Chronic Kidney Disease (CKD) Treatment in iran

What Is Kidney Disease?

Kidney disease can affect your body’s ability to clean your blood, filter extra water out of your blood, and help control your blood pressure. It can also affect red blood cell production and vitamin D metabolism needed for bone health.

You’re born with two kidneys. They’re on either side of your spine, just above your waist.

When your kidneys are damaged, waste products and fluid can build up in your body. That can cause swelling in your ankles, nausea, weakness, poor sleep, and shortness of breath. Without treatment, the damage can get worse and your kidneys may eventually stop working. That’s serious, and it can be life-threatening.

Types of Kidney Disease

Chronic Kidney Disease (CKD) is a condition where your kidneys can’t filter toxins or extra fluid from your blood as well as they should. While the condition can vary in how serious it is, CKD usually gets worse over time. Treatment can slow the progression of the disease. You may have few symptoms in the early stages of chronic renal disease. You may not become aware that you have kidney disease until it has progressed.

If left untreated, CKD may lead to kidney failure. At this stage, called end-stage renal disease (ESRD), the condition must be treated by dialysis or kidney transplant. Diabetes and high blood pressure are the leading causes of CKD.

Other common forms of kidney disease include:

• Polycystic kidney disease. This genetic disorder causes cysts (fluid-filled sacs) to grow on your kidneys, limiting their ability to filter waste from your blood.

• Lupus nephritis. Lupus is an autoimmune disease, meaning your immune system attacks healthy cells. Lupus nephritis is when your immune system attacks your kidneys.

• Interstitial nephritis. This condition happens when you have a bad reaction to a medicine that limits your kidneys’ ability to filter toxins. If you stop the medicine, your kidney health should improve.

• Glomerulonephritis (glomerular disease). Glomeruli are the thousands of tiny filters that remove waste from your blood in your kidneys. This condition damages them, and your kidneys can’t function as well. Inflammation in the glomeruli can happen after a strep infection, as well.

• APOL1-mediated kidney disease. Normally, the APOL1 gene helps make an immune system protein, but if you inherit a mutated version of the gene from both parents, you may be more at risk for kidney disease. You may be more likely to have this gene mutation if you identify as Black, African American, Afro-Caribbean, or Latina/Latino.

• Long-lasting viral illnesses. HIV and AIDS, hepatitis B, and hepatitis C may cause kidney disease.

• Pyelonephritis. This is a urinary tract infection within the kidneys, which can result in scarring as the infection heals. It can lead to kidney damage if it happens several times.

What are the Common Symptoms of Chronic Kidney Disease (CKD)?

Loss of kidney function can result in the following, depending on its severity:

• Nausea

• Vomiting

• Appetite loss

• Weakness and exhaustion

• Issues with sleep

• More or less frequent urination

• Diminished mental clarity

• Cramping in the muscles

• swelling in the ankles and feet

• Itchy, dry skin

• Uncontrollable high blood pressure or hypertension

• Breathing difficulties if there is an accumulation of fluid in the lungs

• If fluid accumulates around the heart’s lining, chest discomfort may result.

Stages of Chronic Kidney Disease (CKD)

Chronic renal disease is divided into five stages. The phases are determined by how effectively your kidneys remove waste from your blood.

• Stage 1: Although you have mild renal impairment, your kidneys function usually. In this case, the glomerular filtration rate (GFR) is 90 mL/min or more.

• Stage 2: You have additional indications of modest renal impairment, but your kidneys are functioning normally. This ranges from 60 to 89 glomerular filtration rate (GFR) (mL/min).

• Stage 3a: Your kidneys exhibit mild to severe damage and aren’t functioning as well as they could. The most typical stage is this one. At this point, you may experience symptoms. This results in a glomerular filtration rate (GFR) of 45 to 59 mL/min.

• Stage 3b: Your kidneys are not functioning as well as they should and exhibit considerable impairment. Many people can remain at this stage and never move on to stage 4 with the correct care. This ranges from 30 to 44 glomerular filtration rate (GFR) (mL/min).

• Stage 4: Your kidneys are badly damaged and nearly non-functional, resulting in extremely low renal function. This ranges from 15 to 29 glomerular filtration rate (GFR) (mL/min).

• Stage 5: Your kidneys have either ceased functioning or are near to failing. At this point, you might require kidney dialysis or a kidney transplant. This indicates a glomerular filtration rate (GFR) of less than 15 mL/min.

Causes, Risk Factors and Complications of Chronic Kidney Disease (CKD)

Causes

The two most frequent causes of chronic kidney disease are diabetes and high blood pressure, or hypertension. Chronic kidney disease can also result from the following other factors and situations that impair kidney function:

• Glomerulonephritis

• Polycystic kidney disease

• Membranous nephropathy

• Blockages in the urinary system

• Vesicoureteral reflux

• Nephrotic syndrome

• Pyelonephritis, or recurrent kidney infection.

• Nephropathy associated with diabetes

• Kidney issues caused by lupus and other immune system disorders

Risk Factors

The following variables may raise your risk of developing chronic kidney disease:

• Diabetes

• Increased blood pressure

• Cardiovascular illness of the heart

• Obesity

• Smoking

• Kidney illness in the family

• Abnormal kidney anatomy

• Older age

• Regular usage of medications that can harm the kidneys

Complications

Nearly every bodily part can be impacted by chronic renal disease. Potential complications include:

• High blood pressure, pulmonary edema, or swelling in your arms and legs could result from fluid retention.

