Chronic Kidney Disease

Overview

Kidney disease occurs in five stages, from mild to severe. The fifth stage, also known as kidney (renal) failure or end-stage renal disease (ESRD), means your kidneys have limited function. With ESRD, you must have regular hemodialysis, where a machine removes waste and fluid from your blood, or you may need a kidney transplant.

Other complications of chronic kidney disease can include:

• Anemia
• Nerve damage
• Weakening of bones
• Cardiovascular problems, including coronary artery disease and heart failure

Chronic Kidney Disease Symptoms

Most people do not have any symptoms until the condition worsens. Symptoms can include:

• Fatigue
• Frequent urination, especially at night
• Swelling of the ankles and feet
• Itchy, dry skin
• Decreased appetite

Chronic Kidney Disease Risks

Your chance of developing chronic kidney disease increases after age 50. Conditions that can cause chronic kidney disease include:

• Diabetes
• High blood pressure
• Autoimmune disorders, such as lupus and scleroderma
• Kidney infections
• Polycystic kidney disease
• Medicine, including certain pain and cancer drugs
• Injuries

Treatment

At IU Health, experts treat all stages of chronic kidney disease. Your physician will provide therapies to prevent or delay further kidney damage and help you avoid complications. Your physician will develop an individualized care plan for your specific needs, concerns and preferences.

Your IU Health physician has access to the most innovative options for diagnosing and treating chronic kidney disease through affiliation with Indiana University School of Medicine. IU Health researchers also conduct studies on ways to improve care and take an active role in training new generations of physicians.

IU Health physicians offer treatment for chronic kidney disease based on your specific needs and lifestyle. Options include:

• Blood pressure medicine. High blood pressure can damage your kidneys. Normal blood pressure is 120/80 (diastolic/systolic), and if you have chronic kidney disease, your target should be 130/80. Research has shown that blood pressure medicines called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) help limit kidney damage and lower your risk for heart disease.
• Phosphate binders: Phosphorous is important for healthy bones, blood vessels and muscles. In people with chronic kidney disease, phosphorous can build to high levels, causing weakened bones and other problems. A diet low in phosphorous may be enough to control this problem. However, if you are in the more advanced stages of chronic kidney disease, you may need medicine to help clear phosphorous from your body. These medicines work only if you take them within 30 minutes of a meal.
• Dietary changes. Being careful about what you eat and drink can help prevent kidney damage. A diet low in fat, cholesterol, sodium and potassium may help control chronic kidney disease, along with cardiovascular disease.