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  1. 1.  The bodily system consisting of the organs that produce, collect, andeliminate urine and including the kidneys, ureters, urinary bladder, andurethra Chronic kidney disease is the slow loss of kidney functions. Chronic kidney disease (CKD) slowly gets worse over time. In the earlystages, there may be no symptoms. The loss of function usually takesmonths or years to occur. It may be so slow that symptoms do not appearuntil 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 enoughwastes and excess fluids from the body. The patient needs dialysis or akidney transplant. Diabetes and high blood pressure are the two most common causes andaccount for most cases.
  2. 2. conditions can damage the kidney Autoimmune disorders (such as systemic lupuserythematous and scleroderma Birth defects of the kidneys (such as polycystic kidneydiseaseCertain toxic chemicals Glomerulonephritis Injury or trauma Kidney stones and infection Problems with the arteries leading to or inside the kidneysSome pain medications and other drugs Reflux nephropathy (in which the kidneys are damaged bythe backward flow of urine into the kidneys)Other kidneydiseasesThis condition affects most body systems and functions,including:Blood pressure control
  3. 3. Symptoms Appetite loss General ill feeling and fatigue Headaches Itching (pruritus) and dry skin Nausea Weight loss without trying to loseweight 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 inthe stool Excessive thirst Frequent hiccups Low level of sexual interest andimpotence Menstrual periods stop(amenorrhea)Shortness of breath Swelling of the feet and hands(edema) Vomiting, typically in the morningNumbness in the hands, feet, orotherareas
  4. 4. • Exams and Tests High blood pressure is almost always present during allstages of chronic kidney disease. A nervous systemexam may show signs of nerve damage. The health care provider may hear abnormal heart orlung sounds when listening with a stethoscope. A urinalysis may show protein or other changes. Thesechanges may appear 6 months to 10 or more yearsbefore symptoms appear.
  5. 5.  Tests that check how well the kidneys are working include: Creatininen clearance Creatininen levels BUN -blood urea nitrogen testChronic kidney disease changes the results of several other tests. Everypatient needs to have the following checked regularly, as often as every2 - 3 months when kidney disease gets worse: Albumin Calcium Cholesterol Full blood count Electrolytes Magnesium
  6. 6.  Phosphorous Potassium SodiumCauses of chronic kidney disease may beseen on: Abdominal CT scan Abdominal MRI Abdominal ultrasound Kidney biopsy Kidney scan Kidney ultrasound This disease may also change theresults of the following tests: Erythropoietin PTH Bone density test Vitamin D
  7. 7. Home Treatments Keep your blood pressure below 130/80. Learn to check your bloodpressure 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 coronaryartery disease, diabetes, high blood pressure, and stroke. For moreinformation, see the topic Weight Management. Follow the eating plan your dietitian created for you. Your eating planwill balance your need for calories with your need to limit certainfoods, such as sodium, fluids, and protein.Kidney Disease: Changing Your Diet.
  8. 8.  Make exercise a routine part of your life. Work with yourdoctor to design an exercise program that is right for you.Exercise may lower your risk for diabetes and high bloodpressure. Dont smoke or use other tobacco products. Smoking canlead toatherosclerosis, which reduces blood flow to thekidneys and increases blood pressure. For moreinformation on how to quit, see the topic Quitting Smoking. Dont drink alcohol or use illegal drug
  9. 9. RefinancesTonelli M, Pannu N, Manns B. Oral phosphate binders in patients withkidney failure. N Engl J Med. 2010;362:1312-1324.Abboud H, Henrich WL. Clinical practice. Stage IV chronic kidneydisease. N Engl J Med. 2010;362:56-65.Upadhyay A, Earley A, Haynes SM, Uhlig K. Systematic review: bloodpressure target in chronic kidney disease and proteinuria as an effectmodifier. Ann Intern Med. 2011;154:541-548.KDOQI. KDOQI Clinical Practice Guideline and Clinical PracticeRecommendations for anemia in chronic kidney disease: 2007 update ofhemoglobin target. Am J Kidney Dis. 2007; 50:471-530.KDOQI; National Kidney Foundation II. Clinical practice guidelines andclinical practice recommendations for anemia in chronic kidney disease inadults. Am J Kidney Dis. 2006;47(5 Suppl 3):S16-S85.Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinicalpractice guidelines on hypertension and antihypertensive agents inchronic kidney disease. Am J Kidney Dis. 2004; 43(5 Suppl 1):S1-S290.