CKD (chronic kidney disease) is a disease that usually follows nephropathy. According to statistics, this outcome with nephropathy is almost inevitable, although exceptions are possible. In most cases, neither the nature of the disease, nor any other features play a role. The treatment of CKD by stages is practiced, each of which has its own violation in the activity of a vital organ.
A correct approach can improve the quality of life and somewhat reduce the discomfort associated with impaired health. And yet you need to understand: from year to year, from decade to decade, the functioning of the kidneys will be less and less quality.
Disease: how is everything serious?
Currently, five stages of CKD are known. According to GFR, we can conclude how the state of a person is running. The doctor receives biological materials for research and, based on the results of laboratory findings, makes a decision: what stage the disease belongs to, how to approach the treatment process and how to improve the quality of life.
As a rule, a comprehensive treatment of the disease is practiced, since it is an approach that takes into account the patient’s general health and gives the best results. There are classic treatment options for the stage of albuminuria in CKD, and you can turn to modern innovative methods.
Sick or not?
Often questions like “Can CKD remain in stage 2” are asked by people who were diagnosed with the disease completely unexpectedly for themselves. According to statistics, the percentage of kidney disease sufferers in our country is very high, and for many problems are found in a rather neglected state.
Modern medical practice in Russia is such that large-scale preventive measures and timely detection of kidney diseases are not practiced, which is why literacy of the general population in this matter is minimal.
In developed countries, where the level of medical services is maintained traditionally high, the classification of CKD stages according to GFR does not present serious difficulties for doctors, and the population is regularly screened to identify the disease at the very beginning of its development. For this, so-called screening studies are organized. In the course of studying the features of the functioning of the kidneys, one can detect not only a chronic disease, but also other pathologies.
Statistical data
As shown by medical studies, at one stage or another, CKD is present in 10% of the world's population. In specific groups of individuals, the frequency doubles. At risk, in the first place, elderly people suffering from type 2 diabetes.
The extent of the problem can be concluded by comparing statistics for other common diseases. So, heart failure is diagnosed on average in one percent of the population, asthma in five percent of adults, and high blood pressure in almost a quarter of the world's population.
In terms of distribution, data on all stages of CKD are approximately comparable to the frequency of diagnosis of diabetes mellitus - the same ten percent (slightly less, slightly more).
How to evaluate?
More recently, the classification of CKD by stage has been very controversial. In fact, a generally accepted system did not exist, and advanced ideas were not applied in practice. In Russian clinics, they mainly resorted to the stage-by-stage CKD classification system developed by Ratner. A feature of this methodology was the orientation on the creatinine content. However, in some clinics this option was considered insufficiently accurate and correct, therefore, in practice, the system proposed by Professor Tareev was used. This specialist suggested determining the severity of the disease by the level of GFR.
A fairly common option for determining the stage of CKD was the method proposed by doctors Kuchinsky and Ryabov. This methodology was considered complex, and to this day they resort to it in some medical institutions. However, it has long been clear that a unified technique was needed that would be used centrally in all medical institutions. As a result, the CKD method developed in America in 2002 was chosen for general use.
What is it about?
As follows from the current terminology, CKD is a violation of the functionality of the kidneys, which provokes a decrease in organ activity for three months or more. CKD is a term that applies to various diagnoses. Violations are described as either structural or functional. To determine the stage of CKD, it is necessary to conduct specialized laboratory studies, in the framework of which, first of all, the GFR indicator is studied.
GFR (glomerular filtration rate) is an indicator that is monitored for suspected CKD for three months. If the value is less than 60 ml / min per 1.73 m 2 , they indicate the presence of chronic organ damage. The disease can be accompanied by damage to the kidneys or develop in the absence thereof.
CKD classification
Stage division is based on average GFR values. The lower normal indicator is equal to 90 ml / min, and the death of half of the nephrons is reflected in the analysis on GFR with a level of 60 ml / min or less. The first stage of the disease is characterized by a normal value or slightly higher than normal. When diagnosing such indicators, it is necessary to start treatment as soon as possible in order to prevent the situation from worsening.
