Stages of CKD and treatment
CKD( chronic kidney disease) is a disease that usually follows nephropathy. As statistics show, this outcome with nephropathy is almost inevitable, although exceptions are possible. In most cases, neither the nature of the disease nor any other characteristics play a role. It is practiced treatment of CKD in stages, each of which is characterized by a violation in the activity of a vital organ.
A correct approach allows you to improve the quality of life and somewhat reduce the discomfort associated with a health problem. And yet you need to understand: from year to year, from decade to decade, the functioning of the kidneys will be less and less qualitative.
Disease: how serious is it?
Five stages of CKD are currently known. According to the GFR, it can be concluded that the state of a person has been started. The doctor receives biological materials for the study and, following the results of the laboratory findings, decides: to what stage is the disease to be attributed, how to approach the treatment process and how it is possible to improve the quality of life.
As a rule, the complex treatment of the disease is practiced, since it is the approach taking into account the general state of health of the patient that gives the best results. There are classical variants of therapy at a stage of albuminuria at CKD, it is possible to address and to modern innovative methods.
Sick or not?
Often questions like "Can CKD remain in 2 stages" are assigned to people who have been diagnosed with a disease quite unexpectedly for themselves. As the statistics show, the percentage of suffering kidney diseases in our country is very large, and many problems are in already quite neglected state.
Modern medical practice in Russia is such that large-scale preventive measures and the timely detection of renal diseases are not practiced, as a result of which the literacy of the general population in this matter is minimal.
In developed countries, where the level of medical services is traditionally high, the classification of CKD stages by GFR is not a serious problem for doctors, and the population regularly undergoes tests to identify the disease at the very beginning of its development. For this purpose, so-called screening studies are organized. In the course of studying the features of kidney function, it is possible to detect not only a chronic disease, but also other pathologies.
As shown by medical research, in one or another stage of CKD is present in 10% of the total population of the planet. In specific groups of persons the frequency doubles. At risk, in the first place, the elderly, suffering from type 2 diabetes.
You can conclude how large the problem is if you compare statistics on other common diseases. For example, heart failure was diagnosed on average in one percent of the population, asthma in five percent of adults, and increased pressure in almost a quarter of the world's population.
The data on all stages of CKD are approximately comparable with the frequency of diagnosis of diabetes mellitus - the same ten percent( slightly less, slightly more).
How to evaluate?
More recently, the classification of CKD by stages has been very controversial. In fact, the generally accepted system did not exist, and advanced ideas were not used in practice. In Russian clinics, the system of CKD classification by stages, developed by Ratner, was mostly used. The peculiarity of this methodology was in the orientation towards the content of creatinine. However, in some clinics this option was considered insufficiently accurate and correct, so in practice they used the system proposed by Professor Tareev. This specialist suggested determining the severity of the disease according to the level of GFR.
Quite a common option for determining the stage of CKD was the method proposed by doctors Kuchinsky and Ryabov. This methodology was considered integrated, and it is still used in some medical institutions to this day. However, it has long been clear that a unified methodology is needed that would be used centrally in all medical institutions. As a result, the CKD method developed in 2002 in America was chosen for general use.
What are we talking about?
As follows from the currently accepted terminology, CKD is a disruption in the functionality of the kidneys, which provokes a decrease in organ activity for three months or more. CKD is a term that applies to different diagnoses. Violations are described either as structural or as functional. To determine the stage of CKD, it is necessary to conduct specialized laboratory studies, in which, first of all, the indicator of GFR is examined.
GFR( glomerular filtration rate) is an indicator that is monitored for suspected CKD for three months. If the value is less than 60 ml / min based on 1.73 m2, there is evidence of chronic organ damage. The disease can be accompanied by damage to the kidneys or develop in the absence of such.
Classification of CKD
The division at the stage is based on the mean GFR.The lower normal value is equal to 90 ml / min, and the death of half of the nephrons is reflected in a GFR analysis of 60 ml / min or less. The first stage of the disease is characterized by a normal value or slightly exceeding the norm. When diagnosing such indicators, it is necessary to start treatment as soon as possible in order to prevent a worsening of the situation.
