Everything you need to know about kidney disease

Having functioning kidneys is very important. Your kidneys remove waste and extra fluid from your body, they control your blood pressure, they keep your bones healthy, and much more. This is why it’s essential to understand the signs of kidney disease and get treated as quickly as possible, if you should need to.

The topic of kidney disease can feel overwhelming without the help of experts. If you’re struggling with symptoms of kidney disease or know someone who does, you’ll want to have as much information about the illness as possible.

Nephrology is the branch of medicine that treats problems with your kidneys. Dr Bassam Alchi is a consultant nephrologist at The Princess Margaret Hospital. Dr Andrew Palmer is a consultant nephrologist at The Clementine Churchill Hospital. Here they answer your most common questions about kidney disease, covering everything from signs and symptoms to causes and effective treatments.

What are the common types of kidney disease?

Dr Bassam Alchi: The most common type of kidney disease is chronic kidney disease, a condition characterised by a gradual loss of kidney function over time. With this condition, both kidneys are affected.

There are five stages of chronic kidney disease, with stage 5 being the more advanced. There are many symptoms of chronic kidney disease, which include tiredness, swollen ankles, shortness of breath, and feeling sick. It has many causes, such as high cholesterol, high blood pressure, blockages in the flow of your urine, for example kidney stones that keep coming back.

Another more serious type of kidney disease is acute kidney injury, which is a sudden and recent reduction in the level of your kidney function. Acute kidney injury is a medical emergency as it can be potentially reversible if treated early. Symptoms of acute kidney disease include feeling sick, dehydration, drowsiness and confusion, and peeing less than usual.

Dr Andrew Palmer: There are many types of kidney disease. These can be split into problems that affect the kidney alone such as inflammation called nephritis, or inherited cystic diseases, or more generalised conditions that affect not only your kidney. These include diabetes, hypertension, and more complex problems such as auto-immune conditions and treatment related to other medical problems such as cancer.

Read about the 7 warning signs of diabetes.

What are the causes of kidney disease?

Dr Bassam Alchi: Kidney disease can be caused by a variety of medical conditions. Some of these are genetic, such as polycystic kidney disease, but the majority are acquired through other conditions. Diabetes, hypertension, glomerulonephritis (inflammation of the filtering units in your kidneys), urinary tract infection, kidney stones, urological malignancies and multiple drugs may damage your kidneys over time, which can lead to chronic kidney problems.

Dr Andrew Palmer: The cause of chronic kidney disease is when the conditions described above lead to the irreversible loss of renal tissue and results in scarring and often the kidneys become smaller with time. This is in contrast to acute renal failure when patients temporarily lose renal function in the context of a severe illness and may need dialysis before recovering. Patients with chronic kidney disease often have a slow decline in renal function with additional factors such as blood pressure affecting the patient's progress.

What are the symptoms of kidney disease?

Dr Bassam Alchi: Most people with kidney disease have no symptoms and the condition is usually diagnosed by a routine blood or urine test. Kidney disease is often associated with high blood pressure. If you do have symptoms, they may include swollen ankles or face, a change in the amount or colour of urine you produce, or loin pain with or without fever. As kidney function deteriorates, symptoms such as general tiredness, loss of appetite or shortness of breath may occur.

Dr Andrew Palmer: The symptoms of kidney disease can be split into two categories: those that come on as a result of the underlying causes, and those that are a direct consequence of the reduced level of kidney function. The former may be obvious and can vary a lot due to the wide range of conditions that can affect the kidneys. The symptoms directly caused by poor kidney function often occur late and only once you’re in quite advanced renal failure. They are rather non-specific and include loss of energy, poor appetite, nausea and itching of the skin. It is for this reason that kidney disease is often only picked up after being present for some time.

What treatments are there for kidney disease?

Dr Bassam Alchi: Kidney disease treatment will depend on the underlying cause as well as the symptoms that you have. It may involve taking certain medications to control your blood pressure, reduce the level of protein in your urine and/or control blood sugar levels.

Treatment is likely to be different for everyone – for example, patients with glomerulonephritis may require specific treatment to supress the immune system. There are treatments available to prevent kidney stone formation. A kidney specialist will be able to advise you about the best treatment in your case.

Dr Andrew Palmer: The treatment of kidney disease is split into two areas. The first is that if the cause can be identified then this should be specifically treated. It is for this reason that patients should be fully investigated. Each diagnosis will need its own therapy so forms of kidney inflammation may need steroids, narrowing of the kidney arteries may require balloon dilatation and stents, and obstruction of the bladder may need a catheter and the advice of a urologist. Patients with chronic kidney disease will also need to maintain good blood pressure control, which may mean taking specific drugs, and you might also be prescribed drugs that help to stop further deterioration in kidney function.

What is kidney dialysis?

Dr Bassam Alchi: Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly. There are two main types of dialysis: haemodialysis and peritoneal dialysis.

Dr Andrew Palmer: Kidney dialysis is a form of treatment that replaces the function of the kidneys. The first of two main types of dialysis is haemodialysis whereby blood is taken from the patient, either by a catheter or a blood vessel called a fistula, and circulated through an artificial kidney. The artificial kidney removes fluid and toxins before the treated blood is returned to the patient.

Most patients need to have haemodialysis three times per week. Sessions last three to four hours and the process is usually done in a local hospital but can be set up at home.

The alternative form of dialysis is peritoneal dialysis where specific fluid is instilled via a catheter into the abdomen either during the day or overnight with a machine with the same effect. Patients in the UK are carefully counselled and can choose which form of therapy they would like.

Get help with Circle Health Group

At Circle Health Group we offer tailored treatment plans for kidney problems, led by talented consultant nephrologists. If you want to know more about our treatment options, book your appointment online today or call a member of our team directly.