The second stage of CKD is characterized by GFR indices in the range from 60 to 89 ml per minute. Treatment of CKD stage 3 is relevant if the indicator decreases to a value from the range of 30 to 59 ml. The fourth stage is characterized by GFR of 15-29 ml, and the fifth is characterized by values lower than 15 ml / min.
Age and features
It is known that in old age the normal rates of kidney function are slightly lower than in younger individuals. Therefore, it was found for people aged 60 years and older with a norm of 60-89 ml per minute. At this level, it is considered that there are no risk factors and such functioning is normal for the body.
Disease: what is it about?
CKD is a chronic violation of the kidneys, which over time leads to the development of insufficiency of the functioning of this body. Often, the disease in the first stages proceeds without symptoms, and the patient goes to the doctor in 4 stages. CKD treatment at this stage is a rather difficult task.
There are quite a few cases from medical practice in which CKD was detected at such a stage when either organ transplantation or hemodialysis could give the only tangible effect. This is the so-called terminal stage.
Kidneys: organ features
The kidneys are one of the paired organs in the human body. Location - retroperitoneal cavity. The kidneys are similar in shape to the fruits of beans, legumes, on average about 12 cm long. Around the kidneys is adipose tissue, which allows the organ to be held in an anatomically correct position. Abrupt weight loss, as well as insufficient weight can lead to degradation of adipose tissue, which provokes nephroptosis, omission of the organ.
A feature of the structure of the kidneys is the presence of two layers, the upper of which resembles a crust, and the inner one is called the cerebral. When studying a kidney in a section, you can see that the organ is formed by numerous tubes collecting fluid and directing it into the urine pelvis - a kind of collector. The kidneys consist of nephrons - capillary tangles enclosed in a capsule.
In normal condition, the kidney is a system of a million active nephrons that filter blood. The glomerular membrane during normal functioning blocks most blood components from entering the organ, but with a number of diseases, a violation occurs, and analyzes show the presence of leukocytes, red blood cells, and other components in the urine.
CKD: Symptoms
It is often difficult to suggest a chronic disease, especially at the beginning. In addition, the main manifestation, for example, 4 stages of CKD, herbal treatment allows you to hide. At the same time, such self-medication does not restore the normal functioning of the organ, but only masks the main manifestations of the disease, not allowing it to be detected on time. So it turns out that a lover of self-medication, having hidden his disease from himself and the doctors, is faced with the need to know at what stage of CKD hemodialysis is performed - after all, nothing else at the late stage of the disease’s development will simply help.
To avoid such an outcome, you should be careful about your body as much as possible and, if there are any doubtful signs, go to the doctor immediately and take tests to identify the cause.
The first symptom that should alert a person is a change in the volume of secretions. The amount of urine may become smaller than usual, which is associated with poor functioning of the organ. In some cases, the opposite happens: urine is produced in volumes exceeding the norm, which is accompanied by constant thirst.
The composition and color of urine under the influence of pathology also change: blood, sediment appears. Quite often, with CKD, the pressure in the kidneys increases, renin is released, due to which the pressure in general increases. A person feels weak, loss of appetite. This is due to toxicosis, provoked by insufficient purification of the blood by the kidneys. At the same time, the swelling of the limbs is disturbing, inflammatory processes occur in the kidneys.
Features of different stages
At the first stage, they say about kidney damage, while GFR remains normal or slightly higher than normal. It is not easy to determine the disease at this level of development - this is possible only with constant monitoring of human tests. There are practically no symptoms of the first stage.
In the second stage, GFR decreases, but not significantly. This is accompanied by organ damage.
Early symptoms are usually fixed in the third stage of the disease. Renal failure is manifested . A pronounced decrease is observed in the fourth stage, in medicine called preterminal. According to statistics, it is at this stage, accompanied by late symptoms of renal failure, that most patients come to the hospital.
