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What it is
One in 10 Canadians has kidney disease, a chronic affliction with no chance of remission. With an aging population, a rising number of overweight Canadians, increasing rates of high blood pressure and an epidemic of diabetes (the leading cause of kidney disease) – the numbers are only going up.
The main function of the kidneys is to remove the body’s waste and excess water. When kidneys are damaged, they have difficulty cleaning blood, controlling blood pressure, producing red blood cells and retaining the essential vitamins and nutrients that keep bones strong. Chronic kidney disease can lead to heart disease and death.
Most common types and causes of kidney disease
- Diabetes is the leading cause of kidney disease. High blood sugar over time causes scarring of the kidneys and inhibits their function. Kidney damage caused by diabetes is called diabetic nephropathy.
- Polycystic kidney disease is an inherited genetic disorder that causes fluid-filled cysts to form inside the kidneys.
- High blood pressure, also known as hypertension, can be both a cause and an effect of kidney disease.
Risk Factors
- Family history is a key risk factor for developing kidney disease. If you have a family member with heart disease, high blood pressure or diabetes you are more at risk of kidney disease.
- Obesity increases the risk of developing both diabetes and high blood pressure the leading causes of kidney disease. Since obesity is largely preventable, this is a risk factor that can be mitigated in most cases.
- People with Asian, First-Nations, African/Caribbean or Hispanic heritage are at higher risk for kidney disease. The reason for the elevated risk isn’t clear but these communities do have higher rates of high blood pressure, obesity and diabetes, all known risk factors for this disease.
- Kidney disease can strike anyone at any age but those over the age of 60 are more at risk as kidney function decreases as people get older.
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Symptoms
Kidney disease is considered a silent killer because there are few symptoms and they don’t appear until the disease is advanced. However early on in some cases one might notice swelling of the feet and your family physician might detect high blood pressure.
- Vomiting
- Loss of appetite
- Sleep issues
- Persistent itching
- Swelling of feet and ankles
- High blood pressure
- Shortness of breath
- Chest pain
Many of these symptoms could also be caused by other illnesses so it’s very important to see a doctor and undergo testing.
Complications
Chronic kidney disease can affect every area of your body.
- Anemia is a condition in which fewer red blood cells are produced. People with chronic kidney disease create less EPO, a hormone required to make red blood cells which carry oxygen throughout the body.
- Poorly functioning kidneys allow waste buildup in the blood. High levels of toxins can lead to dangerous inflammation around the heart.
- High blood pressure can be both a cause and a complication of kidney disease.
- Fluid retention or excess water can lead to swelling and fluid in the lungs.
- When kidneys fail they can’t remove potassium from the blood, which can lead to a build-up of toxic levels that are fatal if untreated.
- Because deteriorating kidneys can’t retain the minerals needed for strong bones, people with kidney disease are at an increased risk of bone fractures.
- Approximately half of the people with this disease experience some sexual dysfunction.
- Depression can be triggered by the variety of effects on the body.
- A decreased immune response can make the person more vulnerable to infection.
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Diagnosis
There are two standard tests to determine if your kidneys are impaired. The first is a blood test which measures serum creatinine, a waste product. Elevated creatinine levels signal a decrease in kidney function.
The second is a test that looks for blood or protein in the urine. Properly functioning kidneys do not leak protein or blood so if either of these show up in a urine sample, it could mean your kidneys aren’t working as well as they should.
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Treatment
Most cases of kidney disease are dealt with by managing blood pressure and in the case of diabetes, blood sugar.
Some cases require other treatments like immunosuppressive therapy or identification of reversible causes.
People with kidney disease may need to make a host of lifestyle and diet changes to manage the conditions causing the disease and to slow its progression. Diabetes and high blood pressure are the leading causes of this disease so managing these health issues is paramount to slowing the deterioration of the kidneys.
Decreased kidney function impairs your body’s ability to eliminate waste and water so your doctor may advise you to decrease your intake of liquids, eat less protein and foods high in potassium and phosphorus. Some people can live with kidney disease for years, and many do. But when kidneys fail, there are only two options: dialysis or a kidney transplant.
Dialysis can take over a person’s world. A patient can spend hours a day, at least three times a week, hooked up to machines that do the kidney’s natural work. Family life, marriage, work, travel – nothing happens as it once did. And dialysis is not a life saver: half of patients 65 years of age and older starting dialysis today will not be alive in five years. What’s more, the cost of dialysis to the system is $2.2 billion annually.
When kidneys fail, the best solution is a kidney transplant. Kidneys can come from both deceased and living donors. How long a donated kidney lasts varies from person to person, but many people will need more than one transplant in their lifetimes.
At St. Michael’s, we have been using minimally invasive surgery techniques for years. Kidney surgery can be completed within a few hours and recovery is usually quicker and less painful with fewer complications than in traditional surgeries.
