General Practice 2022

Chronic renal diseaseônica: what é, symptoms, causes and treatment

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Chronic renal diseaseônica: what é, symptoms, causes and treatment
Chronic renal diseaseônica: what é, symptoms, causes and treatment

Chronic kidney disease, or CKD, is a condition characterized by damage to the kidney that persists for more than 3 months, which causes this organ not to function as it should, which can happen due to decompensated diabetes, high blood pressure or recurrent kidney infections, for example.

Thus, as kidney functions are not properly performed, there is accumulation of minerals, toxins and electrolytes in the blood, which can lead to the appearance of some signs and symptoms, such as foamy urine, nausea, vomiting, cramps and swelling in the feet and ankles, for example.

It is important that CKD is identified as soon as the first symptoms appear, because in this way it is possible to prevent the worsening of kidney damage and the development of renal failure, and the use of medication, changes in diet may be recommended by the nephrologist and, in the most severe cases, kidney transplantation.

Symptoms of chronic kidney disease

The symptoms of chronic kidney disease appear progressively, the main ones being:

  • Nausea and vomiting;
  • General malaise;
  • Loss of appetite for no apparent reason;
  • Excessive tiredness during the day;
  • Difficulty falling asleep;
  • Changes in the amount of urine during the day;
  • Foamy urine;
  • Blood urine;
  • Difficulty concentrating or thinking;
  • Muscle cramps or tremors;
  • Constant itching all over the body;
  • Swelling in the body, especially in the legs, and worsening at the end of the day;
  • Sensation of constant shortness of breath.

In the presence of these signs and symptoms, it is important that the general practitioner is consulted, as it is possible for tests to be carried out to help identify any changes in the kidney and, in this way, prevent the progression of the disease and the development of renal failure.

Symptom Test

To know your risk of having kidney problems, check the symptoms you may be experiencing in the following symptom test:

  1. 1.Frequent urge to urinate Yes No
  2. 2.Urinating a small amount each time Yes No
  3. 3.Constant pain in lower back or flanks Yes No
  4. 4.Swelling of legs, feet, arms or face Yes No
  5. 5.Itchy all over the body Yes No
  6. 6.Excessive fatigue for no apparent reason Yes No
  7. 7.Changes in urine color and smell Yes No
  8. 8.Presence of foam in urine Yes No
  9. 9.Difficulty sleeping or poor sleep quality Yes No
  10. 10.Loss of appetite and metallic taste in the mouth Yes No
  11. 11.Feeling of pressure in the belly when urinating Yes No


Make an appointment with a specialist

How the diagnosis is made

The diagnosis of chronic kidney disease should be made by the nephrologist based on the symptoms presented by the person, he alth history, life habits and results of imaging and laboratory tests, mainly.

Thus, it may be recommended to perform a urine test, which detects or not the presence of albumin protein, and a blood test, with creatinine measurement, to check its amount in the blood. In case of chronic kidney disease, albumin is present in the urine and the concentration of creatinine in the blood is high. Learn all about the creatinine test.

Possible causes

Chronic kidney disease is in most cases a consequence of chronic diseases such as decompensated diabetes, high blood pressure, recurrent kidney infections and kidney inflammation, in addition to chronic use of anti-inflammatory drugs such as ibuprofen.

Furthermore, CKD in men can also occur as a consequence of benign prostatic hypertrophy. It is important that the cause of CKD is identified so that the most appropriate treatment can be initiated.

Stages of chronic kidney disease

The stages of chronic kidney disease can be defined according to the type of kidney injury and signs and symptoms that appear in:

  • Stage 1 chronic kidney disease: Normal kidney function, but urinalysis or ultrasound results indicate kidney damage;
  • Stage 2 chronic kidney disease: Reduced loss of kidney function and test results that indicate kidney damage;
  • Stage 3 chronic kidney disease: Moderately reduced kidney function;
  • Stage 4 chronic kidney disease: Kidney function severely affected;
  • Stage 5 chronic kidney disease: Severely reduced kidney function or end-stage renal failure.

According to the stage of the disease, it is possible that the best form of treatment is indicated to relieve, control the symptoms and prevent the progression of the disease, since CKD has no cure. Thus, the use of medication, changes in eating habits and, in cases of stage 4 or 5 CKD, hemodialysis or kidney transplantation may be indicated.

How the treatment is done

The treatment for CKD aims to prevent the progression of the disease, preventing the development of kidney failure, in addition to being useful in relieving symptoms. The treatment indicated by the nephrologist may vary according to the general state of he alth of the person and the stage of CKD, and may be indicated:

1. Use of medication

Medicines can be indicated by the doctor in order to treat the cause of CKD and prevent some complications, being recommended mainly in cases where there is moderate to severe impairment of kidney function, such as:

  • Diuretics, such as Furosemide: indicated to increase urine production and decrease swelling;
  • Erythropoietin: is a hormone produced by the kidneys, which may be reduced in renal failure, which can cause anemia. Therefore, this hormone must be replaced if it is reduced and is responsible for anemia.
  • Nutritional supplementation: calcium and vitamin D supplements may be necessary to avoid the risk of fractures, deformities and bone pain, which are more common in patients with chronic kidney disease. Iron, folic acid, and vitamin B12 supplements may also be needed when there is anemia;
  • Remedies to control phosphate: dysregulation in phosphate levels can arise with kidney failure and alter bone metabolism, so the use of remedies that control its values, such as Calcium Carbonate, Aluminum Hydroxide or Sevelamer.

It is important that the medication is used according to the doctor's instructions, as it is possible to avoid renal overload, which can favor the development of insufficiency.

2. Change in power

It is also important to take some care with food so that there is no overload on the kidneys. Therefore, it is important to control the intake of s alt, phosphorus, potassium and proteins, and, in the most severe cases of CKD, it may also be necessary to control the consumption of liquids in general.

Thus, it is recommended that the person with chronic kidney disease is also accompanied by a nutritionist, who will be able to give more guidance on the appropriate amounts for each person, according to the kidney function and symptoms presented. Learn how the diet for kidney problems is made.

Check out the following video for some guidelines on how to eat for chronic kidney disease:

3. Dialysis

Dialysis is usually indicated in more severe stages of chronic renal failure, in which the kidneys do not work or work very little, with the accumulation of toxic substances in the body, as there is no adequate filtration of the blood. There are two types of dialysis:

  • Hemodialysis: this procedure filters the blood through a machine that has an artificial filter, replacing the function of the kidney. This type of dialysis is performed in the hospital or treatment center at least 3 times a week and the person must remain connected to the equipment for about 4 hours. However, the time and duration of dialysis will depend on the person's general state of he alth;
  • Peritoneal dialysis: in this type of dialysis, a liquid is used that is present in a bag that is connected to the peritoneum, which is the membrane that lines the abdomen, through a probe, acting as a filter to eliminate toxic substances present in the blood.This type of dialysis does not need to be performed in the hospital, it can be done at home, but it must be done every day, and it is necessary to meet some specific requirements to be able to perform this type of dialysis.

Dialysis allows you to correctly eliminate excess toxins, mineral s alts and excess fluids in the body.

4. Kidney transplant

Kidney transplantation is performed with the aim of restoring kidney function by replacing a diseased kidney with a he althy one, being indicated mainly in cases of stage 4 and 5 CKD, or in cases of patients who undergo several hemodialysis sessions per week.

Although it is the most effective treatment in the case of renal failure due to CKD, it is not always possible to perform a transplant, as it is not always possible to find a compatible donor, and it is also not indicated in the case of people who have other diseases, such as cirrhosis, heart changes and cancer, for example.Learn more about kidney transplantation.

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