What is CKD - Chronic Kidney Disease?
When kidneys are not functioning properly, waste products and fluid can build up in the body. Kidney disease, also called chronic kidney disease (CKD), is when kidneys can no longer remove enough wastes and extra fluid from the blood, or do other jobs as they should. Kidney disease is present when either the eGFR is less than 60 or the ACR is greater than 30 on 2 tests, for 3 or more months.
What is eGFR?
The eGFR describes how well kidneys filter the blood. To measure the function of kidneys, doctors determine the estimate glomerular filtration rate (eGFR) through laboratory testing.
What CAUSES kidney disease?
Over time, different health problems and medications can place stress on the kidneys and cause damage slowly. Type 2 diabetes and high blood pressure are common causes of kidney dysfunction.
What are the 5 STAGES of CKD?
Each stage has its own recommendations for specific treatment and dietary needs:
- Stage 1 with normal or high GFR (GFR > 90 ml/min): At this stage, the kidneys are doing a decent job, but are not functioning at 100% capacity. Most people do not experience symptoms at this point. This early stage of the disease can be stabilized with a healthy and nutrition-rich diet.
- Stage 2 with mild reduction (GFR = 60–89 ml/min): This stage is similar to the first one. Mostly, patients in this category are diagnosed through diabetes or hypertension screening. Patients at this stage have to make sure that they are both consuming a well-balanced diet and maintaining healthy blood pressure
- Stage 3A with mild-moderate reduction (GFR = 45–59 ml/min) and Stage 3B with moderate-severe CKD (GFR = 30–44 ml/min): At this point, symptoms such as tiredness or abdominal swelling become more obvious. Patients should be following a balanced diet that is high in plant-based foods and lower in protein, sodium, and saturated fat. Limiting sodium intake is one way to control blood pressure. For stages 3A and 3B, doctors will most likely prescribe medicine to control blood pressure.
- Stage 4 with severe reduction (GFR = 15–29 ml/min): Patients at this stage are usually approaching the need for dialysis or kidney transplant because the kidney damage is severe. At this point the symptoms grow more drastic: Nausea and vomiting can appear, the kidneys may start hurting, and urea buildup in the blood leads to bad breath. At stage 4, patients likely have to visit a specialist (nephrologist) every three months. People affected should reduce protein consumption, avoid smoking, and exercise regularly to help prolong kidney function. Diet and lifestyle changes may still delay the transition to dialysis or transplant at Stage 4, so patients should work with a dietitian.
- Stage 5 with kidney failure (GFR <15 ml/min): At this point, it is likely that the patient’s kidneys have given up their function completely. The kidneys are no longer able to remove toxins and fluids, which accumulate in the body, causing an overall feeling of sickness. Dialysis and kidney transplantation become necessary for survival.
Can CKD be CURED?
No, when total kidney failure happens, dialysis treatments or a kidney transplant are needed to stay alive. However, you can slow chronic kidney disease progression by changing your diet. Your daily goal is to limit your intake of potassium, sodium, phosphorus and protein according to the stage of your disease. Flavis understands that a renal diet is very restrictive and may interfere with your daily life. This is why we have developed special foods that are low in protein, phosphorus, sodium, and potassium. Our products can help you comply with dietary restrictions, support a diet that slows disease progression, and help you enjoy your food again.
With FLAVIS you can enjoy your food again!
Why are the KIDNEYS so IMPORTANT?
What do they do?
Our two bean-shaped kidneys are about 4–5 inches (approx. 13 cm) long. Their main job is to filter nutrients from the bloodstream and to eliminate waste materials. The kidneys maintain internal fluid balance and have a substantial effect on blood pressure control.
What are the SYMPTOMS of CKD?
The first symptoms of chronic kidney disease are:
- lack of energy and feeling lethargic
- poor concentration
- sleeping problems and muscle cramping at night
- abdominal swelling
- dry, itchy skin
- increased urination, particularly at night
If your kidneys start hurting, you may have missed other warning signals beforehand.
Can a person have CKD WITHOUT SYMPTOMS?
It is possible to have kidney disease and have no symptoms for a long time. The damage to the kidneys can occur slowly and gradually, over many years, even decades.
What TESTS do i need to see how my kidneys are working?
Blood and urine tests show how well the kidneys are doing their job. Both blood and urine tests can show the functional level of your kidneys. Urine tests can show how well the kidneys remove body wastes and whether they are leaking too much protein.
