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Chronic Kidney Disease (CKD)

What is Chronic Kidney Disease?

What are the tests for Chronic kidney Disease

What can cause Chronic Kidney Disease?

Symptoms of chronic kidney disease

5 Stages of Chronic Kidney Disease

Diet for Chronic Kidney Disease

What are the treatments for Chronic Kidney Disease?

What is chronic kidney disease?

chronic kidney disease

Chronic kidney disease (CKD) refers to a progressive loss of renal function over a period of months or years. In clinical, many kidney related diseases like Polycystic Kidney Disease, Diabetic Nephropathy, Nephrotic Syndrome, Glomerular Nephritis and Hypertensive Nephritis and so on can be regarded as Chronic Kidney Disease.

With the progressive loss of renal failure, Chronic Kidney Disease will finally run to kidney failure and cause many fatal complications like heart failure. Chronic Kidney Disease is generally divided into five stages according to Glomerular Filtration Rate (GFR). In the early stage, there is no obvious symptom, so Chronic Kidney Disease is easy to be ignored, which is the reason why many patients are diagnosed with kidney failure when they realize they have kidney problem.

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What are the tests for Chronic Kidney Disease?

Kidney function Test

Kidney has function to excretes toxic substances from blood, keep balance of electrolyte and acid-base as well as generate urine. Through kidney function test, we can know clearly whether our kidneys function well.

Routine Urine Test

Routine urine test is the indispensable test for diagnosing Chronic Kidney Disease. Urinalysis is the most simple of urine tests which are used to screen for kidney problem. A simple dipstick can detect the present of glucose, protein, ketones, or bilirubin in the urine as well as the acidity or alkalinity of the urine, indicators of potential kidney problem.

Routine Blood Test

With routine blood test, we can get to know whether there is excessive creatinine, urea nitrogen or other harmful substances. In normal cases, these substances should be excreted by our kidneys, so increased levels of creatinine and urea nitrogen may indicate kidney problem.

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What can cause Chronic Kidney Disease?

Firstly, the factors which can increase the risk factor of chronic kidney disease are age, diabetes, high blood pressure, family history, etc.

Secondly, factors which can damage kidney are diabetes, high blood pressure, autoimmune disease, primary renal glomerular disease, etc .

Thirdly, after the kidney is damaged, the following factors can accelerate the progression of Chronic Kidney Disease such as continuous proteinuria, anemia, persistent high blood pressure, CVD, staying up late, smoking, etc.

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Symptoms of chronic kidney disease

1. Abnormal Urine Amount

Most chronic kidney disease patients will experience abonormal urine amount which can refer to frequently urination at night, reduced urine and even no urine. In normal condition, a person's urine is 1000ml to 2000ml per 24 hours. If the urine is more than 2500, we can it diuresis, less than 400ml, we call it oliuria, and if it is less than 100ml, we call it anuria.

2. Protein in Urine

Proteinuria is a typical symptom of chronic kidney disease which is caused by the damage of renal glomerular filtration membrane.

3. Hematuria

Hematuria includes gross hematuria and microscopic hematuria. In gross hematuria, the urine color becomes cola-colored or tea-colored. In microscopic hematuria, the number of red blood cells is at least 3 per high power field under microscopy.

4. High Blood Pressure

High blood pressure or hypertension is the late symptom which is caused by long time chronic kidney disease. When patients are suffering from kidney disease, the renal glomerular filtration rate decreases, the filtration of sodium decreases, but the reabsorption ability of renal tubules' function keeps normal. So the unbalance of renal glomerulus and renal tubules takes place, which leads to retention of water and sodium, thus causing high blood pressure.

5. Edema & Swelling

In Kidney Disease, the swelling firstly appears around eyelids. However, in severe case, they may suffer from systemic swelling.

6. Anemia

Firstly, the generation of red blood cells decreases. Because kidney function is damaged, the EPO in kidney disease will produce less, thus leading to anemia.

Secondly, in the late stage of kidney disease, a lot of toxic materials accumulates, which leads to the damage to the red blood cells and the inhibition of hematopoietic function is also damaged. Shortened lifespan of red blood cells leads to anemia.

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5 Stages of Chronic Kidney Disease

On the basis of GFR, chronic kidney disease can be divided into 5 stages.

Stage 1 of CKD: Slightly diminished function; kidney damage with normal or relatively high GFR (≥90 mL/min/1.73 m2). Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.

Stage 2 of CKD: Mild reduction in GFR (60–89 mL/min/1.73 m2) with kidney damage. Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.

Stage 3 of CKD: Moderate reduction in GFR (30–59 mL/min/1.73 m2). British guidelines distinguish between stage 3A (GFR 45–59) and stage 3B (GFR 30–44) for purposes of screening and referral.

