Chronic renal disease affects 26 million people in the United States, according to 2010 information from the National Kidney Foundation, and is a leading cause of death. Because of this epidemic, the National Kidney Foundation revised its definition and management of renal disease into stages in 2002. Earlier detection and treatment of renal disease is key to both slowing the progression of the disease and effective management of its complications.
Definition
Chronic renal disease is a condition where the kidneys have been damaged by other disorders such as diabetes and high blood pressure. Damaged kidneys allow the build-up of waste products and fluids in the blood, making a person feel sick. Having renal disease increases a person’s risk of heart disease. Other complications of renal disease include high blood pressure, anemia, weak bones, nerve damage and poor nutrition. These complications eventually lead to renal failure.
Stages
The National Kidney Foundation has classified renal disease into five stages. Stage 1 represents the earliest stage, and some patients don’t even know they have it. Stage 5 is renal failure. Patients in stage 5 renal disease need dialysis or a kidney transplant to survive. A doctor can determine what stage a patient is in by testing kidney function and kidney damage. The stage of renal disease determines what kind of treatment a patient receives.
Symptoms
Patients in the earlier stages of renal disease, such as stage 1 and 2, typically have very few symptoms. However, symptoms become more severe when a patient reaches stage 3. Symptoms of renal disease include nausea, vomiting, increased urination, swelling in the hands, itchiness, numbness, muscle cramps, fatigue, loss of appetite and trouble concentrating. Symptoms worsen and become more intense as patients progress to stage 5 renal disease.
Early Detection
Earlier detection of renal disease is key to effective management. It allows more time for treating renal disease, which slows kidney function decline. Once the kidneys are damaged the damage cannot be reversed. Preventing more damage to the kidneys is the goal. According to a report by Dr. Joseph Vassalotti, Chief Medical Officer, National Kidney Foundation, renal disease “is usually silent until its late stages”. Many patients with renal disease are detected only shortly before the onset of renal failure and then it’s too late. The National Kidney Foundation has a free screening program called the Kidney Early Evaluation Program, or KEEP, for people who think they are at risk for renal disease.
Treatment
The treatment of renal disease depends on other problems the patient may have, and the stage of renal disease. Diabetes and high blood pressure, for example, are the leading causes of renal disease. These conditions damage the kidneys. Controlling diabetes and high blood pressure is key to controlling further damage to kidneys and preventing heart disease. Treating abnormal cholesterol can also reduce the risk of heart disease. Patients in stage 5 renal disease are typically much sicker than patients in stage 1 renal disease, and they take multiple medications and have much stricter diets. Treatment of complications such as bone disease, anemia, poor nutritional health and nerve damage start in the mid to late stages of renal disease.