• Hyperkalemia

• Anemia

• Heart diseases

• Weak bones and a higher chance of bone fractures

• Central nervous system damage can result in seizures, personality problems, and trouble focusing.

• Weakened immune system, which increases your susceptibility to infection

• An inflammation of the sac-like membrane that surrounds your heart (pericardium) is called pericarditis.

• Risks associated with pregnancy problems for both the mother and the growing fetus

• End-stage renal disease is irreversible kidney deterioration that ultimately necessitates dialysis or a kidney transplant to survive.

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How to Diagnose Kidney Disease

Your doctor will start by asking questions about your family medical history, which medications you’re taking, and if you notice that you’re peeing more or less than normal. After that, they’ll do a physical exam.

You also may have:

• Blood tests to see how much waste product is in your blood

• Urine tests to check for kidney failure

• Imaging tests, like an ultrasound, to let the doctor see your kidneys

• A kidney biopsy, where tissue from your kidney is sent to a lab for testing to figure out the cause of your kidney issues

Kidney transplant

If your kidney disease is advanced, a kidney transplant could be a treatment option.

A successful transplant would mean that you don’t have to get dialysis. After your transplant, you will need to take medicines so that your body accepts the donated kidney.

A kidney from a living donor will generally last 12 to 20 years. One that’s donated from someone who recently died may last 8 to 12 years. If you have “end stage” renal (kidney) disease, doctors consider a transplant to be the best option if you’re a good candidate.

Kidney Disease FAQs

One in ten people is affected by chronic kidney disease (CKD), and millions die annually from it. Is it possible to prevent kidney disease?

Yes, kidney disease can often be prevented, or at least its progression slowed, by making some simple but impactful lifestyle changes. The key is managing conditions like diabetes and high blood pressure, staying active, eating a kidney-friendly diet, and avoiding smoking.

Here are some tips you can follow to prevent CKD:

• Lose weight if you are overweight or obese.

• Stay active, as regular exercise helps control blood sugar levels.

• If you smoke, quitting is one of the best things you can do for your kidney health.

• Take your prescribed medications as directed.

• Keep your cholesterol levels in check.

• Reduce your salt intake and focus on eating more fruits and vegetables.

• Limit alcohol consumption, as it can raise blood pressure.

• Make sure to get your flu shot every year—people with CKD are at higher risk for severe flu complications.

• Small changes like these can make a big difference in your kidney health over time.

Who is at risk for chronic kidney disease (CKD), and what are some complications?

Several factors can put you at a higher risk for CKD. If you have diabetes, high blood pressure, heart disease, or a family history of kidney issues, your chances of developing CKD increase. Additionally, being obese, smoking, or following an unhealthy diet can also raise the risk. Age is another factor—your risk goes up as you get older. If your kidneys are not functioning well, it can lead to complications like anemia, weak bones, fluid retention, gout, heart disease, and high blood pressure. Managing these risk factors early can help reduce the chances of developing CKD and its complications.

What is a kidney-friendly diet?

A kidney-friendly diet focuses on foods that reduce the strain on your kidneys. This includes low-sodium, low-protein, and low-potassium foods. Vegetables like cauliflower, bell peppers, and cabbage, along with fruits like apples, berries, and grapes, are great options. Whole grains like oats and quinoa provide fibre without overwhelming the kidneys. Avoid high-sodium foods like processed snacks and canned soups, and reduce protein intake, especially from animal sources.

What types of tests can help diagnose kidney disease?

The tricky thing about kidney disease is that many people do not realize they have it until it has already progressed because there are often no noticeable symptoms in the early stages. This is why regular testing is so important, especially if you are at higher risk due to factors like diabetes, high blood pressure, or a family history of kidney problems. To diagnose kidney disease, doctors typically use blood tests, like the serum creatinine test, to check how well your kidneys are working. Urine tests can also help by looking for protein or blood in your urine, which are signs of kidney damage. Additionally, imaging tests like ultrasounds or CT scans can give doctors a closer look at kidney health and any abnormalities.

How can diabetes damage the kidneys?

Diabetes is actually the leading cause of kidney disease. Around 1 in 3 adults with diabetes develop kidney problems, according to the National Institute of Diabetes and Digestive and Kidney Diseases. High blood sugar levels from poorly controlled diabetes can damage the tiny blood vessels in the kidneys, making it harder for them to filter waste. Over time, this damage can lead to a condition called diabetic nephropathy, where the kidneys slowly lose their ability to function properly. If diabetes is not well managed, it can progress to kidney failure, and treatments like dialysis or a kidney transplant may be needed.

Can kidney disease be cured?

While you can take steps to slow the progression of chronic kidney disease, there’s no cure for it. Advanced kidney disease must be treated with dialysis or a kidney transplant.

Is kidney disease hereditary?

Yes, kidney disease can caused by gene mutations passed from parent to child. If parents have a gene mutation — or they’re carriers of one — there’s a chance they could pass on the genes that could cause kidney disease in their child.