Chronic kidney disease (CKD) is one of the most silent health problems there is. The kidneys have an enormous functional reserve, so they can lose much of their function before the first clear symptom appears. By the time that symptom arrives, a good deal of the damage is already done. That is why the central message of this article is simple: when it comes to the kidney, prevention and early diagnosis are almost everything.
What chronic kidney disease is
We speak of CKD when the kidneys show an alteration in their structure or function for more than three months. It is measured mainly by two parameters: the glomerular filtration rate, which estimates how much blood the kidneys can clear, and the presence of protein (albumin) in the urine, which indicates that the kidney's filter is damaged.
CKD is classified into stages, from 1 to 5, according to that filtration rate. In the early stages the goal is to slow progression; in the more advanced ones, renal replacement therapy (dialysis or transplant) is prepared if needed.
The early signs
CKD rarely hurts. Its clues are subtler and shouldn't be dismissed:
- Changes in the urine: persistent foam (a sign of protein), urinating more at night, or changes in volume.
- Swelling: in the ankles, legs or around the eyes, from fluid retention.
- Fatigue and poor concentration: linked to the anaemia that accompanies CKD.
- Blood pressure that is hard to control: often the first warning of a struggling kidney.
- Persistent itching or cramps: more common in advanced stages.
The kidney doesn't warn you with pain; it warns you with lab tests. A simple check-up can get ahead of the problem by years.
Who should keep an eye on their kidneys
Some people are at higher risk and benefit especially from regular checks:
- People with high blood pressure or diabetes, the two leading causes of CKD.
- A family history of kidney disease.
- People over 60.
- Cardiovascular disease or obesity.
In these cases, a blood and urine test once a year is usually enough to detect any alteration in time.
What can be done
The good news is that the progression of CKD can be slowed, especially if we act early. The most effective measures are also the best known: controlling blood pressure and glucose well, looking after diet by cutting excess salt, staying active, avoiding tobacco and using anti-inflammatory drugs sparingly. In recent years, moreover, we have medicines that protect the kidney and have changed the outlook for many patients.
Follow-up by the nephrologist makes it possible to tailor treatment to each person and anticipate complications. CKD does not mean immediate dialysis at all: it means looking after the kidneys so they last a lifetime.