Kidney disease, specifically Chronic Kidney Disease (CKD), is often called a “silent” condition because it frequently shows no symptoms until the kidneys are significantly damaged. Early diagnosis is key to slowing its progression.
Below is an overview of how kidney disease is typically identified and managed.
1. Diagnosis: Key Tests
Doctors primarily use three types of assessments to determine how well your kidneys are functioning.
Blood Tests
- eGFR (Estimated Glomerular Filtration Rate): This is the “gold standard” for measuring kidney function. It calculates how many milliliters of blood your kidneys filter per minute.
- Normal: 90 or higher.
- Kidney Disease: Below 60 for three months or more.
- Serum Creatinine: Measures the level of creatine, a waste product from muscle breakdown. High levels in the blood suggest the kidneys aren’t filtering it out effectively.
- BUN (Blood Urea Nitrogen): Measures nitrogen in the blood that comes from the breakdown of protein.
Urine Tests
- uACR (Urine Albumin-to-Creatinine Ratio): This checks for albumin, a protein that should stay in the blood. If it’s in your urine, it indicates the filters in your kidneys are damaged.
- Urinalysis: A general screen for blood, protein, or signs of infection.
Imaging & Biopsy
- Ultrasound/CT Scan: Used to look at the size and structure of the kidneys to check for blockages, stones, or tumors.
- Kidney Biopsy: A small tissue sample is taken to determine the specific cause of damage.
2. Treatment: Slowing Progression
Since kidney damage is usually irreversible, treatment focuses on protecting the remaining function.
Lifestyle Management
- Blood Pressure Control: Keeping BP below 130/80 mmHg is critical.
- Blood Sugar Control: Essential for those with diabetes, the leading cause of kidney disease.
- Dietary Changes: Often involves reducing sodium (salt), potassium, and sometimes phosphorus or protein intake.
- Weight & Activity: Maintaining a healthy weight and staying active helps reduce the load on the heart and kidneys.
Medications
- ACE Inhibitors or ARBs: These blood pressure medications have specific protective effects on the kidneys.
- SGLT2 Inhibitors: Originally for diabetes, these are now widely used to slow CKD progression even in non-diabetics.
- Statins: To lower cholesterol and reduce the high risk of heart disease associated with CKD.
- Diuretics: “Water pills” to help the body eliminate excess fluid and swelling.
3) Advanced Stages: Kidney Replacement Therapy
If kidney function drops below 15% (Stage 5), life-sustaining treatments are required:
| Treatment | How it Works |
| Hemodialysis | An artificial kidney machine filters the blood (usually 3 times a week at a center). |
| Peritoneal Dialysis | A fluid is put into the abdomen to absorb waste, then drained (often done at home). |
| Kidney Transplant | A healthy kidney from a donor is surgically placed into the body. |
Note: Because early CKD has no symptoms, people with high-risk factors like Diabetes or High Blood Pressure should ask their doctor for an annual uACR and eGFR test.