Chronic Kidney Disease 101: Causes, Symptoms and Care

Kidney disease is not one single disease, but a range of conditions that impair your kidneys’ ability to filter fluid and waste from the bloodstream. Kidney disease affects as many as one in ten Australians, though this number may be much higher as kidney disease is considered to be underdiagnosed. 

Kidney disease often presents no obvious symptoms until kidney function has already been seriously depleted. When the kidneys can no longer filter waste and fluid from the blood, they build up in the body leading to further health complications. Kidney disease can be serious, but the earlier it is caught the more effective treatment can be.

Two of the most common risk factors for kidney disease are having diabetes and/or high blood pressure. Therefore, lifestyle changes that prevent these conditions can also reduce your risk of kidney disease. Knowing how to keep your kidneys healthy can help you avoid developing chronic kidney disease, or effectively manage your condition if you are already diagnosed.

What is chronic kidney disease?

Your kidneys are a pair of small organs that are shaped like beans. They play a vital role in your body, acting as your internal waste filtration and removal system. Kidneys work hard to keep waste, water and unwanted chemicals out of the body by flushing them out of the bloodstream into your urine. Healthy kidney function is essential to good overall health, as they regularly perform four important biological functions:

1. Cleaning the blood and replenishing the body with a fresh blood supply. The kidneys filter the blood around 12 times every hour, amounting to processing about 200 litres of blood every day.
2. Clearing excess fluid and unwanted chemicals from the blood through the urine. The kidneys detoxify your body by clearing around one to two litres of urine each day.
3. Maintaining healthy blood pressure by controlling the expansion and contraction of your blood vessels.
4. Managing the body’s production of Vitamin D, a nutrient that is important for bone health and red blood cell production.

Chronic kidney disease is not one singular illness, but a collection of conditions that impair the function and health of the kidneys. Chronic kidney disease (CKD) impedes the effective filtration and elimination of waste from the blood by the kidneys, which indicates poor kidney function. It can also cause leakages of protein or albumin in the urine, which is a sign of potential kidney damage. To be considered chronic, kidney disease must be present for three months or longer.

Symptoms of chronic kidney disease

Kidney disease is a serious condition, made worse by the fact that it often goes unnoticed until it has become advanced. Kidney disease is sometimes referred to as a ‘silent disease’ due to its subtle or non-existent warning signs. The symptoms of kidney disease can be quite generic and difficult to pick up on, so it is important to know what to look for. Symptoms for kidney disease can include:

• Hypertension or high blood pressure
• Urine changes – such as increased frequency, change in appearance (colour), or changes to the volume of urine being passed
• Pain or burning sensation when urinating
• Inflamed or swollen legs and ankles
• Blood in the urine
• Pain in the kidney area (located in the lower back on either side of your spine)
• Fatigue or unexplained tiredness
• Reduced appetite
• Sleeping difficulties or insomnia
• Headaches
• Nausea and/or vomiting
• Brain fog or difficulty concentrating
• Itching
• Bad breath
• Metallic taste in the mouth
• Shortness of breath and breathing difficulties

It is important to seek medical advice if you or a loved one is experiencing any of these symptoms. Early diagnosis and management is essential for the immediate and long term wellbeing of people with kidney disease. Concerningly, people can lose up to 90% of their kidney function before developing more severe symptoms, so do not delay seeking treatment until your kidneys may have progressed to a later stage of disease.

The stages of chronic kidney disease

Without timely intervention, kidney disease is generally progressive, meaning that it becomes more severe over time. The stage, or severity of your kidney disease will determine the treatment and management strategies that are appropriate for you. The stage of an individual’s chronic kidney disease can be determined by testing:

• Blood pressure
• The blood’s estimated glomerular filtration rate (eGFR)
• The blood’s albumin : creatinine ratio (ACR)

The stages of chronic kidney disease are outlined below.

Adapted from American Kidney Fund

The causes of chronic kidney disease

Chronic kidney disease can be caused or exacerbated by a range of factors. In Australia, the most common cause of chronic kidney disease is diabetes. Approximately one quarter of all cases of diagnosed chronic kidney disease is present in people with diabetes, which is sometimes referred to as diabetic nephropathy. In diabetic individuals, there is often a higher than normal blood sugar level. High levels of glucose (sugar) in the blood can damage the blood vessels in the kidneys, leading to impaired function. Given its status as a significant risk factor for developing kidney disease, people with diabetes should take care to effectively manage their condition to avoid further complications.

