2.  The bodily system consisting of the organs that produce, collect, and
eliminate urine and including the kidneys, ureters, urinary bladder, and
urethra
 Chronic kidney disease is the slow loss of kidney functions
.
 Chronic kidney disease (CKD) slowly gets worse over time. In the early
stages, there may be no symptoms. The loss of function usually takes
months or years to occur. It may be so slow that symptoms do not appear
until kidney function is less than one-tenth of normal.
 The final stage of chronic kidney disease is called end-stage renal disease
(ESRD). At this stage, the kidneys are no longer able to remove enough
wastes and excess fluids from the body. The patient needs dialysis or a
kidney transplant.
 Diabetes and high blood pressure are the two most common causes and
account for most cases.

3. conditions can damage the kidney
 Autoimmune disorders (such as systemic lupus
erythematous and scleroderma
 Birth defects of the kidneys (such as polycystic kidney
disease
Certain toxic chemicals
 Glomerulonephritis
 Injury or trauma
 Kidney stones and infection
 Problems with the arteries leading to or inside the kidneys
Some pain medications and other drugs
 Reflux nephropathy (in which the kidneys are damaged by
the backward flow of urine into the kidneys)Other kidney
diseases
This condition affects most body systems and functions,
including:
Blood pressure control

4. Symptoms
 Appetite loss
 General ill feeling and fatigue
 Headaches
 Itching (pruritus) and dry skin
 Nausea
 Weight loss without trying to lose
weight
 Abnormally dark or light skin
 Bone pain
 Brain and nervous system symptom
 Drowsiness and confusion
 Problems concentrating or thinking
 Muscle twitching or cramps
 Breath odor
 Easy bruising, bleeding, or blood in
the stool
 Excessive thirst
 Frequent hiccups
 Low level of sexual interest and
impotence
 Menstrual periods stop
(amenorrhea)
Shortness of breath
 Swelling of the feet and hands
(edema)
 Vomiting, typically in the morning
Numbness in the hands, feet, or
other
areas

5. • Exams and Tests
 High blood pressure is almost always present during all
stages of chronic kidney disease. A nervous system
exam may show signs of nerve damage.
 The health care provider may hear abnormal heart or
lung sounds when listening with a stethoscope.
 A urinalysis may show protein or other changes. These
changes may appear 6 months to 10 or more years
before symptoms appear.

6.  Tests that check how well the kidneys are working include:
 Creatininen clearance
 Creatininen levels
 BUN -blood urea nitrogen test
Chronic kidney disease changes the results of several other tests. Every
patient needs to have the following checked regularly, as often as every
2 - 3 months when kidney disease gets worse:
 Albumin
 Calcium
 Cholesterol
 Full blood count
 Electrolytes
 Magnesium

7.  Phosphorous
 Potassium
 Sodium
Causes of chronic kidney disease may be
seen on:
 Abdominal CT scan
 Abdominal MRI
 Abdominal ultrasound
 Kidney biopsy
 Kidney scan
 Kidney ultrasound
 This disease may also change the
results of the following tests:
 Erythropoietin
 PTH
 Bone density test
 Vitamin D

8. Home Treatments
 Keep your blood pressure below 130/80. Learn to check your blood
pressure at home.
 High Blood Pressure: Checking Your Blood Pressure at Home.
If you have diabetes, keep your blood sugar within a target range.
Diabetes: Checking Your Blood Sugar.
 Stay at a healthy weight. This can also reduce your risk for coronary
artery disease, diabetes, high blood pressure, and stroke. For more
information, see the topic Weight Management.
 Follow the eating plan your dietitian created for you. Your eating plan
will balance your need for calories with your need to limit certain
foods, such as sodium, fluids, and protein.
Kidney Disease: Changing Your Diet.

9.  Make exercise a routine part of your life. Work with your
doctor to design an exercise program that is right for you.
Exercise may lower your risk for diabetes and high blood
pressure.
 Don't smoke or use other tobacco products. Smoking can
lead toatherosclerosis, which reduces blood flow to the
kidneys and increases blood pressure. For more
information on how to quit, see the topic Quitting Smoking.
 Don't drink alcohol or use illegal drug

10. Refinances
Tonelli M, Pannu N, Manns B. Oral phosphate binders in patients with
kidney failure. N Engl J Med. 2010;362:1312-1324.
Abboud H, Henrich WL. Clinical practice. Stage IV chronic kidney
disease. N Engl J Med. 2010;362:56-65.
Upadhyay A, Earley A, Haynes SM, Uhlig K. Systematic review: blood
pressure target in chronic kidney disease and proteinuria as an effect
modifier. Ann Intern Med. 2011;154:541-548.
KDOQI. KDOQI Clinical Practice Guideline and Clinical Practice
Recommendations for anemia in chronic kidney disease: 2007 update of
hemoglobin target. Am J Kidney Dis. 2007; 50:471-530.
KDOQI; National Kidney Foundation II. Clinical practice guidelines and
clinical practice recommendations for anemia in chronic kidney disease in
adults. Am J Kidney Dis. 2006;47(5 Suppl 3):S16-S85.
Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical
practice guidelines on hypertension and antihypertensive agents in
chronic kidney disease. Am J Kidney Dis. 2004; 43(5 Suppl 1):S1-S290.