What Is Kidney Disease?

Staff WriterLast Updated Sep 15, 2020 1:15:15 PM ET
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Your kidneys play an essential role in your body, cleaning waste products and toxins out of your blood to keep it (and you) healthy. Sometimes, however, due to a health condition, infection or number of other potential causes, your kidneys may start to lose their ability to function properly. When this happens, it means you have kidney disease. Learning what kidney disease is, how it can affect you and what treatment options exist can help you understand how to maintain your health and advocate for yourself while living with this condition.

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Types of Kidney Disease

In general, having kidney disease means your kidneys have endured some type of damage that has caused them to not work the way they should. Normally, as your blood flows through your body, it gathers waste products like old or non-functioning cells, extra electrolytes and acids that your other organs produce. Once it reaches your kidneys, they filter out the harmful waste and excess water before returning the refreshed blood to your body and excreting the water and waste as urine. Each day, healthy kidneys with typical functioning filter about 30 gallons of blood.

When your kidneys become damaged, they also become unable to filter out the cellular and electrolyte waste products efficiently, and these toxins begin building up in your blood. This can cause a range of complications, such as heart disease, anemia, weakened bones, damage to your nervous system and anemia. Left untreated, this buildup can also be fatal, which is another reason why these organs are so important — and why it’s so essential to understand kidney disease.

Kidney disease is often classified into two types: acute and chronic. Acute kidney disease, which is also called acute kidney failure, happens when your kidneys suddenly become unable to filter your blood properly. This failure usually takes place over the course of a few hours or days, and it often happens to at-risk people who are already hospitalized and getting care for another health condition. According to the Mayo Clinic, acute kidney disease usually results from a condition that slows the flow of blood to your kidneys; a blockage in your ureters that prevents urine from leaving your body, instead causing the waste to back up into your kidneys; or direct damage to your kidneys from an infection, blood clot, physical accident or other type of disease, condition or agent.

In contrast to acute kidney disease, chronic kidney disease takes place gradually over time as your kidneys lose their function at a slower rate. This type of kidney failure happens over months or years instead of hours or days. It’s typically the result of having another disease or condition that impairs kidney function more and more the longer you live with that disease or condition. Having uncontrolled diabetes and high blood pressure or experiencing frequent kidney infections can lead to the long-term damage that causes chronic kidney disease. 

Symptoms of Kidney Disease

Symptoms of chronic kidney disease may appear to develop suddenly like they do with acute kidney disease, but because the damage happens gradually over the course of months or years, symptoms may initially be too faint to really notice — this is called the “silent phase” of the disease. Once they become noticeable, it can feel like they came on quickly, when they could’ve been developing for several decades.

Common symptoms of chronic kidney disease include nausea, vomiting and a loss of appetite. People with this condition also frequently experience sleep changes and feel fatigued or unable to focus. You may notice swelling around your body, but particularly in your legs and ankles. It’s also possible that you’ll start urinating less, both in frequency and in volume. These symptoms are nonspecific, which means they could be signs of other conditions. It’s important to talk to your doctor about the symptoms you’re experiencing if they don’t resolve in a day or two.

Kidney Disease Staging and Diagnosis

When you have chronic kidney disease, your doctor will likely stage it. This means they’ll assess your kidney functioning and assign it to a category that indicates how far the damage has progressed and how well your kidneys are working. To do this, your doctor will measure your glomerular filtration rate (GMR), which is a test that measures the amount of a substance called creatinine in your blood. Your kidneys process and remove creatinine from your blood, and increasing levels of it mean your kidney function is diminishing.

There are five stages of kidney disease, and each has a typical GFR range and percentage to indicate function. Stage 1 kidney disease means your kidneys are working at 90% efficiency or better with a creatinine reading of 90 mL/min. At this stage, your kidneys may be working normally or showing very early signs of damage, and you may be able to prevent further disease from developing by making lifestyle modifications. In contrast, having Stage 5 kidney disease means the organs are working at 15% or less of their full capacity with creatinine readings of less than 15 mL/min. At this stage, you’re experiencing complete kidney failure and will need dialysis or a transplant.

Treatment Options for Kidney Disease

Both acute and chronic kidney disease require treatment, although it’s generally more urgent for people with acute kidney disease to need treatment urgently. Getting treatment is essential for helping you maintain or even improve your health while living with these conditions because it can slow the progression of damage or, in the case of acute kidney disease, potentially return your kidneys to their pre-failure condition and functioning levels after the organs heal. Just as the causes and symptoms of the two types of kidney failure differ, so do some of the treatment options.

If you’re treated for acute kidney disease, you’ll likely be hospitalized, but you might already be in the hospital when it happens. Your treatment will address the underlying injury that caused the failure once doctors have diagnosed it, and this can vary greatly depending on the cause. However, there are several common treatments that people undergo for acute kidney failure. Your doctor may give you intravenous fluids to restore the hydration balance in your body, and you may also need medications that restore the mineral levels back to normal in your blood.

If waste products have built up in your blood, you may also need a type of treatment called dialysis while your kidneys heal and return to normal functioning. This involves pumping your blood out of your body and through a machine that filters it the way your kidneys typically would before returning it into your body.

While treatments for acute kidney disease often focus on taking care of the underlying injury that caused it and giving your kidneys time to heal, treatments for chronic kidney failure may involve treating the health conditions that led to it while trying to keep the damage from worsening. Restoring your kidneys back to normal functioning usually isn’t possible once they’ve been weakened long-term by disease, but treatments can slow the progression of the damage.

Once your doctor has determined your kidneys’ level of function, you may need to start taking medications that treat any underlying health conditions contributing to the damage. You may also need to make lifestyle changes, such as quitting smoking or eating a lower-protein diet, which won’t create as many waste products that your kidneys need to filter out. If your kidneys are very damaged and aren’t functioning, you’ll need regular dialysis treatments. You may also be a good candidate for a kidney transplant, which is a surgery to remove your non-functioning kidney and replace it with a healthy organ from a donor.

Resource Links:

https://www.niddk.nih.gov/health-information/kidney-disease

https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

https://www.mayoclinic.org/diseases-conditions/kidney-failure/symptoms-causes/syc-20369048

https://www.umcvc.org/health-library/aa106178

https://www.umcvc.org/health-library/aa65427#aa65430

https://nephcure.org/livingwithkidneydisease/what-is-kidney-disease-2/