Renal disease affects 26 million people in the United States and another 20 million people are at risk for developing it, according to the National Kidney Foundation. To deal with the crisis, the National Kidney Foundation redefined renal disease in 2002 and introduced a more effective system to manage it. Detecting and treating renal disease early are essential for effective management of the disease.
Definition
According to the National Kidney Foundation, the persistent reduction in kidney function or glomerular filtration rate (GFR) defines renal disease. GFR is a numerical value used for measuring kidney function and is used by doctors to stage and manage renal disease. Renal or kidney damage causes protein to be spilled in the urine. Patients with persistent protein in the urine are also defined as having renal disease.
Risk Factors
"Diabetes and high blood pressure are the leading causes of kidney failure," states the National Kidney Disease Education Program, or NKDEP. Therefore, patients who have diabetes and high blood pressure are at risk for developing renal disease. People who have family members with a history of renal disease are also at higher risk for developing the disease. Other factors such as polycystic kidney disease, trauma to the kidneys, ingestion of painkillers such as acetaminophen and ibuprofen can all cause renal disease. Patients who suffer heart disease are also susceptible to renal disease.
Tests
Some important tests used for renal disease, according to the NKDEP, include urine albumin or protein, blood pressure, creatinine and GFR. A positive urine test for albumin can specify a patient with early renal disease. Renal insufficiency causes a waste product called creatinine to accumulate in blood; therefore creatinine is a test for renal disease. The National Kidney Foundation considers GFR the best test to measure the level of renal function. A person's age, weight, gender and level of creatinine are entered into a GFR calculator to generate a number which represents the level of renal function.
Complications
The National Kidney Foundation notes that renal disease causes many complications. Abnormal renal function causes abnormal levels of calcium, phosphorus and vitamin D. These abnormalities lead to bone disease. Anemia, which is a decrease in the number of red blood cells, is also caused by renal disease; the effects of anemia can significantly reduce patients' quality of life. Renal disease can also lead to poor nutritional health. By the time renal patients reach end stage renal failure, they are normally on protein-restricted diets. Too much dietary protein can stress the kidney. However, inadequate intake of protein and calories causes poor nutrition in renal disease. Trying to manage protein intake and nutrition involves a delicate balancing act for nutritionists.
Prevention/Solution
Preventing progression of renal disease is possible, says the National Kidney Foundation. Early treatment of renal disease slows progression and reduces the possibility of developing heart disease and kidney failure. According to guidelines developed by the National Kidney Foundation in 2005 on blood pressure in renal disease, ACE inhibitors or angiotensin receptor blockers (ARBs) slow progression of renal disease. Renal disease patients who have diabetes and high blood pressure should take ACE inhibitors or ARBs. Renal disease patients should aim to keep their blood pressure below 130/80 mm Hg. Patients with diabetes should also keep their glucose levels within the normal range.
References
- National Kidney Foundation: Chronic Kidney Disease
- National Kidney Disease Education Program: Chronic Kidney Disease (CKD) Information
- National Kidney Foundation: Keeping in Control: Lowering Your Risk for Kidney and Heart Disease
- National Kidney Foundation: Clinical Practice Guidelines on Hypertension. Guideline 7
- National Kidney Disease Education Program: Protein
