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Chronic kidney disease


Chronic kidney disease means that for some time your kidneys have not been working the way they should. Your kidneys have the important job of filtering your blood. They remove waste products and extra fluid and flush them from your body as urine. When your kidneys do not work right, wastes build up in your blood and make you sick.

Chronic kidney disease may seem to have come on suddenly. But it has been happening bit by bit for many years as a result of damage to your kidneys.

Each of your kidneys has about a million tiny filters, called nephrons. If nephrons are damaged, they stop working. For a while, healthy nephrons can take on the extra work. But if the damage continues, more and more nephrons shut down. After a certain point, the nephrons that are left cannot filter your blood well enough to keep you healthy.

There are things you can do to slow or stop the damage to your kidneys. Taking medicines and making some lifestyle changes can help you manage your disease and feel better.
What causes chronic kidney disease?

Chronic kidney disease is caused by damage to the kidneys. By far the most common causes of this damage are:

    * High blood pressure.
    * High blood sugar (diabetes).

Other things that can lead to chronic kidney disease include:

    * Kidney diseases and infections, such as polycystic kidney disease, pyelonephritis, and glomerulonephritis, or a kidney problem you were born with.
    * A narrowed or blocked renal artery. The renal artery carries blood to the kidneys.
    * An enlarged prostate gland, kidney stones, or a tumor that keeps urine from flowing out of the kidneys.
    * Lead poisoning.
    * Long-term use of medicines that can damage the kidneys. Examples include pain medicines, like acetaminophen (such as Tylenol) and ibuprofen (such as Advil), and certain antibiotics.

What are the symptoms?

You may start to have symptoms only a few months after your kidneys begin to fail. But most people do not have symptoms early on. In fact, many do not have symptoms for as long as 30 years or more. This is called the "silent" phase of the disease.

How well your kidneys work is called kidney function. As your kidney function gets worse, you may:

    * Urinate less than normal.
    * Have swelling from fluid buildup in your tissues. This is called edema (say "ih-DEE-muh").
    * Feel very tired or sleepy.
    * Not feel hungry, or you may lose weight without trying.
    * Often feel sick to your stomach (nauseated) or vomit.
    * Have trouble sleeping.
    * Have headaches or trouble thinking clearly.

How is chronic kidney disease diagnosed?

Your doctor will do blood and urine tests to help find out how well your kidneys are working. These tests can show signs of kidney disease and anemia. (You can get anemia from having damaged kidneys.) You may have other tests to help rule out other problems that could cause your symptoms.

Your doctor will ask questions about any past kidney problems, whether you have a family history of kidney disease, and what medicines you take—both prescription and over-the-counter drugs.

You may have a test that lets your doctor look at a picture of your kidneys, such as an ultrasound or CT scan. These tests can help your doctor measure the size of your kidneys, estimate blood flow to the kidneys, and see if urine flow is blocked. In some cases, your doctor may take a tiny sample of kidney tissue (biopsy) to help find out what caused your kidney disease.
 

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