Chronic Kidney Disease

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Chronic Kidney Disease Program
Symptoms of Kidney Disease
What Increases One's Risk of Having Chronic Kidney Disease?
How Can the Progression of Kidney Disease be Delayed?
Goals
Stages of Kidney Disease
Treatments for Kidney Failure

Chronic Kidney Disease Program

Chronic Kidney Disease (CKD) means that the kidneys have become damaged. Common causes of CKD are diabetes, mellitus, hypertension, inherited diseases, and nephritis.

The purpose of the Nephrology Associates, P.A., CKD Program is to slow the progression of damage to the kidneys and to treat the associated complications such as hypertension, anemia, and bone disease. If we are unable to arrest the disease process and the kidney damage progresses to end state renal disease (ESRD), our plan is to manage these complications while preparing the patient for renal (kidney) replacement therapy. This therapy will consist of hemodialysis, peritoneal dialysis, and/or kidney transplantation.

Managing these complications and preparing patients for renal replacement therapy is a complex process of visits, treatment, and teaching sessions. Our team consists of nephrologists, registered nurses, medical assistants, and a renal dietician.

As kidney disease progresses through its five stages (based on the degree of damage to the kidneys), different diagnosis studies, treatments, and teaching sessions will take place.

We hope that you will fully participage in this effort by keeping appointments and following treatment recommendations. Please assist us by bringing your medications and questions on each visit.

Thank you.

CKD Team
Nephrology Associates, P.A.

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Symptoms of Kidney Disease

  1. Often no symptoms in the earlier stages (I-III)
  2. Feeling tired or weak
  3. Headaches
  4. Itching
  5. Nausea and Vomiting
  6. Loss of appetite
  7. Swelling
  8. Shortness of Breath
  9. A metallic taste in your mouth
  10. Darkening of the skin
  11. Trouble concentrating
  12. Change in urination

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What Increases One's Risk of Having Chronic Kidney Disease?

  1. Diabetes Mellitus
  2. Hypertension
  3. Race: African-American, Hispanic, and Native Americans
  4. Age > 65
  5. Relative with CKD

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How Can the Progression of Kidney Disease be Delayed?

  1. Keeping blood pressure under control: that is < 140/90 or 125/75 if you have diabetes or protein in urine.
  2. Taking certain types of medication called ACE-Inhibitors or Angiotensin Receptor Blockers.
  3. For Diabetics, keeping blood sugars under control with HbAIc less than 7.0. This requires frequest monitoring of your blood sugars.
  4. Avoiding medication that will damage your kidneys such as non-steroidal anti-inflamatory drugs (NSAIDS). Examples are ibuprofin, Advil, Motrin, Aleve, Celebrex and Naprosyn.
  5. Avoid Fleets® Phospho-soda and Fleets® Enema.
  6. Avoiding, if possible, IV Contrast used for CT scans and Heart Catheterizations.
  7. Controlling your cholesterol.
  8. Quit smoking.
  9. If overweight, losing weight.
  10. Treating Anemia, if present.

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Goals

eGFR stable or higher
BP (Systolic)
  
CKD
 <140
Diabetes &/or proteinuria <125
Urine protein/creatinine <1 or lower
Anemia  
Hgb >11
Iron Saturation >20%
Ferritin >200
Bone Disease  
Calcium 8.4-10.2
Phosphorus 2.7-4.6
PTH  
Stage III 35.70
Stage IV 70-110
Stage V 150-300
Nutrition  
Albumin >3.8
Diabetes Mellitus  
Hgb A-I-C <7.0%
Cholesterol  
LDL <100
HDL >45

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Stages of Kidney Disease

Stage GFR Treatment Goals
I (2) >90 Diagnosis and Treatment, slow progression
II (2) 60-89 Estimating Progression
III (3) 30-59 Evaluating and Treating Complications
IV (4) 15-29 Preparation for Dialysis/Transplant
V (5) <15 Dialysis/Transplant

GFR (Glomerular Filtration Rate) can be measured directly or estimated (eGFR) from the blood creatinine. It is the measurement of how well your kidneys perform their most important function - filtering waste from your blood stream

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Treatments for Kidney Failure

  1. Hemodialysis (Home & In-Center)
  2. Peritoneal Dialysis (Home)
  3. Kidney Transplant
    • Living Related
    • Living Non-related
    • Cadaveric

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