The second stage of CKD is characterized by GFR in the range of 60 to 89 ml per minute. Treatment of Stage 3 CKD is topical if the indicator decreases to a value in the range of 30 to 59 ml. The fourth stage is characterized by GFR 15-29 ml, and for the fifth, values less than 15 ml / min are characteristic.
Age and characteristics of
It is known that in old age the normal performance of the kidneys is somewhat lower than that of younger individuals. Therefore, it was established for people aged 60 years and older with a norm of 60-89 ml per minute. At this level, it is considered that there are no risk factors and such a functioning for the organ is normal.
Disease: What are we talking about?
CKD is a chronic impairment of kidney function, which eventually leads to the development of inadequate functioning of this organ. Often the disease in the first stages proceeds without symptoms, and the patient turns to the doctor for 4 stages. Treatment of CKD at this stage is a rather difficult task.
There are quite a few cases from medical practice in which CKD was found at a stage where the only tangible effect could have been either organ transplantation or hemodialysis. This is the so-called terminal stage.
Kidneys: features of the organ
Kidneys are one of the paired organs in the human body. Location - the abdominal cavity. The kidneys are similar in shape to the beans, legumes, on average - about 12 cm. Around the kidneys is located fat tissue, which allows the organ to remain in anatomically correct position. Sharp weight loss, as well as a lack of weight can lead to fatty tissue degradation, which causes nephroptosis, omission of the organ.
The peculiarity of the structure of the kidneys is the presence of two layers, the upper one of which resembles the crust, and the inner one is called the cerebral layer. When studying the kidney in a section, one can see that the organ is formed by numerous tubules that collect the liquid and direct it into the pelvis of the urine - a peculiar collector. Kidneys consist of nephrons - capillary tangles, encapsulated.
In a normal state, the kidney is a system of one million active nephrons that filter blood. The glomerular membrane during normal functioning blocks the majority of blood components from getting into the organ, but in a number of diseases there is a violation, and tests show the presence of leukocytes, erythrocytes, and other constituents in the urine.
CKD: signs of
Often it is very difficult to presume a chronic illness, especially at first. In addition, the main manifestation, for example, 4 stages of CKD, herbal treatment allows you to hide. However, this self-treatment does not restore the normal functioning of the body, but only masks the main manifestations of the disease, not allowing it to be detected on time. So it turns out that an amateur self-treatment, hiding from himself and the doctors his disease, is faced with the need to know at what stage of CKD hemodialysis - after all nothing else in the late stage of the disease already simply does not help.
In order to avoid such an outcome, it is necessary to treat your organism with as much attention as possible and with dubious signs immediately go to the doctor, take tests to determine the cause.
The first symptom that should alert a person is a change in the amount of secretions. The amount of urine can become smaller than usual, which is associated with a weak functioning of the organ. In a number of cases, the opposite happens: urine is produced in volumes exceeding the norm, which is accompanied by a constant thirst.
The composition and color of urine under the influence of pathology also change: there is blood, sediment. Quite often in CKD, the pressure in the kidneys increases, renin is released, thereby increasing the pressure as a whole. The person feels weak, the appetite disappears. This is due to toxicosis, provoked by insufficient purification of the blood by the kidneys. At the same time, the puffiness of the extremities is disturbed, inflammatory processes occur in the kidneys.
Features of different stages of
At the first stage, they speak of kidney damage, while GFR remains normal or slightly above normal. Define the disease at this level of development is not easy - it is possible only with the constant monitoring of human analyzes. There are practically no symptoms at the first stage.
In the second stage, the GFR decreases, but is insignificant. This is accompanied by damage to the body.
Early symptoms are usually recorded in the third stage of the disease. Renal failure is manifested. The marked decrease is observed at the fourth stage, in medicine called preterminal. As the statistics show, at this stage, accompanied by late symptoms of kidney failure, most patients come to the hospital.