Finally, treatment of stage 5 of CKD is the most difficult task, since this degree is the most neglected. Substitution therapy is needed here because it is about uremia.
CKD: causes and treatment
CKD is a term used to denote various diseases that provoke the same outcome - renal failure. Symptoms vary greatly depending on what pathology provoked CKD. Of course, treatment also significantly depends on why the kidneys were affected. As you know from medicine, most often the problem is in the inflammatory process that affects the organ.
At the moment, scientists were unable to find out why glomerulonephritis develops. It is only known that at risk are people who have had an upper respiratory tract infection. A virus introduced into the body or hereditary factors can play a role.
This disease often begins imperceptibly, proceeds quite secretively, and is detected completely by accident. As a rule, bilateral inflammation is manifested by the presence of red blood cells, a protein in the urine. In some cases, the pathology is accompanied by swelling, increased pressure.
Accurate diagnosis is possible by biopsy. Features of treatment are chosen, focusing on the specifics of glomerulonephritis in a particular case. The most common form of this disease is characterized by a gradual decrease in the quality of kidney function: the process lasts for decades, but the condition of the organ is steadily worsening.
Diabetes and kidney
As soon as a person has diabetes, he is immediately assigned to a risk group for the development of renal failure. Nephropathy is one of the most serious complications that accompany diabetes. Microalbuminuria is usually not accompanied by symptoms, complaints, so the onset of the disease is often missed. Proteinuria is accompanied by swelling of the extremities, the face may swell, and blood pressure rises. However, it so happened that due to a careless attitude to their health, many patients miss these symptoms, attributing them to the manifestations of diabetes.
In some cases, CKD is accompanied by vomiting and nausea, appetite completely disappears, the skin begins to itch, a person feels tired, forces leave him, and rest does not help to recover. The progress of the disease can be stopped at the stage of microalbuminuria, timely therapy allows you to return the kidneys to a healthy state and fully normalize functionality.
If the lesion is detected at the stage of proteinuria, there is a likelihood of blocking the progress of negative processes. If the pathology is diagnosed with CKD status, treatment becomes impossible. The only positive development is successful replacement therapy.
Infection and CKD
Inflammation of the kidneys in recent years occurs with a much greater frequency than several decades ago. Of the other bacterial diseases common to all ages, it is renal inflammation that is diagnosed most often.
In a healthy state, a person is known to have sterile urine, and the urinary tract is free of germs. If the source of the disease enters the urinary canals, bladder, an inflammatory process may begin. The disease is usually accompanied by painful sensations and an increased frequency of urination, and a burning sensation occurs during the release of the bladder from the fluid. When analyzing, it is noted that the urine is cloudy, often pinkish, due to the presence of red blood cells.
The progress of the disease is accompanied by fever, abdominal pain, back pain, as well as vomiting, nausea. Re-infection can occur without an increase in temperature. At the same time, it is known that in childhood it is often the temperature that is the only indicator of the presence of infection. Repeated inflammatory process is associated with a high probability of developing renal failure. Often secondary infection shows the progress of CKD.
Treatment: where to start?
The treatment of CKD shows more or less good results only when it was possible to correctly determine the reason for the development of the disease. If glomerulonephritis is detected, then immunosuppressive therapy is necessary, with diabetes, measures must be taken to eliminate the negative impact of this pathology on internal organs and systems. If CKD is caused by an inflammatory process, it is necessary to take antibiotics and undergo other systematic treatment.
For any root cause, a good effect will show compliance with a healthy lifestyle and proper nutrition. It is necessary to control the number of calories absorbed, to lead an active life, including moving quite a bit, although in accordance with age standards. The diet is selected, focusing on the root cause that provoked CKD. As a rule, the attending physician helps to choose the best option. It is necessary to carefully follow his recommendations. In addition, with CKD, you need to keep pressure under control and, if increased, take measures to eliminate the symptom.