Chronic kidney disease

     Chronic kidney disease is a condition in which the kidneys are damaged, leading to a failure of kidney functions such as maintaining fluid balance, controlling water and mineral levels in the blood, removing waste products from the blood, and eliminating drugs and toxins from the body. Secretion of hormones into the bloodstream, etc.

Causes of chronic kidney disease

• Genetics
• Other diseases that affect the kidneys, such as high blood pressure, diabetes, etc.
• Eating spicy food (salty, sweet, or spicy)
• Nephritis
• Autoimmune diseases
• Gallstones
• Virus, Cancer

Symptoms of Chronic Kidney Disease

There are almost no warning signs of kidney disease in the early stages, with symptoms usually appearing in the late stages when the kidneys have already suffered significant damage.

• Blood and urine: Normally, urine color should be light or dark yellow, which depends on the amount of water consumed. However, if the urine is found to be bloody, this may be caused by a urinary tract infection, kidney stones, or tumors in the urinary tract.
• Frothy urine: This is due to the leakage of albumin protein in the urine, which is often a symptom of chronic kidney disease.
• Frequent night urination: People with kidney disorders will not be able to absorb water back into the bladder normally, which causes them to urinate more often than usual.
• Swelling: Face and feet swelling
• Fatigue: Weakness, lack of concentration
• Weight loss or swollen body: leading to weight gain  
• Pale, itching skin: Blood blotches
• Loss of appetite: Bitter tongue; Inability to taste

Stages of Chronic Kidney Disease

Chronic kidney disease is divided into 5 stages.

• Stage 1: When the kidneys begin to deteriorate (a protein found in urine). Normal kidney function level or GFR at approximately 90 or more.
• Stage 2: Renal impairment: Kidney function or GFR is slightly reduced at approximately 60-89.
• Stage 3: Moderate decrease in kidney function or GFR at approximately 30-59.
• Stage 4: Renal function or GFR  is significantly reduced at approximately 15-29.
• Stage 5: Renal failure GRF level is lower than 15, eGFR level (estimated Glomerular Filtration Rate) is the amount of blood flowing through the kidney filter in one minute (ml/min/1.73 m²).

Treatment of Chronic Kidney Disease

1.  Treatment to decelerate renal degeneration

• Control underlying diseases, including diabetes and high blood pressure.
• Control diet by reducing salty foods, and ensuring sufficient protein intake to receive appropriate energy
• Treatment with medications such as phosphate absorption suppressants, diuretics, anemia medications, antihypertensive drugs, blood lipid-lowering medication, and pH-balancing medication
• Behavior modifications such as weight loss, abstinence from smoking, regular exercise, and avoiding medications that hurt the kidneys.

2.  Renal Replacement Therapy

The treatment process for patients with stage 5 chronic kidney disease is to replace the kidneys that cannot function. The process helps to eliminate waste and fluid in the body. There are three options below:

• Hemodialysis: Blood flows through vascular access into a dialyzer with a filter to eliminate waste and excess water, and return the dialyzed blood into the patient’s body.
• Peritoneal dialysis: A cleansing fluid called dialysate passes through a catheter tube into part of the abdomen known as the peritoneal cavity. At the end of the specified time, the dialysate is discharged filled with waste and excess water, and replaced with a new bag of dialysate. The patient must undergo surgery to insert a catheter tube for peritoneal dialysis solution before the treatment.
• Kidney transplantation: a surgery to transplant a good kidney from a donor into the kidney recipient. Currently, kidney transplantation is considered the most effective dialysis treatment and helps to improve the patient's quality of life.