CKD (chronic kidney disease) is a disease that usually follows nephropathy. As statistics show, this outcome in nephropathy is almost inevitable, although exceptions are possible. In most cases, neither the nature of the disease, nor any other features play a role. Treatment of CKD is practiced in stages, each of which is characterized by its own violation in the activity of a vital organ.
The correct approach allows you to improve the quality of life and somewhat reduce the discomfort associated with impaired he alth. And yet you need to understand: from year to year, from decade to decade, the functioning of the kidneys will be less and less qualitative.
Disease: how serious is everything?
Currently, five stages of CKD are known. According to the GFR, one can draw a conclusion about how neglected the state of a person is. The doctor receives biological materials for research and, based on the results of laboratory findings, decides: at what stage the disease should be attributed, how to approach the treatment process and how the quality of life can be improved.
As a rule, complex treatment of the disease is practiced, since it is the approach that takes into account the general state of he alth of the patient gives the bestresults. There are classical options for therapy at the stage of albuminuria in CKD, you can also turn to modern innovative methods.
Sick or not?
Often, questions like “Can CKD stay in stage 2” are asked by people who have been diagnosed with the disease completely unexpectedly for themselves. As statistics show, the percentage of people suffering from kidney diseases in our country is very high, and for many, the problems are already in a rather neglected state.
Modern medical practice in Russia is such that large-scale preventive measures and timely detection of kidney diseases are not practiced, which is why the literacy of the general population in this matter is minimal.
In developed countries, where the level of medical services is traditionally high, the classification of stages of CKD by GFR is not a serious problem for doctors, and the population regularly undergoes examinations to detect the disease at the very beginning of its development. For this, so-called screening studies are organized. In the course of studying the features of the functioning of the kidneys, it is possible to detect not only a chronic disease, but also other pathologies.
Statistics
As shown by medical studies, CKD is present in one stage or another in 10% of the total population of the planet. In specific groups of people, the frequency doubles. At risk, in the first place, are older people suffering from type 2 diabetes.
On how bigproblem, we can conclude if we compare the statistics for other common diseases. Thus, on average, heart failure is diagnosed in one percent of the population, asthma - in five percent of adults, and high blood pressure - in almost a quarter of the population of our planet.
In terms of distribution, data on all stages of CKD are approximately comparable to the frequency of diagnosing diabetes - the same ten percent (a little less, a little more).
How to evaluate?
Until recently, the classification of CKD by stages was very controversial. In fact, there was no generally accepted system, and advanced ideas were not applied in practice. Russian clinics mainly resorted to the CKD classification system by stages developed by Ratner. The peculiarity of this methodology was in focusing on the content of creatinine. However, in some clinics this option was considered insufficiently accurate and correct, therefore, in practice, they used the system proposed by Professor Tareev. This specialist suggested determining the severity of the disease by the level of GFR.
A fairly common option for determining the stage of CKD was the method proposed by Drs. Kuchinsky and Ryabov. This methodology was considered complex, and is still used in some medical institutions to this day. However, it has long been clear that a single methodology is needed, which would be used centrally in all medical institutions. As a result, the method developed in 2002 in America was chosen for general use. CKD.
What is it about?
As current terminology suggests, CKD is a disorder of kidney function that causes a decrease in organ activity for three months or more. CKD is a term applicable to different diagnoses. Impairments are described as either structural or functional. To determine the stage of CKD, it is necessary to conduct specialized laboratory studies, in which, first of all, the GFR indicator is examined.
GFR (glomerular filtration rate) is an indicator that is monitored for suspected CKD for three months. If the value is less than 60 ml/min per 1.73 m2, it indicates the presence of a chronic organ lesion. The disease may be accompanied by kidney damage or develop in the absence of such.
CKD classification
Staging is based on average GFR. The lower normal value is equated to 90 ml/min, and the death of half of the nephrons is reflected in the analysis of GFR at a level of 60 ml/min or less. The first stage of the disease is characterized by a normal value or slightly higher than normal. When diagnosing such indicators, it is necessary to start treatment as soon as possible in order to prevent the situation from worsening.