Creatinine (kree-AT-uh-nin) is a waste product that comes from the normal wear and tear on muscles of the body. A creatinine level around 1 is normal in most people, but can differ based on age, race, and body size. The level of creatinine in the blood goes up if kidney disease gets worse. Estimated glomerular filtration rate (eGFR) is the more accurate test of kidney function.
Estimated Glomerular Filtration Rate (eGFR)
This test is the best measure of how well the kidneys are removing wastes and excess fluid from the blood. Your healthcare practitioner can estimate GFR (eGFR) from the blood creatinine level using your age, weight, gender, and body size. Normal eGFR can vary according to age (as you get older it goes down). An eGFR below 60 is a sign that the kidneys are not working properly.
An eGFR below 15 may mean that the person will need treatment for kidney failure, such as dialysis or a kidney transplant. You can think of eGFR as a percent of kidney function with less than 60% being lower than normal. The eGFR goes down if kidney disease gets worse.
Albumin-Creatinine Ratio (ACR)
The albumin-creatinine ratio (ACR) is a test which can find a protein called albumin in the urine. Albumin is present in high amounts in the blood, but almost no albumin is present in the urine when the kidneys work properly. However, albumin may be present in the urine even in the early stages of kidney disease (and before a reduction in eGFR).
Protein-Creatinine Ratio (PCR)
The protein-creatinine ratio is another test for kidney damage.
What can I do to PROTECT my kidneys?
There are a number of lifestyle choices you can make to protect your kidneys:
- Maintain a healthy weight
- Consume a balanced diet
- Avoid processed foods
- Participate in physical activity regularly
- Quit smoking
- Manage blood sugar and blood pressure levels as prescribed by your doctor.
How does DIET affect kidney function?
Is there a special diet for CKD?
For CKD, the clearly defined form of nutrition is called renal diet. A renal diet is low in sodium, phosphorus, potassium and protein.
Sodium is one of the three electrolytes that controls our fluid balance. Hydration is critical for maintaining blood pressure and acid-base balance, as well as nerve and muscle function. Chronic kidney disease patients should limit sodium intake because their kidneys are unable to clear the excess sodium from their blood. This may cause fluid retention, high blood pressure, and potentially even heart failure.
Extra phosphorus induces the release of calcium, which makes our bones weaker. The remaining calcium may accumulate in the blood vessels and heart tissue, leading to arterial calcification (hard deposits in the arteries), which in turn increases the risk for cardiovascular diseases.
Consume more high quality proteins. Protein consumption is a tricky thing for damaged kidneys. The right amount is determined by the stage of the disease. However, some protein is necessary for tissue maintenance and repair.
Keep an eye on blood potassium levels. Some CKD patients experience hyperkalemia, which means they have elevated blood potassium levels. Potassium is important for heart function and muscle activity. However, if it accumulates in the blood due to failed extraction, the muscle cells of the heart can start to beat irregularly and lead to heart attack. In cases of hyperkalemia, potassium intake may need to be limited.
It is important that your diet be adjusted step by step because everybody is different. We recommend working with a renal dietitian.
A renal diet is low in sodium, phosphorus, potassium and protein. We recommend working with a renal dietitian.
What is a DIETITIAN?
Dietitians are credentialed healthcare providers that specialize in medical nutrition therapy. A renal dietitian specializes in evidence-based medical nutrition therapy and counseling for individuals with chronic kidney disease. Renal dietitians help patients preserve their remaining kidney function, continue to feel well, and reduce their risk of developing other complications such as cardiovascular disease. They can walk you through how to implement this complicated diet in everyday life and can answer any questions you have about the diet.
Find your dietitian now ! (Just click on the white button on the right)
WHAT can you EAT on a ranal diet? WHAT can you NOT EAT on a renal diet?
Your main goal is to provide your body with high-quality nutrients that it can use up completely without producing waste:
- Prioritize consumption of fresh fruits and vegetables.
- Choose unsalted food. Use herbs and spices to spice up your meal.
- Try to replace your starches with low-protein substitutes.
- Choose olive oil as source of anti-inflammatory fatty acids.
You should try to avoid anything that is high in phosphorus, potassium, and sodium. Therefore, you may need to:
- Reduce portions of foods high in potassium such as avocado, banana, fish and potatoes.
- Reduce foods high in phosphorus such as fast food, meat, and sweetened beverages.
- Cut back on milk and dairy products.
- Avoid salt.
