It’s an all too familiar scenario.  A patient gets admitted to the hospital under my care. As I review their admission laboratory tests, I suspect they may have chronic kidney disease. My suspicions are confirmed when I take a look at their laboratory tests over the last several months to a year.
Then I ask if they have ever been told that they have abnormal kidney function?  They respond by saying either, “No one has ever mentioned that to me” or “Yes my doctor mentioned they were a little abnormal and that we would just watch it for now”. 
When I inform them they indeed have chronic kidney disease they ask in disbelief “How come my doctor never told me this?”.
Just as in pre-diabetes, your healthcare provider may feel that early chronic kidney disease is not that serious. That is until it becomes serious enough to require referral to a specialist or to be started on medications.
Just as in many chronic illnesses, there is usually enough time to reverse their trajectory. That is if we intervene early enough in the disease process.
This is a two-part series on what you need to know about chronic kidney disease. In this article, I’ll go over
  • An outline of the functions of the kidney.
  • Definition of chronic kidney disease.
  • Some of the common causes of chronic kidney disease.
  • Stages of chronic kidney disease.
  • How to predict if you are at risk of developing chronic kidney disease.
Functions of the kidney:
The kidneys are a pair of organs vital to the metabolic health of the body. They have many important functions. Some of these include:
  • Getting rid of waste products from the body.
  • Removes the end products of the breakdown of substances such as drugs.
  • Maintaining the balance of fluids and electrolytes in the body.
  • Helps in the production of red blood cells.
  • Helps in the production of the active form of Vitamin D. Vitamin D which is essential for many important functions in the body including maintaining healthy bones and hormonal health amongst other functions.
What is Chronic Kidney Disease?
 Chronic kidney disease is defined as irreversible damage to the kidneys. This damage affects the ability of the kidneys to perform their normal functions.  The decrease in kidney function must have been present for at least three months.
According to the Centers for Disease Control, 37 million Americans are estimated to have chronic kidney disease. What’s even more concerning is that 9 in 10 adults are living with chronic kidney disease and do not know they have it. Chronic kidney disease also affects women more than men.
Some Causes of Chronic Kidney Disease
The two leading causes of chronic kidney disease in the United States are type 2 diabetes and hypertension.
Some other causes of chronic kidney disease include:
  • Repeated use of medications called nonsteroidal agents (NSAIDs).  NSAIDs are agents that are commonly used for pain and fever. Examples of NSAIDs include the following naproxen, ibuprofen, meloxicam, celecoxib, indomethacin, piroxicam, ketoprofen to name a few.
  • Autoimmune diseases such as systemic lupus erythematosus.
  • Following an infection such as streptococcal infection.
  • Pressure on the kidney due to blockage within the kidney such as a tumor. Pressure can also be transmitted to the kidneys from another part of the urinary system such as an enlarged prostate gland in males.
The Stages of Chronic Kidney Disease
The kidney function is calculated with a mathematical calculation called the Glomerular Filtration Rate (GFR). The GFR is an indirect measure of kidney function.
Based on the GFR, there are several stages of chronic kidney disease:
Stage 1 chronic kidney disease kidney damage with normal or elevated GFR 90 ml/min or above
Stage 2 chronic kidney disease kidney damage with a mild decrease in GFR 60-89 ml/min
Stage 3 chronic kidney disease is usually the first red flag. The GFR at this stage is 30-59 ml/min.
Stage 4 chronic kidney disease is 15-29 ml/min.
Stage 5 chronic kidney disease is <15 ml/min. This is the stage at which dialysis is usually initiated.
Could you be at risk of chronic kidney disease?
A number of factors increase the risk of developing chronic kidney disease. They are:
  • Personal history of type 2 diabetes or hypertension.
  • If you have a family member with type 2 diabetes or hypertension.
  • Being overweight or obese.
  • If you have a family member who has had kidney disease, kidney transplant or has been on dialysis.
You can take a quiz by the National Kidney Foundation to fully determine your personal risk.
In the next part of these series, I will review:
  • What laboratory tests you need to be ordered.
  • How to interpret your lab tests.
  • Questions you need to ask your healthcare provider.
  • Some ways to reduce your risk of developing chronic kidney disease.
  • Steps you need to take if you have been diagnosed with chronic kidney disease.
  • When (or if)  you need to see a specialist.
In the meantime, if you have ever been told that you have chronic kidney disease and you haven’t had any further follow-up, or would like some direction about the next steps you need to take,  schedule a free discovery call.  I offer critical guidance by partnering with you to potentially reverse or slow down chronic illness whilst addressing the root cause of illness.
Until next time, here’s to your health and wellbeing,