Stage 2 CKD is characterized by GFR values ranging from 60 to 89 ml per minute. Treatment of stage 3 CKD is relevant if the indicator decreases to a value in the range from 30 to 59 ml. The fourth stage is characterized by a GFR of 15-29 ml, and the fifth is characterized byvalues less than 15 ml/min.
Age and characteristics
It is known that in old age the normal indicators of kidney function are somewhat lower than in younger people. Therefore, it was established for people aged 60 years and older at a rate of 60-89 ml per minute. At this level, it is considered that there are no risk factors and such functioning is normal for the organ.
Disease: what is it about?
CKD is a chronic disorder of the kidneys, which over time leads to the development of insufficiency in the functioning of this organ. Often, the disease in the first stages proceeds without symptoms, and the patient consults a doctor already at stage 4. Treating CKD at this stage is quite a challenge.
There are quite a few cases from medical practice in which CKD was discovered at a stage when either organ transplantation or hemodialysis could give the only tangible effect. This is the so-called terminal stage.
Kidneys: features of the organ
The kidneys are one of the paired organs in the human body. Location - abdominal cavity. The kidneys are similar in shape to the fruits of beans, legumes, on average, about 12 cm in length. Adipose tissue is located around the kidneys, which allows the organ to be held in an anatomically correct position. Sudden weight loss, as well as underweight, can lead to the degradation of adipose tissue, which provokes nephroptosis, prolapse of the organ.
A feature of the structure of the kidneys is the presence of two layers, the upper of which resemblescrust, and the inner one is called the brain. When examining a kidney in section, one can see that the organ is formed by numerous tubes that collect fluid and direct it into the urine pelvis - a kind of collector. The kidneys are made up of nephrons - capillary tangles enclosed in a capsule.
In a normal state, the kidney is a system of a million active nephrons that filter the blood. During normal functioning, the glomerular membrane blocks most of the blood components from entering the organ, but in a number of diseases a violation occurs, and tests show the presence of leukocytes, erythrocytes, and other components in the urine.
CKD: signs
It is often very difficult to assume a chronic illness, especially at the beginning. In addition, the main manifestation, for example, 4 stages of CKD, herbal treatment allows you to hide. At the same time, such self-treatment does not restore the normal functioning of the organ, but only masks the main manifestations of the disease, not allowing it to be detected in time. So it turns out that a lover of self-treatment, having hidden his disease from himself and doctors, is faced with the need to know at what stage of CKD hemodialysis is carried out - after all, nothing else at a late stage of the development of the disease will simply help.
To avoid such an outcome, you should be as attentive as possible to your body and, in case of doubtful signs, immediately go to the doctor, take tests to identify the cause.
The first symptom that should alert a person is a change in the volume of secretions. The amount of urine may be less thanusually associated with poor functioning of the organ. In some cases, the opposite happens: urine is produced in volumes exceeding the norm, which is accompanied by constant thirst.
The composition and color of urine under the influence of pathology also change: blood appears, sediment. Quite often, with CKD, the pressure in the kidneys increases, renin is released, due to which the pressure in general rises. The person feels weak, appetite disappears. This is due to toxicosis, provoked by insufficient purification of the blood by the kidneys. At the same time, swelling of the limbs worries, inflammatory processes occur in the kidneys.
Features of different stages
In the first stage, they talk about kidney damage, while GFR remains normal or slightly above normal. It is not easy to determine the disease at this level of development - this is possible only with constant monitoring of human analyzes. There are practically no symptoms in the first stage.
GFR decreases in the second stage, but not significantly. This is accompanied by organ damage.
Early symptoms are usually fixed in the third stage of the disease. Renal failure appears. A pronounced decrease is observed in the fourth stage, in medicine called preterminal. According to statistics, it is at this stage, accompanied by late symptoms of kidney failure, that most patients come to the hospital.