Finally, the treatment of stage 5 CKD is the most difficult task, since this degree is the most neglected. Here, substitution therapy is needed, since it is about uremia.
CKD: causes and treatment
CKD is a term that is used to describe various diseases that provoke the same outcome-renal failure. The symptomatology is quite different depending on which pathology CKD provoked. Of course, treatment also depends heavily on the cause of the kidney damage. As is known from medicine, most often the problem is in the inflammatory process that damages the organ.
At the moment, scientists have not been able to find out why glomerulonephritis develops. It is only known that in the risk group people who have had an infectious disease of the upper respiratory tract. A virus or hereditary factors can play its role.
This disease often begins imperceptibly, proceeds rather secretively, and is discovered quite by accident. As a rule, bilateral inflammation is manifested by the presence of erythrocytes, a protein in the urine. In a number of cases, pathology is accompanied by swelling, increased pressure.
Exact diagnosis is possible by biopsy. The features of treatment are chosen, focusing on the specificity of glomerulonephritis in a particular case. The most common form of this disease is characterized by a gradual decrease in the quality of kidney function: the process is stretched for decades, but the condition of the body is steadily deteriorating.
Diabetes mellitus and kidneys
Once a person has diabetes mellitus, he is immediately considered a risk group for developing kidney failure. Nephropathy is one of the most serious complications that accompany diabetes. Microalbuminuria is usually not accompanied by symptoms, complaints, so the onset of the disease is often overlooked. Proteinuria is accompanied by swelling of the extremities, the face can swell, pressure increases. However, it so happened that because of careless attitude towards their health, many patients miss these symptoms, writing off them for manifestations of diabetes.
CKD in some cases is accompanied by vomiting and nausea, appetite disappears completely, the skin starts to itch, the person feels tired, the forces leave him, and rest does not help to recover. The progress of the disease can be stopped at the stage of microalbuminuria, timely therapy allows the kidneys to return to a healthy state and completely normalize the functionality.
If the lesion is detected during the proteinuria stage, there is a possibility of blocking the progress of negative processes. If the pathology is diagnosed in the status of CKD, treatment becomes impossible. The only option of positive development of events is successful substitution therapy.
Infection and CKD
Inflammation of the kidneys in recent years is much more frequent than several decades ago. Of the other bacterial diseases characteristic of all ages, it is the renal inflammation that is diagnosed most often.
It is known that in a healthy state, a person has sterile urine, and the urinary tract is free from microbes. If the source of the disease enters the urinary canals, the bladder, the inflammatory process may begin. The disease is usually accompanied by painful sensations and increased frequency of urination, and during the release of the bladder from the fluid there is a burning sensation. At analyzes it is noticed, that urine muddy, often pinkish that speaks presence of erythrocytes.
Progress of the disease is accompanied by fever, pain in the abdomen, back, as well as vomiting, nausea. Repeated infection can occur without fever. At the same time it is known that in childhood it is often the temperature - the only indicator of the presence of infection. A repeated inflammatory process is associated with a high probability of developing renal failure. Often secondary infection shows the progress of CKD.
Treatment: where to start?
More or less good results treatment of CKD only shows if it was possible to correctly determine for what reason the disease develops. If glomerulonephritis is detected, then immunosuppressive therapy is necessary, in case of diabetes it is necessary to take measures to eliminate the negative impact of this pathology on internal organs and systems. If CKD is caused by an inflammatory process, it is necessary to take antibiotics and undergo other systematic treatment.
For any primary reason, a healthy effect will show a healthy lifestyle and proper nutrition. It is necessary to control the amount of calories consumed, to lead an active life, including a lot of movement, albeit in accordance with age standards. The diet is selected, being guided by the root cause, which provoked CKD.As a rule, the attending physician helps to choose the best option. It is necessary to follow his recommendations as carefully as possible. In addition, in CKD, you need to keep the pressure under control and take steps to eliminate the symptom when you increase.