CKD-Chronic Kdney Disease

Chronic kidney disease, CKD, involves a gradual loss of kidney function. Kidneys filter wastes and excess fluids from the blood, which are then removed in the urine. CKD can cause dangerous levels of fluid, electrolytes and wastes to build up in the body. In the early stages of CKD, one may have few signs or symptoms. One may not realize that there is have kidney disease until the condition is quite advanced.

STATS: 36 million Americans have kidney disease. About 810,000 Americans are living with kidney failure. Kidney disease is growing at an alarming rate. It currently affects more than 1 in 7 or 15% of USA adults.

https://www.healio.com/news/cardiology/20240429/most-us-adults-estimated-to-have-subclinical-cardiovascularkidneymetabolic-syndrome?utm_source=selligent&utm_medium=email&utm_campaign=news

Symptoms:

• Nausea
• Vomiting
• Loss of appetite
• Fatigue and weakness
• Sleep problems
• Urinating more or less
• Decreased mental sharpness
• Muscle cramps
• Swelling of feet and ankles
• Dry, itchy skin
• High blood pressure
• Shortness of breath, if fluid builds up in the lungs
• Chest pain, if fluid builds up around the pericardium
• Kidney disease is often caused by diabetes, which raises the risk of eye disease in itself, but if the kidneys are not filtering out waste properly, it can also contribute to eye problems.
• Sudden Visual Deterioration is the First Symptom of CKD (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4777964/)

• Some of the other eye changes associated with signs of CKD include:

  • Retinal vascular changes: The retina is a part of the eye that senses light and transmits images to the brain. The retinal blood vessels are susceptible to blood flow and pressure changes. In early-stage kidney disease, the blood vessels in the retina may start to narrow, twist, or bulge, causing vision changes. As a result, patients may experience blurry vision or difficulty seeing in low-light conditions.

  • Hard exudates: Hard exudates are yellowish-white deposits that form in the retina when lipids or fats accumulate. In early-stage kidney disease, hard exudates may appear around the macula, the part of the retina responsible for sharp, detailed vision. It may result in patients experiencing distorted vision or having difficulty reading small print.

  • Cotton wool spots: Cotton wool spots are white, fluffy lesions on the retina. They are caused by the accumulation of nerve fibers and white blood cells. In early-stage kidney disease, cotton wool spots may appear around the optic nerve, the part of the eye that transmits visual signals to the brain. Patients with cotton wool spots may experience blind spots or reduced peripheral vision.

  • Papilledema: Papilledema is a condition in which there is swelling in the optic nerve head, the part of the optic nerve that enters the eye. In early-stage kidney disease, papilledema may occur due to increased pressure in the blood vessels in the head. Patients have been known to experience headaches, nausea, and vomiting due to papilledema.

    kidney function tests

    • Blood urea nitrogen (BUN) measures nitrogen (made from protein breakdown) in the blood.
    • Estimated GFR (eGFR) calculates filtration rates based on protein levels, age, gender, size and race.
    • Serum creatinine looks for the buildup of creatinine, a waste product from muscle tissue breakdown.

          24-hour urine tests:

    • Microalbuminuria looks for a specific protein called albumin.
    • Urinalysis evaluates urine for blood, proteins and function.

Treatment for CKD focuses on slowing the progression of kidney damage, usually by controlling the cause. But, even controlling the cause might not keep kidney damage from progressing. CKD can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Who is more likely to get CKD

Anyone can get CKD, but some people have a higher chance, such as people who:

• Have diabetes, high blood pressure or heart disease
• Have a close family member with kidney disease
• Are over age 60 

Talk to your PCP and or a Nephrologist about getting tested if you have any of the risk factors or are experiencing symptoms of CKD. Do not DELAY. Get TIMELY help.

Author

Paddy Kalish OD, JD and B.Arch