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All About Chronic Kidney Disease (CKD) Fact Sheet

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All About Chronic Kidney Disease (CKD) Fact Sheet Last Reviewed April 2017 Page 1 Prevent, Detect, Support. Fact sheet All About Chronic Kidney Disease (CKD) Inside each kidney there are about called Acute Kidney Failure and is one million tiny units called nephrons. often short lived but can occasionally The nephrons are the part of the lead to lasting kidney damage. kidney, that filter the blood. As blood More often kidney function worsens passes through the nephron, water over a number of years. If kidney and waste products are removed. disease is found early, medication, Most of the water returns to the blood dietary and lifestyle changes can and the waste products collect in the increase the life of your kidneys and bladder then leave the body as urine keep you feeling your best for as long (wee). Most kidney diseases attack as possible. the nephrons. Sometimes kidney disease leads Sometimes kidney failure can happen to kidney failure, which requires quickly. For example, kidney failure can dialysis or a kidney transplant to be caused by a sudden loss of large keep you alive. amounts of blood or by an accident. A sudden drop in kidney function is What are the signs of chronic kidney disease? Kidney disease is called a ‘silent • high blood pressure • difficulty sleeping disease’ as there are often no warning • changes in the amount and number • headaches signs. It is not uncommon for people of times urine is passed, e.g. at night to lose up to 90% of their kidney • lack of concentration function before getting any symptoms. • changes in the appearance of urine • itching The first signs may be general • blood in the urine and include: • shortness of breath • puffiness e.g. legs and ankles • nausea and vomiting • pain in the kidney area • bad breath and a metallic taste • tiredness in the mouth • loss of appetite Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia All About Chronic Last Reviewed April 2017 Prevent, Detect, Support. Kidney Disease Page 2 How is chronic kidney disease diagnosed? If kidney disease is suspected, you • An ultrasound or Computed will have some kidney function tests Tomography scan (CT scan) to take to measure how well your kidneys a picture of your kidneys and urinary are working and help plan your tract. These tests show the size of treatment. This includes: your kidneys, locate kidney stones or tumours and find any problems • Tests for albumin (a type of protein) in the structure of your kidneys and and/or blood in your urine. urinary tract. • A blood test to find out the level You may also visit a kidney specialist of waste products in the blood and (called a nephrologist) to help manage calculate your glomerular filtration your care and decide if a kidney rate (GFR — see below). biopsy is needed. During a kidney • A blood pressure test. Kidney disease biopsy a small piece of kidney tissue causes high blood pressure, which is removed and looked at under can damage the small blood vessels a microscope to find out the type in the kidneys. High blood pressure of kidney disease and check if your can also cause kidney disease. kidneys are damaged. What do kidney test results mean? The following blood and urine tests If you have albuminuria, your kidneys Creatinine is a waste product made are often performed to assess kidney are damaged so albumin, a kind by your muscles. It is usually removed function. of protein, leaks into your urine. from your blood by your kidneys Albuminuria is often an early warning and passed out in your urine. When Glomerular filtration rate (GFR) is of kidney disease. Albuminuria can be your kidneys are not working well, the best measure of your kidney detected by a special urine test called creatinine stays in your blood. A function and helps decide the stage a albumin:creatinine ratio (ACR). blood test helps to work out how of kidney disease. It shows how well An ACR is performed on a single quickly your kidneys remove or ‘clear’ your kidneys are cleaning your blood. sample of your urine. creatinine from the blood. Creatinine Your GFR is usually estimated (known levels vary with age, gender and body as your eGFR) from the results of your See the Albuminuria fact sheet weight so it is not always an accurate creatinine blood test. eGFR is reported for more information. way of measuring your kidney function. in millilitres per minute per 1.73m2(mL/ Haematuria occurs when red blood min/1.73m2). Urea is a waste product made by your cells leak into your urine. It can turn body as it uses protein from the food Your eGFR can also