Chronic Kidney Disease

Chronic kidney disease (CKD) is when the kidneys have become damaged over time (for at least 3 months) and have a hard time doing all their important jobs. CKD also increases the risk of other health problems like heart disease and stroke.

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 Kidney Care Consultants CKD Program is to treat and try to resverse the disease process, if the kind of CKD was not reversible then we work on slowing the progression of damage to the kidneys and to treat the associated complications such as hypertension, anemia, electrolytes disturbances 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.

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 participate 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
Kidney Care Consultants, PSC.

Symptoms of Kidney Disease

Often no symptoms in the earlier stages (I-III)

Headaches

Nausea and Vomiting

Swelling

A Metallic taste in your mouth

Trouble Concentrating

Feeling tired or weak

Itching

Loss of appetite

Shortness of Breath

Darkening of the skin

Change in Urination

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

Diabetes Mellitus

Race: African-American, Hispanic, and Native Americans

having a relative with CKD

being on arthritis medications (NSAIDs)

Hypertension

Age > 65

being on water pills ( diuretic)

several medications can potentially affect the kidneys, ask your doctor if you are on any of these medications.

How Can the Progression of Kidney Disease be Delayed?

Keeping blood pressure under control: that is at least < 140/90, the golden reading is 125/75 if you have diabetes or protein in urine.

Taking certain types of medication called ACE-Inhibitors or Angiotensin Receptor Blockers.

For Diabetics, keeping blood sugars under control with HbAIc less than 7.0. This requires frequest monitoring of your blood sugars.

Avoiding medication that will damage your kidneys such as non-steroidal anti-inflamatory drugs (NSAIDS). Examples are ibuprofin, Advil, Motrin, Aleve, Celebrex and Naprosyn.

Avoid Fleets® Phospho-soda and Fleets® Enema.

Avoiding, if possible, IV Contrast used for CT scans and Heart Catheterizations.

Controlling your cholesterol.

Quit smoking.

If overweight, losing weight.

Treating Anemia, if present.

Goals

BP (Systolic)

CKD

Diabetes &/or proteinuria

Urine protein/creatinine

<140

<125

< 0.15

Anemia

Hgb

Iron Saturation

Ferritin

>11

>20%

>200

Bone Disease

Calcium

Phosphorus

PTH

Stage III

Stage IV

Stage V

8.4 – 10.2

2.7 – 4.6

less than 300

35.70 70-110

150-300

Nutrition

Albumin

>3.8

Diabetes Mellitus

Hgb A-I-C

<7.0%

Cholesterol

LDL

HDL

<100

>45

Stages of Kidney Disease

Stage

GFR

Treatment Goals

I (1)

II (2)

III (3)

IV (4)

V (5)

>90

60-89

30-59

15-29

<15

Diagnosis and Treatment, slow progression

Estimating Progression

Evaluating and Treating Complications

Preparation for Dialysis/Transplant

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