- Avoid marinated food with an excess of sodium, phosphorus or potassium.
- Cut down on high protein foods, especially those coming from animal sources.
- Avoid processed foods, as they contain additives and chemicals that may not be cleared by your kidneys as well and accumulate in your body.
Finding alternatives is the key!
It can be frustrating to turn down a barbecue with your family and friends because you feel like you’re not allowed to eat anything there. But following a renal diet does not mean that you cannot participate in social events and dining with friends and family.
Instead of having heavily salted meat for your barbecue, try putting your favorite herbs and spices on veggies coated in olive oil. This creates a delicious meal that is also good for you! Researching alternatives requires some time and energy, but it will help you keep the disease from becoming overwhelming in the long run.
Flavis can help you! We develop foods that are low in protein, phosphorus, sodium, and potassium, which can help you stick to your dietary recommendations. Our products are also completely safe for your friends and family to eat. In our product range you will find pasta, bread, and sweet treats. This brings back that variety you love and have been missing ever since you started your diet. It also allows you to eat the same food as your friends and loved ones again.
Do people with CKD need to watch their FLUID INTAKE?
This depends on your doctor’s recommendation. Fluid retention places additional stress on the kidneys and heart. Your doctor will determine your fluid needs based on your lab results and urine output.
What is a NEPHROLOGIST?
A nephrologist is a doctor who treats patients with kidney problems and related hypertension or high blood pressure. Once you have been diagnosed with kidney disease, early referral to a nephrologist is important for preserving your kidney function. As a specialist in kidney disease, your nephrologist has the knowledge and skills to work with you in developing a plan of care specific to your needs.
How long can I LIVE with CKD?
This depends on your age, other health problems, and how involved you become in your care. There are major advances in today's healthcare. We have better drugs, knowledge, and technology to give you a better life than we had some years ago. But diet and lifestyle are still the most critical factors.
What are my TREATMENT options if my kidneys fail ?
How is it treated?
Dialysis and kidney transplant are the only treatment options for kidney failure. A kidney transplant surgically places a healthy kidney from another person into your body. The donated kidney does the work that your kidneys used to do.
What is DIALYSIS?
What are the different typer of dialysis treatments?
Dialysis is a way of cleaning your blood. It is a medical treatment that does some of the work healthy kidneys would do, including:
- Removing waste, salt and extra water from your body
- Regulating your body’s fluid balance
- Helping to control your blood pressure
There are 2 main types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD)
Each has different advantages, requirements and scheduling options. Depending on your health status, lifestyle, and other factors, you and your doctor should decide which type of dialysis is right for you.
Hemodialysis is a process where blood is filtered outside the body by a machine called a dialyzer or “artificial kidney,” and then returned to your body.
Peritoneal dialysis gets its name from the lining of your abdomen, which is called the peritoneum. This lining is a membrane that surrounds the space in your abdomen called the peritoneal cavity. This natural lining can be used to filter your blood.
What is a VASCULAR ACCESS?
For hemodialysis it is necessary to create a vascular access or pathway to your blood. The access is usually created in your arm during a short surgery. In some cases an external catheter may be inserted into a vein in your chest or neck. A catheter is usually temporary and replaced by a fistula or graft.
How are my DIABETES CONTROL and BLOOD PRESSURE CONTROL related to my kidney function?
Diabetes is one of the most common causes of chronic kidney disease (CKD). High blood sugar levels can damage the blood vessels and affect the filtering ability of the kidney. Controlling your blood sugar can help slow the progress of your kidney disease.
High blood pressure damages the blood vessels and reduces blood supply to the kidneys. High blood pressure can cause kidney problems and vice versa. Uncontrolled high blood pressure can cause a decrease in kidney function and irreversible kidney damage.
Why do i have ANEMIA? What is it?
Anemia is a decrease in red blood cells. Red blood cells carry oxygen throughout the body and a decrease in red blood cells can result in fatigue, shortness of breath, depression, poor appetite and heart disease. The kidneys make a hormone called erythropoietin which helps form red blood cells. With CKD there is a decrease in the production of this hormone and subsequent decrease in red blood cells.
What is UREMIA?
Uremia is a serious complication of chronic kidney disease. It occurs when urea and other waste products buildup in the body because the kidneys are not able to eliminate them. These substances can become poisonous (toxic) to the body if they reach high levels.
Should I keep WORKING?
Yes! Work can make you feel like you're still you, and that you are still helping to support your family. Work may also be an important vital part of your social life.