How does CKD affect kidney function in India?

The Chronic Kidney Disease Solution™ By Shelly Manning It is an eBook that includes the most popular methods to care and manage kidney diseases by following the information provided in it. This easily readable eBook covers up various important topics like what is chronic kidney disease, how it is caused, how it can be diagnosed, tissue damages caused by chronic inflammation, how your condition is affected by gut biome, choices for powerful lifestyle and chronic kidney disease with natural tools etc.

Chronic kidney disease (CKD) progressively impairs kidney function over time, leading to a range of health complications. In India, the burden of CKD is significant due to various factors, including high prevalence of diabetes, hypertension, and limited access to healthcare. Here’s a detailed look at how CKD affects kidney function, with a focus on the Indian context:

Stages of CKD and Kidney Function

CKD is classified into five stages based on the glomerular filtration rate (GFR), which measures how well the kidneys filter blood. As CKD progresses, kidney function declines:

Stage 1: Kidney damage with normal or increased GFR (≥90 mL/min/1.73 m²).
- Impact: Often asymptomatic, but early signs of kidney damage may be present.
- Management: Focus on controlling underlying conditions like diabetes and hypertension.
Stage 2: Mild decrease in GFR (60-89 mL/min/1.73 m²).
- Impact: Mild reduction in kidney function; may still be asymptomatic.
- Management: Regular monitoring and lifestyle modifications to slow progression.
Stage 3: Moderate decrease in GFR (30-59 mL/min/1.73 m²).
- Impact: Noticeable reduction in kidney function; symptoms like fatigue, swelling, and changes in urine output may appear.
- Management: More intensive management of underlying conditions, dietary adjustments, and medications to manage symptoms.
Stage 4: Severe decrease in GFR (15-29 mL/min/1.73 m²).
- Impact: Significant loss of kidney function with more pronounced symptoms such as anemia, bone disease, and cardiovascular complications.
- Management: Preparation for potential dialysis or kidney transplant, in addition to aggressive management of symptoms and complications.
Stage 5 (End-Stage Renal Disease – ESRD): GFR <15 mL/min/1.73 m².
- Impact: Kidneys are no longer able to maintain fluid and electrolyte balance, leading to severe complications and the need for dialysis or transplant.
- Management: Dialysis or kidney transplant becomes necessary to sustain life.

Effects of CKD on Kidney Function

Impaired Filtration:
- Mechanism: Damaged nephrons (the functional units of the kidney) reduce the kidneys’ ability to filter waste products and excess fluids from the blood.
- Symptoms: Accumulation of waste products (uremia), leading to nausea, vomiting, fatigue, and confusion.
Fluid and Electrolyte Imbalance:
- Mechanism: CKD disrupts the kidneys’ ability to regulate the balance of fluids and electrolytes such as sodium, potassium, and calcium.
- Symptoms: Swelling (edema), high blood pressure, and dangerous electrolyte imbalances like hyperkalemia (high potassium levels), which can cause cardiac arrhythmias.
Acid-Base Imbalance:
- Mechanism: Reduced kidney function impairs the kidneys’ ability to maintain the body’s acid-base balance, leading to metabolic acidosis.
- Symptoms: Shortness of breath, confusion, and muscle weakness.
Hormonal Imbalance:
- Mechanism: The kidneys produce hormones like erythropoietin (which stimulates red blood cell production) and activate vitamin D (essential for calcium absorption).
- Symptoms: Anemia due to decreased erythropoietin production and bone disease (renal osteodystrophy) due to impaired vitamin D activation.

Specific Challenges in India

High Prevalence of Diabetes and Hypertension:
- Impact: Diabetes and hypertension are major risk factors for CKD. The high prevalence of these conditions in India contributes significantly to the CKD burden.
- Management: Effective management of these conditions through lifestyle changes and medications is crucial to prevent CKD progression.
Healthcare Access:
- Urban vs. Rural Divide: Access to nephrology services, dialysis, and transplant facilities is often limited in rural areas.
- Economic Barriers: Financial constraints can prevent timely diagnosis and treatment, leading to advanced CKD at the time of presentation.
Awareness and Education:
- Impact: Lack of awareness about CKD symptoms and risk factors leads to delayed diagnosis and treatment.
- Initiatives: Public health campaigns and community education programs are essential to improve awareness and early detection.
Nutritional Challenges:
- Dietary Habits: Traditional Indian diets high in sodium and low in balanced nutrients can exacerbate CKD progression.
- Recommendations: Dietitians and healthcare providers need to offer culturally appropriate dietary advice to manage CKD.
Environmental and Lifestyle Factors:
- Impact: Exposure to environmental toxins, use of non-steroidal anti-inflammatory drugs (NSAIDs) without prescription, and traditional remedies can affect kidney health.
- Management: Education on the safe use of medications and avoidance of nephrotoxic substances is crucial.

Complications of Untreated CKD in India

Cardiovascular Disease:
- CKD patients are at higher risk for heart attacks, strokes, and heart failure due to the interplay between kidney and cardiovascular health.
Infections:
- Weakened immune system in CKD patients increases susceptibility to infections, which can further complicate the disease.
Quality of Life:
- CKD significantly impacts quality of life due to symptoms like fatigue, pain, and mobility issues, affecting daily activities and mental health.
Economic Burden:
- The cost of managing advanced CKD, including dialysis and transplant, can be a significant financial burden for patients and families.

Conclusion

CKD significantly impairs kidney function, leading to a range of complications if left untreated. In India, the high prevalence of diabetes and hypertension, coupled with challenges in healthcare access and awareness, exacerbates the impact of CKD. Early detection, effective management of underlying conditions, lifestyle modifications, and improved healthcare access are crucial to slow CKD progression and improve outcomes for patients. Public health initiatives and education programs play a vital role in addressing these challenges and promoting kidney health.