Some other important risk factors for chronic kidney disease are:

• Hypertension (high blood pressure)
• Heart failure
• History of having had a heart attack or stroke
• Being overweight or obese
• Lifetime smoking status (i.e. current or past smoker)
• Glomerulonephritis – an inflammation of the kidneys which can occur following an infection, or in some cases be hereditary
• History of kidney infection, cyst or injury
• Being of Aboriginal or Torres Strait Islander origin
• Being aged over 60 – your risk of kidney disease increases with age, making kidney health screening an important part of aged care nursing and health appointments
• History of misuse of substances including some painkillers, prescription medicines and illegal drugs

Ways to improve kidney function as you age

Chronic kidney disease typically progresses with time. The damage already done to the kidneys is usually irreversible, however there are lifestyle changes you can make to protect your kidney health, prevent chronic kidney disease or slow its progression if you are already diagnosed. Preventative strategies for chronic kidney disease include:

• Quit smoking
• Keep alcohol consumption moderate (consuming no more than two standard drinks per day)
• Adhere to medicinal treatment plans for existing conditions like hypertension, diabetes and high cholesterol
• Stay physically active on most days – as age is a risk factor for chronic kidney disease, it is important to find safe ways to stay active even in your later life
• Maintain a healthy weight
• Manage stress – psychosocial stress has been linked with poorer renal function, so it is important to manage your stress to keep cortisol levels safe
• Get regular check ups with your doctor to identify any additional risk factors
• Consume a diet rich in varied, nutritious food

Dietary changes to prevent or manage chronic kidney disease

Eating a healthy diet is one important way of managing your risk of chronic kidney disease. You should aim to consume a varied selection of fruit and vegetables, wholegrain foods, lean sources of protein, nuts and seeds, beans and legumes and low-fat fairy products or calcium-enriched dairy alternatives each day. 

You should also try to limit your sodium intake, as excess salt consumption can increase your risk of high blood pressure. Keeping salt intake to 6 grams or 6000mg of sodium per day is recommended. You should also try to limit your intake of saturated fats and trans fats, as well as following any dietary protocols prescribed to manage co-existing conditions such as diabetes.

Caring for a loved one with chronic kidney disease

Receiving a diagnosis of chronic kidney disease can be a shock, for the person being diagnosed and for their family, friends and loved ones. Chronic kidney disease can be life changing, requiring you to adapt to changes to your physical abilities, medication regimes and your energy levels. It can also take a toll on your mental health, due to the fear or anxiety you may experience about your condition or that of someone near and dear to you. If you care for a loved one who is living with chronic kidney disease, you may be at risk of carer fatigue or stress. It is important to take care of yourself, even when you are taking care of someone else. 

Kidney Health Australia is a central source of support and information for people living with kidney disease, as well as their loved ones. They provide services such as an informative helpline, and peer support groups for people living with kidney disease, or those who provide unpaid care to someone with kidney disease. Talking to other people with a lived experience of what you are going through can offer emotional support, peace of mind, and reassurance that you are not alone.

Taking a break from caring can also help you recharge your batteries so that you are at your best and able to provide the best care for your loved one. You can rest easy taking a well-deserved break knowing that our professional and highly trained team are ready to step in to provide expert respite care whenever and wherever you need it.

Chronic kidney disease can also put you at risk of other conditions such as stroke. People living with renal disease, especially cases severe enough to require dialysis, can be at a much higher risk for stroke than the general population. People living with kidney disease should take care to get regular screenings for other health conditions that may be exacerbated by poor kidney function. 

Kidney disease can also reduce how much energy you have to do things like attend your regular screening or check-up medical appointments. Homage can assist you to stay on top of your health by supporting you with high quality, expert nursing care services from the safety of your own home. Knowing that our team of compassionate and qualified Care Professionals are there to help you manage your medical care allows you and your loved ones to spend your precious time and energy doing the things that matter most to you.

Our Care Pros can support you and your loved one through the different stages of dementia. If you need kidney disease care support, reach out to our Care Advisors at 0480 093 788 to learn more.