Stage 4 of CKD: Severe reduction in GFR (15–29 mL/min/1.73 m2) Preparation for renal replacement therapy

Stage 5 of CKD: Stage 5 (GFR<15ml/min/1.73m2)is the last stage of Chronic Kidney Disease and it can be called ESRD(End Stage Renal Disease) or end stage of kidney failure.

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Diet for Chronic Kidney Disease

Firstly, low potassium. High potassium content of foods should be forbidden: all kinds of edible fungi, potato, Chinese yam, cabbage, date, bananas, oranges, white fungus, peach, apricot, spinach, rape, etc.

Secondly, low salt. Salt content of foods: MSG, soda, cracker, fine dried noodles, soy sauce, etc. Patients whose blood pressure is not stable or has severe edema, should avoid salt. In general, every patient takes salt less than 3 g every day.

Thirdly, low phosphorus. High phosphorus content of foods: marine food product and marine plant such as seaweed, laver, animal's bowels, sesame, tea, honey, yolk, etc.

Fourthly, low fat. note: It is forbidden to use animal oil while cooking. Take vegetable oil mainly, do not take in fatty food. It is better for the kidney disease patients to have corn oil contained unsaturated fatty acid.

Fifthly, high quality protein. We can take proper amount of egg white, milk and fine lean meat, the amount of intake should be less than 100g. Don't take every kind of nuts, such as peanuts, melon seeds and walnuts.

Last but not least, high vitamin. Take more vegetable and every kind of vitamin such as pear, apple, cucumber, tomato, etc.

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What are the treatments for Chronic Kidney Disease?

Chronic Kidney Disease is a refractory disease with long course. As the gradual loos of kidney function, Chronic Kidney Disease will ultimately develop to kidney failure which makes patients have a high risk of developing cardiovascular diseases. According to clinical survey, the most common cause of death in people with Chronic Kidney Disease is therefore cardiovascular diseases rather than kidney problem. Therefore, halting the progression of CKD to stage 5 is of dominant significance for saving patient's life.

Hormonotherapy

In past, the most commonly seen method of stopping CKD is oral hormone medicines which show great treatment effects in halting kidney problem for the time being. There is no doubt that hormonotherapy is effective for controlling kidney disorder, but unfortunately, it fail to treat kidney disease fundamental, that is to say, it only focuses on remitting the symptoms and has nothing to do with the repairing of kidney damages.

It is acceptable for patients to take hormone medicines for a shorter time to avoid further kidney damages. However, in many cases, as the root cause of kidney damage is not removed, CKD sufferers have to take hormone medicines for a life-long time. Long-term taking of hormone medicines weaken patient's immunity and worsen their immune system. Therefore, in the long run, hormonotherapy is not advisable. Even though, the treatment effects of Hormonotherapy should not be ignored.

Immunotherapy

Immunotherapy is a new therapy for Chronic Kidney Disease and it occurs on the basis of hornomotherapy, but different from hormone treatment, it treats kidney problem from the root. What is more, this therapy causes no side effects.

On the basis of clinical study, about 95% cases of kidney disease occurs because of immunodeficiency accompanied by lower immunity. In normal case, we can live normally without being affected by any diseases owing to our strong and normal immune system. However, once this system is damaged, we are susceptible to various bacterium or viruses. The antigen invade our body and form immune complexes with antibodies which are generated by our body to against these harmful substance. Because of abnormal immune system, these immune complexes can not be excreted smoothly and timely, as a result of which, they circulate with our blood. Our kidneys take charge of filtering blood and when these immune complexes deposit in kidney, inflammatory response occurs and consequently, kidney damages are caused.

In Immunotherapy, hormone medicines are applied firstly to block inflammatory response, the purpose of which is to prevent further kidney damages, and then Chinese medicines are applied to play the role of adjusting immune system as well as clearing immune complexes away from the kidney. As we know, Chinese medicines have history more than 5000 years and in the past long river of time, many of them have been proven to be effective in regulating our immune system as well as increasing our self-curative ability. With these functions, our resistance to antigen can be increased greatly, and also, our immunity to Chronic Kidney Disease is strengthened at the same time.

Dialysis and Kidney Transplant

Once kidney failure occurs, patients have to start dialysis or prepare for kidney transplant to further their life. Many patients start dialysis or kidney transplant once they step to kidney failure, actually, many patients still have chance to avoid dialysis and kidney transplant at that moment. Dialysis and kidney transplant are the last two treatments only for these whose two kidneys have been totally damaged and with no urine for a very long time (usually more than 2 years).

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