Kidney Disease – Part II

What are the possible causes of CKD?

• Diabetes – Diabetes is the leading cause of CKD in the US.  It is a disease in which your body either cannot make enough insulin or cannot use normal amounts of insulin properly.  This results in high levels of glucose (sugar) in the blood.  These high blood sugar levels can cause damage in many parts of the body, including the kidneys.
• High blood pressure – This is the second leading cause of CKD in the US.  High blood pressure can narrow the blood vessels in your body and can also cause damage that can weaken the blood vessels.  This damage increases the risk for heart attacks, strokes, and CKD.  If the blood vessels in the kidneys are damaged, they are not able to remove all of the waste and extra fluid from your body.  Extra fluid in the blood vessels can raise your blood pressure even more, which can set up a dangerous cycle that might eventually lead to kidney failure.
• Glomerulonephritis – An inflammatory disease of the kidneys, with several possible causes.  It can happen suddenly, such as after an infection like strep throat.  Or it may be a more chronic, low-grade inflammation that causes kidney damage over a longer period of time.
• Polycystic kidney disease – This is the most common inherited kidney disease.  This condition causes numerous cysts within the kidneys, which can get larger over time.  It can cause serious kidney damage, even leading to kidney failure.
• Drugs and toxins – Using large amounts of over-the-counter pain relievers over long periods of time can be harmful to the kidneys.  Certain other medications, toxins, pesticides, and illicit drugs such as heroin or crack cocaine can also cause kidney damage.
• Congenital diseases – Problems that happen in the urinary tract while a baby is developing can affect the kidneys.  A problem that allows urine to back up from the bladder into the kidneys is one of the most common.  It can cause infections and kidney damage.

• Protein in the urine – When the filtering mechanism in the kidney has been damaged, it can allow too much of a protein called albumin to be released into the urine.  Sometimes protein is found in the urine after heavy exercise or after an acute illness (especially one that causes fever), so if you have protein in your urine once, your doctor will want to repeat the test several weeks later to confirm the results.  Protein levels in the urine can be measured with different tests.
• Blood creatinine level – Creatinine is a waste product from the normal processes in your body.  When your kidneys are working normally, they remove creatinine from your blood and keep the blood level low.  When your kidneys are not working well, the level goes up.  The results of this test can be used to calculate your glomerular filtration rate (GFR), which is a measure of how well your kidneys are filtering your blood.

• High blood pressure – We talked about the fact that high blood pressure can cause CKD, but it can also be caused by CKD.  Anyone with high blood pressure should be evaluated for CKD.
• Blood in the urine
• Persistent foamy looking urine can indicate too much protein in the urine.
• More frequent urination, particularly at night.
• Less frequent urination with less overall amount of urine
• Swelling of the hands and feet, and/or persistent puffiness around the eyes.
• Fatigue
• Persistent nausea

Dr. Anita Bennett MD – Health Tip Content Editor