Do you have signs of Chronic Kidney Disease (CKD)? Without the results of pathology tests, many of us won't know as the signs and symptoms can be quite subtle. Maintaining optimal kidney function is crucial for our longevity, and knowing how to look for signs in your pathology results is crucial.
Two types of Kidney Disease
There are 2 types of kidney disease:
Acute Kidney Injury - where there is lack of blood flow to the kidneys from an injury, infection etc, but recovery back to normal function happens within a 3-month period.
Chronic Kidney Disease - is progressive, and is associated with high blood pressure, diabetes, immune dysfunction etc. Whilst it can't be reversed, it can be prevented from progressing further with diet and lifestyle improvements.
Signs of Chronic Kidney Disease
The below symptoms may be present for other conditions, not just Chronic Kidney Disease. It's important to be checked by your healthcare practitioner.
High blood pressure
Change in frequency of urination
Changes in appearance of urine (e.g. frothy or foaming)
Blood in urine
Puffiness in legs, ankles, and around eyes
Pain in kidney area
Tiredness
Loss of appetite
Difficulty sleeping
Headaches
Lack of concentration
Itching
Shortness of breath
Nausea and vomiting
Bad breath and a metallic taste in your mouth
Muscle cramps
Pins and needles in your fingers and toes
Stages of Chronic Kidney Disease
There are progressive stages to kidney disease, and these can be predicted by measuring:
Blood Pressure - healthy is now considered <120/80
Estimated Glomerular Filtration Rate (eGFR) - estimated as it is based on our blood Creatinine levels (which is a waste product), your age, sex and ethnicity. The higher your Creatinine level in blood, which is a toxic waste product, the lower the amount is filtered out urine, which reflects the decreased kidney function. This is discussed in greater detail below.
Urinary Albumin:Creatinine Ratio (UAC) - healthy kidneys will prevent the leakage of albumin filtering out of our kidneys, while unhealthy kidneys can be shown with albumin present in our urine, even if our eGFR is normal. This is discussed in greater detail below.
Estimated Glomerular Filtration Rate
The 5 stages of Kidney Dysfunction via the estimated glomerular filtration rate (eGFR) are shown below. Hypertension and Heavy Metal Toxicity have an impact on eGFR, as well as ageing, protein intake and dehydration.
Stage 1: >90
Stage 2: 60-89
Stage 3a: 45-59 - this is the level where Chronic Kidney Disease is defined
Stage 3b: 30-44
Stage 4: 15-29
Stage 5: <15 or on dialysis
Urinary Albumin to Creatinine Ratio
The collection of a first void urine is used to calculate how much urinary albumin is released, and is often an earlier marker to change before eGFR does.
Urinary Albumin to Creatinine Ratio - normal values are <2.5 for males and <3.5 for females
Other Pathology Tests to Monitor for Kidney Disease
There are many other indictors of impending Chronic Kidney Disease. Keeping these markers at optimal levels will help prevent Chronic Kidney Disease.
Urinalysis by dipstick - the presence of protein or blood may be a sign even before eGFR impacted. Dipsticks are purchasable form chemists for home checks (as shown by graphic below)
Anion Gap (which measures metabolic acidosis, and is a measure of Sodium + Potassium - Chloride - Bicarbonate) - optimal is 10-14
Serum Urea - optimal is 4-7mmol/L
Serum Creatinine - often doesn't change until there is up to 50% loss of eGFR
Fasting Insulin - optimal is 3-10 mU/L
Fasting glucose - optimal is 4.2-4.8 mmol/L
HbA1c - Optimal is up to 5.9%
HDL - Optimal is 1-1.6 mmol/L
Triglycerides - Optimal is up to 1.5mmol/L
ESR (Erythrocyte Sedimentation Rate) - Optimal is 0-7 mm/hr
C-Reactive Protein - Optimal is 0-5 mg/L
High sensitive CRP (hsCRP) - Optimal is 0-1 mg/L
Dietary and Lifestyle Improvements
While Chronic Kidney Disease cannot be reversed, further progression downwards can be halted with dietary and lifestyle changes like:
Give up smoking
Eat a diet that focuses on more alkaline generating foods like vegetables and fruits, rather than a lot of acidic producing foods like red meat, sugar, and processed foods. An alkaline diet is called a Potential Renal Acid Load (PRAL Diet and this can be found in my Resources section)
Minimise/ eliminate alcohol
Improve exercise and daily movement
If you would like to discuss your own personal kidney results and dietary needs, then please don't hesitate to make a booking with me.
Sign Up for Further Educational Material
If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page.
References:
BioConcepts Handout: Kidney Function: Using Pathology to assess metabolic and inflammatory markers
ARTICLE/CONTENT DISCLAIMER
The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.