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Signs of Chronic Kidney Disease

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.

  1. Stage 1: >90

  2. Stage 2: 60-89

  3. Stage 3a: 45-59 - this is the level where Chronic Kidney Disease is defined

  4. Stage 3b: 30-44

  5. Stage 4: 15-29

  6. Stage 5: <15 or on dialysis

Graphic of normal and diseased kidney showing eGFR levels and urinary albumin to creatine ratios (UAC)
Stages of Chronic Kidney Disease by eGFR and UAC

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

Graphic showing healthy and damaged kidneys by the amount of albumin excreted
Healthy versus Damaged Kidneys based on Albumin Excretion

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

Full graphic and explanation of urinalysis by urine dipstick
Urinalysis Interpretation from a Dipstick

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.

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