Causes & Stages of Kidney Disease

Kidney disease is a growing problem. More than 20 million Americans may have kidney disease and many more are at risk. Anyone can develop kidney disease, regardless of age or race. Diabetes, high blood pressure, cardiovascular (heart or blood vessel) disease, and a family history of kidney failure are the key risk factors for chronic kidney disease. The main risk factors for developing kidney disease are:

Diabetes,
High blood pressure,
Cardiovascular (heart and blood vessel) disease, and
A family history of kidney failure.

If you or a family member have any of these risk factors, it is important to learn about the basics of kidney disease and how to keep the kidneys healthy longer.

Acute kidney failure (AKF) is a condition where your kidneys suddenly stop working properly. Usually this happens when you are unwell from another illness or hospitalized, particularly in critically ill people who need intensive care. However, AKF may be reversible. If you’re otherwise in good health, you may recover normal or nearly normal kidney function.

Chronic kidney disease (CKD) is progressive loss in kidney function over a period of months or years. Kidney damage occurs slowly over many years, often due to diabetes or high blood pressure.

Causes of Kidney Disease:

Diabetes is the Number one Cause of Kidney Failure
High Blood Pressure is the Second Leading Cause
Glomerulonephritis is kidney inflammation
Genetic diseases such as polycystic kidney disease (PKD)
Autoimmune diseases such as Lupus
Birth defects and other problems can also cause kidney disease.

You are at greater risk to develop chronic kidney disease if you have of a family history of kidney failure and the following:

Diabetes: Diabetes is the leading cause of kidney failure. Forty Four percent of people starting dialysis have kidney failure caused by diabetes. Diabetes can damage your kidneys. This damage can happen over many years, without you feeling it. That is why it is so important for people with diabetes to manage their diabetes and get tested for kidney disease. Both type 1 and type 2 diabetes can cause kidney disease.

High blood pressure: High blood pressure is the second leading cause of kidney failure. High blood pressure can damage your kidneys. This damage can happen over many years, without you feeling it. That is why it is so important for people with high blood pressure to control their blood pressure and get tested for kidney disease. For most people, a blood pressure of 140/90 or above is considered high. Talk to your health care provider about the right blood pressure for you.

Heart disease: There is a connection between kidney disease and cardiovascular (heart or blood vessel) disease. People with heart disease are at higher risk for kidney disease and people with kidney disease are at higher risk for heart disease.

Use of analgesics such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) regularly over long durations of time can cause analgesic nephropathy, another cause of kidney disease. Certain other medications can also damage the kidneys.

Clogging and hardening of the arteries (atherosclerosis) leading to the kidneys causes a condition called ischemic nephropathy, which is another cause of progressive kidney damage.

Obstruction of the flow of urine by stones, an enlarged prostate, strictures (narrowings), or cancers may also cause kidney disease.

Other causes of chronic kidney disease include HIV infection, sickle cell disease, heroin abuse, amyloidosis, kidney stones, chronic kidney infections, and certain cancers.

Stages of Kidney Disease

GFR stands for glomerular (glo-mer-u-lar) filtration rate. A blood test checks your GFR, which tells how well your kidneys are filtering.It’s important to know your GFR if you are at risk for kidney disease. A urine test will also be used to check your kidneys.

Normal: 90 or more
Stage 1: Signs of mild kidney disease but with normal or better GFR greater than 90%
Stage 2: Mild kidney disease with reduced GFR 60-89 mL/min
Stage 3: Moderate chronic renal insufficiency 30-59 mL/min
Stage 4: Severe chronic renal insufficiency 15-29 mL/min
Stage 5: End-stage renal failure less than 15 mL/min (Person will require dialysis or a transplant)*Glomerular filtration rate (GFR) tells how quickly your kidneys are cleaning your blood. GFR is also reported in milliliters per minute.

GFR below 60: This may mean kidney disease. Talk to your provider about treatment to keep your kidney health at this level. Ask about:

medicines you should take,
medicines to stay away from,
changes to your diet,
other lifestyle changes,
whether your kidney disease is likely to get worse,
ways to treat kidney failure, and
if you should begin preparing for dialysis.

GFR of 15 or lower: This is usually referred to as kidney failure. Most people at this point may need dialysis or a kidney transplant. Talk to your provider about your treatment options.

Note: If the lab doesn’t list your GFR, your provider can get it by entering your serum creatinine result into a GFR Calculator.

End-stage Renal Disease (ESRD) is the total and irreversible loss of kidney function and requires treatment with either a kidney transplant or dialysis for the rest of the person’s life.

Testing for Kidney Disease

Early kidney disease usually does not have signs (a change in your body) or symptoms (a change in how you feel). Testing is the only way to know how your kidneys are doing. It is important for you to get checked for kidney disease if you have the key risk factors – diabetes, high blood pressure, heart disease, or a family history of kidney failure.

Two tests are needed to check for kidney disease.

1. A blood test checks your GFR, which tells how well your kidneys are filtering. GFR stands for glomerular (glow-MAIR-you-lure) filtration rate.

2. A urine test checks for albumin in your urine. Albumin is a protein that can pass into the urine when the kidneys are damaged.

It is also important to have your blood pressure checked. High blood pressure can be a sign of kidney disease. Keep your blood pressure at or below the target set by your health care provider. For most people, the blood pressure target is less than 140/90 mm Hg.

The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. If you have diabetes, get checked every year. If you have other risk factors, such as high blood pressure, heart disease, or a family history of kidney failure, talk to your provider about how often you should be tested.

Source: National Institute of Diabetes and Digestive and Kidney Diseases