Finally, the treatment of stage 5 CKD is the most difficult task, since this stage is the most neglected. This is where replacement therapy is needed, because speechtalking about uremia.
CKD: causes and treatment
CKD is a term that refers to different diseases that provoke the same outcome - kidney failure. Symptoms vary quite a lot depending on what pathology provoked CKD. Of course, treatment also significantly depends on the reason for which the kidneys were affected. As is known from medicine, most often the problem is in the inflammatory process that affects the organ.
At the moment, scientists have not been able to find out why glomerulonephritis develops. It is only known that people who have had an infectious disease of the upper respiratory tract are at risk. An introduced virus or hereditary factors may play a role.
This disease often begins insidiously, proceeds quite secretly, and is discovered quite by accident. As a rule, bilateral inflammation is manifested by the presence of red blood cells, protein in the urine. In some cases, the pathology is accompanied by swelling, increased pressure.
Accurate diagnosis is possible by biopsy. Features of treatment are chosen, focusing on the specifics of glomerulonephritis in a particular case. The most common form of this disease is characterized by a gradual decline in the quality of kidney function: the process stretches for decades, but the condition of the organ is steadily deteriorating.
Diabetes and kidneys
As soon as a person is diagnosed with diabetes mellitus, he is immediately referred to the risk group for the development of kidney failure. Nephropathy is one of the most severe complicationsaccompanying diabetes. Microalbuminuria is usually not accompanied by symptoms, complaints, so the onset of the disease is often missed. Proteinuria is accompanied by swelling of the extremities, the face may swell, and blood pressure rises. However, it so happened that due to a careless attitude to their he alth, many patients miss these symptoms, attributing them to manifestations of diabetes.
CKD in some cases is accompanied by vomiting and nausea, the appetite completely disappears, the skin begins to itch, the person feels tired, his strength leaves him, and rest does not help to recover. The progress of the disease can be stopped at the stage of microalbuminuria, timely therapy allows the kidneys to return to a he althy state and fully normalize functionality.
If a lesion is detected at the stage of proteinuria, there is a possibility of blocking the progress of negative processes. If the pathology is diagnosed in the status of CKD, treatment becomes impossible. The only option for a positive development of events is a successful replacement therapy.
Infection and CKD
Inflammation of the kidneys in recent years is much more common than a few decades ago. Of the other bacterial diseases common to all ages, it is kidney inflammation that is diagnosed most often.
It is known that in a he althy state, a person has sterile urine, and the urinary tract is free from germs. If the source of the disease enters the urinary canals, bladder, inflammatoryprocess. The disease is usually accompanied by painful sensations and increased frequency of urination, and during the release of the bladder from the fluid there is a burning sensation. When analyzed, it is noted that the urine is cloudy, often pinkish, which is explained by the presence of red blood cells.
Progress of the disease is accompanied by fever, pain in the abdomen, back, as well as vomiting, nausea. Re-infection can occur without fever. At the same time, it is known that in childhood it is often the temperature that is the only indicator of the presence of an infection. Repeated inflammatory process is associated with a high probability of developing renal failure. Often secondary infection shows the progress of CKD.
Treatment: where to start?
More or less good results of CKD treatment are shown only in the case when it was possible to correctly determine the reason for the development of the disease. If glomerulonephritis is detected, then immunosuppressive therapy is necessary, in case of diabetes, measures must be taken to eliminate the negative impact of this pathology on internal organs and systems. If CKD is caused by an inflammatory process, antibiotics and other systematic treatment should be taken.
For any root cause, maintaining a he althy lifestyle and proper nutrition will show a good effect. It is necessary to control the number of calories consumed, lead an active life, including quite a lot of movement, although in accordance with age standards. Choose a dietfocusing on the root cause that provoked CKD. As a rule, the attending physician helps to choose the best option. You must follow his instructions as carefully as possible. In addition, with CKD, you need to keep pressure under control and, if it increases, take measures to eliminate the symptom.
