Page 10 - Beaumont_Book_1
P. 10

CHAPTER 2







               hronic kidney disease (CKD) is a condition in which the kidneys
              cannot perform their normal functions. Your kidneys lose the
        Cmajority of their filtering ability and, as a result, fluid and waste
        accumulates in your body.
           When CKD happens suddenly, it is known as             This is commonly known as
        ACUTE KIDNEY DISEASE (AKD). The most common           END STAGE KIDNEY DISEASE
        causes of acute damage to the kidneys are:            (ESKD). In other words, kidney
        ● Decreased blood flow to the kidney: this may        damage is irreversible and cannot      WHAT IS KIDNEY DISEASE?
           occur when there is extremely low blood            be controlled by conservative
           pressure caused by trauma, complicated surgery,    management       alone.    When
           septic shock, haemorrhage, burns, associated       kidneys reach 'end-stage', they
           dehydration or other severe or complicated         never recover.
           illnesses.
        ● Over-exposure to metals, solvents, x-ray dye,       PROGRESSION OF CHRONIC
           certain antibiotics and other medications or       KIDNEY DISEASE
           substances.                                           Once somebody has some
        ● Acute Tubular Necrosis (ATN) may occur when         degree of kidney disease it
           the tissues are not getting enough oxygen.         frequently progresses over time.
           Short-term treatment may be needed for acute       The rate of progression can vary.
        kidney disease, but the kidneys usually recover on    The stages of CKD can be
        their own. However, if the cause of the acute         thought of in terms ranging from
        kidney disease persists, there can be permanent       1 to 5.
        damage to the kidney, which would lead to CKD.           In CKD stage 1, the patient has normal filtering
           CHRONIC KIDNEY DISEASE (CKD) usually               function as measured by the Glomerular Filtration
        develops slowly, with few signs or symptoms in the    Rate (GFR) of about 120 mls/min. Other levels of
        early stages. You may still be passing normal         CKD are outlined below:
        amounts of urine, but it will be poor quality, and
        waste products, which should normally be filtered         CKD 1      GFR greater than 90mls/min
        out, will remain in the body. Many people, with CKD,      CKD 2      GFR 60 to 89
        do not realise they have a problem until their kidney     CKD 3      GFR 30 to 59
        function has decreased to less than 25 percent of         CKD 4      GFR 15 to 29
        normal (CKD4). This damage usually occurs slowly,         CKD 5      GFR less than 15mls/min
        and is not reversible.
           The rate of deterioration of kidney function is       Most patients who are diagnosed as having CKD
        variable, ranging from more than ten years to only    1, 2, or 3 have only mild kidney disease and do not
        a few months.                                         progress to ESKD. The GFR can be calculated by
           Eventually, the kidneys can only function at less  doing a 24 hour urine collection. Once the GFR is
        than 10 percent of normal capacity. The kidneys       below 70, it frequently continues to decline. If the
        have almost stopped working at this stage and         GFR declines by one ml per year, it will take 80
        treatment, in the form of dialysis or a kidney        years to progress from CKD Level 1 to CKD Level 5,
        transplant is required to take over the work of the   requiring dialysis or a kidney transplant. However,
        kidneys and maintain life.                            if GFR declines by 10mls per year it will only take
                                                              8 years to go from CKD Level 1 to CKD Level 5.
                                                                 Please refer to Book 5 for more information.


         P.8 Kidney Disease — A Guide for Patients
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