Chronic Kidney Disease: Symptoms, Risks, And Prevention Tips

Chronic Kidney Disease (CKD) has emerged as a significant health concern in the Philippines, ranking among the leading causes of death in the country. The National Kidney Transplant Institute (NKTI) revealed that every hour, one Filipino is diagnosed with chronic renal failure, translating to an estimated 2.3 million Filipinos currently living with CKD, with projections indicating that 1 in 10 Filipinos will develop this life-threatening disease. Another unsettling fact is that CKD often presents no symptoms in its early stages, with many individuals only realizing they have the condition when it has progressed to a severe stage.

Raising awareness and expert insights

In a bid to combat CKD, patient organizations and medical societies celebrated the National Kidney Month with an event titled “It Starts With U: Get CheCKD,” held last June 29, 2024, at the Glorietta Activity Center in Makati. Supported by Boehringer Ingelheim (Philippines), Inc., the event aimed to educate Filipinos on the early detection and prevention of CKD.

During the event, experts emphasized the prevalence and dangers of CKD and provided practical advice on prevention. Dr. Maaliddin B. Biruar, a leading nephrologist, highlighted the challenge of early detection due to the absence of symptoms in the initial stages. “CKD is one of the most common chronic illnesses in the Philippines, and part of its danger is the difficulty in early detection since its symptoms don’t manifest until it’s too late. However, this condition can be easily mitigated by regular testing and adapting a few lifestyle changes,” said Dr. Biruar.

Dr. Rose Marie Rosete-Liquete, Executive Director of NKTI underscored the importance of early detection and regular medical consultations to prevent the progression of CKD, thereby ensuring better quality of life and productivity for patients. “By addressing the risk factors of CKD, such as hypertension and diabetes mellitus, we can also reduce the socioeconomic burden of treating end-stage CKD,” she said.

What is Chronic Kidney Disease?

Chronic kidney disease, also known as chronic kidney failure, refers to the gradual loss of kidney function. Kidneys are primarily responsible for filtering our body’s wastes and excess fluids, removing them via our urine. When kidneys fail to function properly, dangerous levels of waste and fluid can build up in the body. CKD can progress to end-stage renal disease (ESRD), which is fatal without dialysis or a kidney transplant. CKD can also increase the risk of other health problems like heart disease and stroke.

Symptoms of Chronic Kidney Disease

Chronic Kidney Disease can often go unnoticed until it reaches an advanced stage. However, here are some symptoms that can signal kidney problems:

• Nausea
• Vomiting
• Loss of appetite
• Fatigue and weakness
• Sleep problems
• Urinating more or less
• Decreased mental sharpness
• Muscle cramps
• Swelling of feet and ankles
• Dry, itchy skin
• High blood pressure (hypertension) that’s difficult to control
• Shortness of breath, if fluid builds up in the lungs
• Chest pain, if fluid builds up around the lining of the heart

Signs and symptoms of kidney disease are often nonspecific and can also be caused by other illnesses. 

People who might have more advanced stages of CKD might also experience:

• Trouble concentrating
• Numbness or swelling in arms, legs, ankles, or feet
• Achy muscles or cramping
• Shortness of breath
• Vomiting
• Trouble sleeping
• Breath smells like ammonia (or urine-like or “fishy”)

Causes and risk factors of Chronic Kidney Disease

Anyone can develop CKD at any age, but people who might have a higher risk for the disease include those with:

• Diabetes
• High blood pressure (hypertension)
• Heart disease and/or heart failure
• Obesity
• Aged 60 and above
• Family history of CKD or kidney failure
• Personal history of acute kidney injury (AKI)
• Smoking and/or use of tobacco products

Many people diagnosed with CKD attribute the illness to several physical, environmental, and societal factors. Early detection is key; knowing the risk factors can help you understand your level of risk and whether you should get checked for CKD.

Other causes

CKD can also be caused by other conditions or circumstances, such as:

• Glomerular diseases: glomerulonephritis, IgA nephropathy (IgAN), and HIV nephropathy
• Inherited conditions: polycystic kidney disease
• Autoimmune conditions: lupus (lupus nephritis)
• Severe infections: sepsis and hemolytic uremic syndrome (HUS)
• Other causes: kidney cancer, kidney stones, frequent untreated and/or long-lasting urinary tract infections (UTIs), hydronephrosis, and kidney and urinary tract abnormalities before birth

Diagnosis of Chronic Kidney Disease

Tests and procedures typically needed to diagnose kidney disease include:

• Blood tests: Kidney function tests assess the level of waste products, such as creatinine and urea, in your blood.
• Urine tests: Analyzing a sample of your urine can reveal abnormalities that can point to chronic kidney failure and help identify the cause of CKD.
• Imaging tests: Ultrasounds can be used to assess the kidney’s structure and size. Other imaging tests can also be used.
• Kidney biopsy: In some cases, a small sample of kidney tissue is examined for signs of damage or disease. This is often done using local anesthesia; a long thin needle inserted through the skin and into the kidney. The sample is then sent to a lab for testing.

How to manage and treat Chronic Kidney Disease

Managing CKD involves slowing its progression, treating underlying causes, and managing its symptoms to improve quality of life. Strategies include:

Lifestyle changes

Changes in diet: Reducing sodium, potassium, and phosphorus intake can help manage CKD. A diet low in processed foods and high in fruits and vegetables is often recommended.

Regular exercise: Physical activity can help control blood pressure and blood sugar levels.

Avoid smoking and limit alcohol: These activities can further damage the kidneys and worsen the CKD symptoms.

Medications

Blood pressure medications: ACE inhibitors or ARB can help control blood pressure and reduce kidney damage.

Diabetes medications: Managing blood sugar levels is important.

Cholesterol-lowering drugs: These are used to reduce the risk of cardiovascular disease, which is common in CKD patients.

Anemia management: Medications and supplements that boost red blood cell production are also used, as anemia is common in CKD patients.

Dialysis and kidney transplant

These might be necessary for advanced CKD or ESRD patients:

Hemodialysis: Blood is filtered outside the body using a machine.

Peritoneal dialysis: The blood is filtered inside the body using the lining of the abdomen.

Kidney transplant: Replacing the diseased kidney with a healthy one from a donor.

Preventing Chronic Kidney Disease

CKD prevention involves managing risk factors and maintaining a healthy lifestyle, which can include the following:

• Regular health check-ups: Early detection through regular blood and urine tests.
• Control blood sugar and blood pressure: These are key in preventing diabetes and hypertension-related kidney damage.
• Healthy diet: Low in salt, minimal processed foods, and rich in fruits, vegetables, and whole grains.
• Stay hydrated: Drinking plenty of water helps kidneys clear sodium and toxins.
• Avoid overuse of painkillers: Excessive use of painkillers such as ibuprofen can damage kidneys.
• Quit smoking: Smoking slows blood flow to the kidneys, impairing their function.

Ultimately, regular check-ups, lifestyle changes, and awareness are essential in combating CKD. As Dr. Greta Cortez from Boehringer Ingelheim Philippines said, “Accessible tools and education are essential in combating CKD. With tools like ItStartsWithYou.com.ph, we can empower Filipinos with the knowledge and understanding for detecting CKD early and managing it effectively.”

Read here for symptoms that could potentially mean kidney problems.