Chronic Kidney Disease (CKD)
Overview
CKD slowly destroys the kidneys over time. 1 in 10 adults worldwide has CKD, which could be fatal without proper care. The mortality rate associated with CKD continues to increase every year, and it is projected to be the 5th leading cause of death by 2040. Over 2 million people globally are on dialysis treatment or have undergone a transplant each year. In Cyprus in February of 2022, 933 people were on dialysis. There was a 70% increase between 2014 – 2021 in the number of patients on dialysis in Cyprus.
Diagnosis
The disease is divided into different stages depending on the severity of the kidney damage. Diabetes is the most common cause of CKD. Other causes include high blood pressure (arterial hypertension), heart disease, autoimmune kidney diseases (glomerulonephritis), long-term use of certain drugs (such as lithium and non-steroidal anti-inflammatory drugs – painkillers) and certain genetic conditions such as polycystic kidney disease.
The early stages of CKD may not manifest any symptoms at all. Symptoms generally occur when there is significant kidney damage and may include:
- Swelling in the legs, body and/or face
- Muscle cramps
- Dry, itchy skin
- Chest pain
- Numbness
- Fatigue
- Decreased appetite
- Unexplained weight loss
- Nausea
- Vomiting
- Difficulty breathing
CKD can be diagnosed through blood and urine tests. These tests look for high levels of certain substances in the blood and urine, which are signs that the kidneys are not working properly. If there is a high risk of developing kidney disease (for example, having a known risk factor, such as high blood pressure or diabetes mellitus), regular testing is recommended to check for CKD so that it can be detected at an early stage. The results of these blood and urine tests can determine whether kidney disease is present, and at what stage.
Blood tests:
The main test for kidney disease is blood creatinine levels. Creatinine levels, along with the age, body mass, gender, and ethnic group are used to calculate how many milliliters of waste the kidneys should be able to filter in one minute. This calculation is known as the estimated glomerular filtration rate (eGFR). Healthy kidneys should be able to filter more than 90 ml/min. CKD may be present if the rate is lower than this.
Urine tests:
A urine test is also conducted to:
- Check the levels of albumin and creatinine in the urine – known as the albumin-creatinine ratio or uACR.
- Test for blood or protein in urine.
Alongside eGFR, urine tests can help give you a more accurate picture of how well the kidneys are working.
Other tests:
Sometimes other tests are recommended to assess the level of damage to the kidneys. These may include:
- Ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scan – checking the image of the kidneys and the possible presence of blockages.
- Kidney biopsy – a small sample of kidney tissue is removed with a needle and the cells are examined under a microscope for signs of damage.
Treatment
There is no specific treatment for most cases of CKD. The treatment can help relieve symptoms and slow or stop the progression of CKD. The treatment varies depending on the severity of each patient’s condition. The main treatments are:
- Changes in lifestyle, including diet, exercise, fluid intake and more
- Medication to control problems such as high blood pressure, diabetes, and high cholesterol
- Dialysis treatment to restore some of the kidney functions (may be necessary in advanced stages of CKD)
- Kidney transplant, which may be necessary in advanced CKD
- Testing at regular intervals to monitor CKD
Why GMI
The medical and nursing staff of the Department of Nephrology are highly specialized and trained for the early recognition, diagnosis, and treatment of chronic kidney disease.
The GMI is equipped with everything that you may need during your diagnosis and treatment, including everything that is needed to conduct the necessary and specialized tests (laboratory and imaging) for CKD. The Nephrology Department works closely with other medical disciplines that can aid the nephrology team to better address patients’ needs are also present at the GMI. We treat each patient individually considering: (i) the individual characteristics of their chronic kidney disease, (ii) international guidelines, (iii) state-of-the-art treatment regimens and (iv) their personal preferences and wishes.
The GMI team will never offer a simple “one size fits all” approach to any patient. We believe each patient’s case is as individual as they are and strive to find the best solution for each of our patients, taking their specific case and diagnosis, their lifestyle, and choices into account.
We believe each of our patients is more than their diagnosis. That’s why our dedicated paramedics team supports patients with CKD by offering more than just expert medical care. We offer psychological help, integrative medical services (including yoga classes, and acupuncture) and have a GMI Patient Advocacy Program.
Adhering to our passion for innovation, and desire to progress the medical field, the GMI both initiates and participates in several clinical trials in which the most modern and advanced treatment concepts are tested. At the GMI patients have the opportunity to participate in these clinical trials.
