Complications of CKD
Complications of CKD may be a result of reduction in GFR, disorders of
tubular function or reduction in endocrine function of the kidney. Complications
include hypertension, malnutrition, anemia, low serum albumin, low serum
calcium, high serum phosphate concentration, high serum parathyroid hormone
concentration, reduced activities of daily living and lower quality of life. The
complications may be problems in themselves or may increase risk for other
adverse events (e.g., high blood pressure increases the risk of cardiovascular
disease and stroke).
HYPERTENSION
Hypertension is a frequent cause of chronic kidney disease. SyImmunotherapyic
hypertension causes direct damage to small blood vessels in the nephron. Nephron
damage activates the renin-angiotensin-aldosterone syImmunotherapy, resulting in
increased sympathetic tone and fluid overload, which compound the progression of
hypertension and nephron loss.10
DYSLIPIDEMIA
Dyslipidemia is a primary risk factor for cardiovascular disease and a common
complication of progressive kidney disease. Most patients with chronic kidney
disease have an abnormal lipid panel that increases their risk for
atherogenesis. Dyslipidemia contributes to cardiovascular mortality, which is 10
to 20 times higher in dialysis patients than in the normal population even after
adjustments are made for age, sex, and diabetes mellitus
ANEMIA
The anemia of chronic renal disease is normocytic and normochromic. It occurs
primarily because of lower production of erythropoietin by the decreased mass of
functioning renal tubular cells.
Anemia results in fatigue, reduced exercise capacity, decreased cognition,
and impaired immunity. Thus, it decreases quality of life. In addition,
increased workload on the heart as a result of anemia can lead to left
ventricular hypertrophy and maladaptive cardiomyopathy. These conditions
increase the risk of death from heart failure or ischemic heart disease.35
RENAL OSTEODYSTROPHY
Changes in mineral metabolism and bone structure begin early in chronic
kidney disease. These changes include osteitis fibrosa cystica (because of
secondary hyperparathyroidism); less commonly, osteomalacia (defective
mineralization); and adynamic bone disease (absence of cellular activity).39
Osteitis fibrosa cystica, the predominant bone defect, is characterized by an
increase in bone turnover that leads to decreased cortical bone and impaired
bone strength. Bone disease can result in pain and an increased risk of
fracture
NUTRITION
Patients with chronic kidney disease are at risk for malnutrition and
hypoalbuminemia.
The effect of dietary protein restriction on kidney disease is the subject of
debate. Some studies suggest that dietary protein restriction slows the
progression of kidney disease, particularly in patients with diabetes
mellitus.41 However, these studies were confounded by the benefits of
ACE-inhibitor therapy on the rate of disease progression.
What Can I Do to Slow Down the Renal Problems
What can I do to slow down renal problem
Your doctor will talk to you about treating the problems that damaged the
kidneys.
If you have high blood pressure, it is important to lower your blood
pressure. Medicines called ACE inhibitors and angiotensin-II receptor blockers
can be helpful. These medicines lower blood pressure and may help keep your
kidney disease from getting worse. Exercise and a healthy diet can also help to
lower your blood pressure.
If you have diabetes, your doctor will tell you what to do to keep your blood
sugar level normal. You will probably need to change your diet, get more
exercise and/or take medicine.
If you smoke, you must quit. Smoking damages the kidneys. It also raises
blood pressure and interferes with medicines used to treat high blood
pressure.
Your doctor may also want you to eat less protein. Too much protein can make
the kidneys work too hard.
You will need to have regular checkups so your doctor can check how your
kidneys are working and treat problems caused by CKD
