function check-ups
Medications or interventions for CKD
The main goal of treatment is to slow the progression of the disease and manage the symptoms.
Medications: These help control blood pressure, manage diabetes, or address other related health problems.
Diet changes: Lowering the intake of salt, protein, and phosphorus can help protect your kidneys.
Dialysis or a kidney transplant: These options come into play in the later stages of CKD when the kidneys can no longer function on their own.
Dietary restrictions if someone has CKD
There are some dietary restrictions which need to be followed in patients with CKD. It is important to be vigilant of numerous myths and misconceptions related to dietary changes in CKD. It is worthwhile to get a Dietitian's advice and a Nephrologist's opinion before making changes to regular healthy dietary patterns in the Indian setting.
Some key tips include:
Limiting salt intake: Too much salt can raise the blood pressure. Avoiding table salt is an easy way to begin. In certain situations, and advanced stages of CKD, salt substitutes should be avoided.
Limiting the protein intake: This needs to be done after discussion with the dietitian. Inadvertent and over-aggressive protein restriction can have deleterious effects.
Monitoring potassium and phosphorus intake: People with CKD often need to avoid foods high in potassium (like bananas & potatoes) and phosphorus (like dairy and nuts).
FAQs:
How often should the kidney function be checked?
If at risk for CKD or conditions like diabetes or high blood pressure, the kidney function tests may need to be repeated frequently. While there are no fixed guidelines, the Nephrologist may determine the frequency based on the stage of CKD and its rate of progression, which may differ from patient to patient. Yearly kidney function tests must be performed in people with age more than 60 years of age.
Can a normal life be led by patients with CKD?
Yes, many people with CKD lead full, active lives. The key is early detection, regular monitoring, and making lifestyle changes. With the right treatment and care under a Nephrologist, CKD patients can continue their daily activities.
Chronic Kidney Disease is a spectrum ranging from stage 1 to stage 5. The diagnosis of CKD does not entail or necessitate life changing decisions or alteration in day to day living. Simple steps as mentioned in this blog, especially if undertaken at the earliest, go a long way in preventing the progression of CKD.
At P. D. Hinduja Hospital, Mumbai, we have a dedicated Department of Nephrology for a comprehensive and holistic care of CKD patients. In case of doubts and guidance, you can book an appointment with Dr. Ayan Dey, Consultant Nephrologist and Transplant Physician or call on 022 6766 8181/022 4510 8181 for appointment.