be used to work your urine a red or dark cola colour. you eat. If you have lost some kidney out your percent of kidney function. Sometimes the blood in the urine can function, your kidneys may not be able This is an estimate of the level that not be seen with your eyes, but it may to remove all the urea from your blood. each kidney is working. A GFR of be detected using a special urine test. 100 mL/min/1.73m2 is in the normal This is called microscopic haematuria. Potassium is a mineral found in many range so it is useful to say that 100 Blood in your urine is a common sign foods. If your kidneys are healthy, they mL/min/1.73m2 is about equal to of urinary tract infections but can also remove extra potassium from the ‘100% kidney function’. A GFR of 50 be the first sign of a problem with your blood. If your kidneys are damaged, mL/min/1.73m2 could be called kidneys or bladder. the potassium level can rise and affect ‘50% kidney function’ and a GFR of your heart. A low or high potassium 30 mL/min/1.73m2 could be called level can cause an irregular heartbeat. ‘30% kidney function’. See the eGFR fact sheet for more information. Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia All About Chronic Last Reviewed April 2017 Prevent, Detect, Support. Kidney Disease Page 3 What is the definition of chronic kidney disease? To be diagnosed with chronic kidney Kidney damage can be any of disease you must have a eGFR less the following: than 60 mL/min/1.73m2 for more than • albuminuria three months. • haematuria or • pathological abnormalities (such Evidence of kidney damage for as an abnormal kidney biopsy result) more than three months, regardless of your eGFR. • structural abnormalities (such as an abnormal kidney ultrasound result) Stages of chronic kidney disease Kidney function can be classified into stages depending on your eGFR. Stage 1 A normal eGFR greater than or equal to 90 mL/min/1.73m2 Stage 2 Slightly decreased eGFR between 60–89 mL/min/1.73m2 If your kidney function is at stage 1 or 2, you only have CKD if you have albuminuria, haematuria, a pathological abnormality or a structural abnormality. Stage 3a Mild–moderate decrease in eGFR between 45–59 mL/min/1.73m2 Stage 3b Moderate–severe decrease in eGFR between 30–44 mL/min/1.73m2 Stage 4 Severe decrease in eGFR between 15–29 mL/min/1.73m2 Stage 5 Kidney failure as eGFR decreases to less than 15 mL/min/1.73m2 or dialysis is started Description of kidney disease Early stages (stages 1–2) Treatment can slow the progress of kidney disease and reduce the Please note that the following Some people have no symptoms of likelihood of further complications. descriptions are a general guide only, chronic kidney disease; however there and may not apply to everyone. Some is more risk of dehydration and a higher Later stages / end stage kidney people reach end stage kidney disease sensitivity to medications. It is very disease (stage 5) (Stage 5) without experiencing any important to talk to your doctor before Changes may occur in the amount of symptoms, while some people may starting any new medications including urine passed. High blood pressure is start to feel unwell in the early stages over the counter and ‘natural’ or herbal almost always present. The amount of kidney disease. Many factors affect medications. The risk of heart of protein in the urine increases, as do the progress of kidney disease and (cardiovascular) disease also starts to the levels of creatinine and potassium these are not completely understood. increase. Treatment includes maintaining in the blood. You are more likely to feel a healthy blood pressure and making unwell, and you may also experience healthy lifestyle choices to delay or other complications of kidney disease, prevent progress to the next stage. such as low haemoglobin (anaemia). Middle stages (stages 3–4) Even with the best treatment, kidney Discovering kidney disease during disease sometimes leads to stage 5 this stage is more common as the (or end-stage kidney disease), which level of waste (urea and creatinine) requires dialysis or a kidney transplant in your blood rises. You may begin to to stay alive. feel unwell and notice changes in the number of times you pass urine. As kidney function slows down, blood pressure rises. Early signs of bone disease and anaemia may appear. Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia All About Chronic Last Reviewed April 2017 Prevent, Detect, Support. Kidney Disease Page 4 Who is more at risk? THINGS TO REMEMBER You are at increased risk of chronic kidney disease if you: • You can lose up to 90% of your kidney function before getting any symptoms.
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