Definition and Symptoms of Chronic Kidney Disease

What is chronic kidney disease (CKD)?

Healthy kidneys function to remove extra water and wastes, help control blood pressure, keep body chemicals in balance, keep bones strong, tell your body to make red blood cells and help children grow normally. Chronic kidney disease (CKD) occurs when kidneys are no longer able to clean toxins and waste product from the blood and perform their functions to full capacity. This can happen all of a sudden or over time.

What is acute renal failure?

"Renal" means related to the kidneys. "Acute" means sudden. So acute renal failure means the kidneys have failed suddenly, often due to a toxin (a drug allergy or poison) or severe blood loss or trauma. Dialysis is used to clean the blood and give the kidneys a rest. If the cause is treated, the kidneys may be able to recover some or all of their function.

What are kidney stones?

A kidney stone occurs when substances in the urine form crystals. Kidney stones can be large or small. Large ones can damage the kidneys; small ones may be able to pass in the urine. Because crystals have sharp edges, passing even small stones can be very painful. Treatment depends on what the stones are made of.

What is PTH?

Parathyroid hormone (PTH) is produced by several small, bean-like parathyroid glands in your neck. Its "job" is to tell your bones to release calcium into your bloodstream. Too much PTH can become a problem in people with kidney disease.

Healthy kidneys convert a hormone called calcitriol to its active form of vitamin D. Calcitriol lets your body absorb calcium from food you eat. When your kidneys are not working well, they start to make less calcitriol-so even if you eat calcium, your body can't absorb it. PTH kicks in to make sure you always have enough calcium in your blood. Over time, this can weaken your bones.

A blood test can show if your PTH levels are above normal. If they are, your doctor may prescribe a form of active vitamin D.

What are the symptoms of chronic kidney disease?

Knowing the symptoms of kidney disease can help people detect it early enough to get treatment. Symptoms can include:

  • Changes in urination — making more or less urine than usual, feeling pressure when urinating, changes in the color of urine, foamy or bubbly urine, or having to get up at night to urinate.
  • Swelling of the feet, ankles, hands, or face — fluid the kidneys can't remove may stay in the tissues.
  • Fatigue or weakness — a build-up of wastes or a shortage of red blood cells (anemia) can cause these problems when the kidneys begin to fail.
  • Shortness of breath — kidney failure is sometimes confused with asthma or heart failure, because fluid can build up in the lungs.
  • Ammonia breath or an ammonia or metal taste in the mouth — waste build-up in the body can cause bad breath, changes in taste, or an aversion to protein foods like meat.
  • Back or flank pain — the kidneys are located on either side of the spine in the back.
  • Itching — waste build-up in the body can cause severe itching, especially of the legs.
  • Loss of appetite
  • Nausea and vomiting
  • More hypoglycemic episodes, if diabetic

If you believe you have any of these symptoms, talk to your doctor about your concerns. This is especially important if you have a close family member who has kidney disease, or if you have diabetes or high blood pressure, which are the main causes of kidney failure.

How can I find out if I have kidney disease?

Kidney disease can be found through lab tests or by symptoms. High blood levels of creatinine and urea nitrogen (BUN) or high levels of protein in your urine suggest kidney disease. Diabetics should have a yearly urine test for microalbumin, small amounts of protein that don't show up on standard urine protein test.

If I have signs of kidney disease, what should I do?

After you have basic screening tests done, if you have signs of kidney disease, you should ask for a referral to a nephrologist, a specialist in treating kidney disease. A nephrologist will perform an evaluation then suggest medications or lifestyle changes to help slow the progression of kidney disease.

Where can I learn more about kidney disease?

It's great that you want to learn more about kidney disease and dialysis so you can make more informed decisions. DaVita offers a class for people who have kidney disease as well as their families. Depending on where you live in the U.S. , there may be a class near you. Call 1-888-MY-KIDNEY (695-4363; operating hours: 5:00 a.m. - 6:30 p.m. PT / 8:00 a.m. - 9:30 p.m. ET). Learn more about DaVita education classes.

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