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Each year, more than 500,000 Americans consult their doctors about kidney disease and urinary tract infections. One in three American adults is at increased risk of developing chronic kidney disease, and one in ten has some sign of chronic kidney disease.

What is kidney disease? Your kidneys are two bean-shaped organs that act as your body’s waste filtration system.

They filter your blood 12 times per hour. Excess water and unwanted chemicals or waste in the blood are disposed of as urine (wee). Kidney disease is when your kidneys are damaged in some way and are not filtering your blood effectively.

Kidney disease is called a ‘silent disease’ as there are often few or no symptoms. In fact, you can lose up to 90 per cent of your kidneys’ functionality before experiencing any symptoms. Some signs and symptoms include:

  • a change in the frequency quantity of urine you pass especially at night (usually an increase at first) If your kidneys begin to fail
  • waste products
  • extra fluid build up in your blood

This, and other problems, gradually leads to: bad breath and a metallic taste in the mouth.

If detected early enough, the progress of kidney disease can be slowed and sometimes even prevented. In the early stages, changes to diet and medication can help to increase the life of your kidneys.

If kidney function is reduced to less than 10 per cent of normal, the loss of function must be replaced by dialysis or a. Dialysis is a treatment for kidney failure that removes waste products and extra water from the blood by filtering it through a special membrane (fine filter). You are more at risk of developing chronic kidney disease if you: are of Aboriginal or Torres Strait Islander origin and 18 years and older.

Untreated, high blood pressure can damage your kidneys. (narrowing of the main artery to one or both kidneys).

Your kidneys control the amount of fluid in your blood vessels and produce a hormone called renin that helps to control blood pressure. This is a serious disease and may worsen other diabetic complications such as nerve and eye damage, as well as increasing the risk of cardiovascular (heart) disease. (also known as ‘end-stage kidney disease’ or ESKD).

Compared to the general population, people with chronic kidney disease are two to three times more likely to have cardiovascular (heart and blood vessel) problems such as:

  • This increased risk is partly caused by factors common to both chronic kidney disease
  • cardiovascular disease
  • such as

However, researchers are discovering that chronic kidney disease is, in itself, an important risk factor for the development of cardiovascular disease, and a history of cardiovascular disease is a risk factor for the development of chronic kidney disease.

The kidneys regulate water and salts, remove certain wastes and make various hormones. Kidney disease increases the risk of cardiovascular disease in many ways, including: – the kidneys help to regulate blood pressure by producing a hormone called renin. They also help to regulate the amount of salt and fluid in the body heart strain – holding excess fluid in the body puts strain on the heart and increases the risk of complications such as left ventricular hypertrophy (enlarged left heart chamber), which can cause heart failure – kidneys make a hormone that helps to regulate the use of calcium throughout the body.

A person with chronic kidney disease may develop calcified (stiffened) arteries and heart valves – some people with chronic kidney disease have increased levels of low-density lipoprotein (LDL) cholesterol, which may be caused by disturbed hormone levels. High levels of LDL cholesterol is a known risk factor in the development of cardiovascular disease – the blood of people with some types of chronic kidney disease, and those with kidney failure, is prone to clotting.

A clot (thrombus) lodged within a blood vessel may cut off the blood supply.

This increases the risk of many complications, including heart attack and stroke. A clot in one of the kidney arteries may cause high blood pressure.

If kidney disease is suspected, you will have some kidney function tests (also known as a kidney health check) to measure how well your kidneys are working and help plan your treatment.

This includes:

  • Tests for albumin (a type of protein) and/or blood in your urine. A blood test to find out the level of waste products in the blood
  • calculate your glomerular filtration rate A blood pressure test. Kidney disease causes high blood pressure
  • which can damage the small blood vessels in the kidneys

High blood pressure can also cause kidney disease

An ultrasound or Computed Tomography scan (CT scan) to take a picture of your kidneys and urinary tract. These tests show the size of your kidneys, locate kidney stones or tumours and find any problems in the structure of your kidneys and urinary tract. You may also visit a kidney specialist (called a nephrologist) to help manage your care and decide if a kidney biopsy is needed.

During a kidney biopsy a small piece of kidney tissue is removed and looked at under a microscope to find out the type of kidney disease and check if your kidneys are damaged. Damaged or inflamed kidneys ‘leak’ substances such as blood or protein into the urine. The preferred test for detecting protein in the urine is a urine albumin-to-creatinine ratio (urine ACR) test, which shows the amount of albumin (a type of protein) in the urine.

A urine ACR test should be done at least once a year if you have diabetes or high blood pressure, and every two years if you have any of the other identified risk factors for developing chronic kidney disease. A urine ACR test is performed by sending a sample of your urine to a laboratory for analysis.

The best measure of kidney function is the glomerular filtration rate (GFR), which can be estimated from a blood test that checks the blood for creatinine (a waste product made by muscle tissue).

A normal GFR result is higher than 90 mL/min/1.73 m2.

If the result is persistently less than 60 mL/min/1.73 m2 for at least three months, this confirms that you have chronic kidney disease. Blood tests can reveal other abnormalities of kidney function, such as:

  • (insufficient red blood cells or haemoglobin
  • the protein in red blood cells that transports oxygen) changes to the levels of calcium

Tests that create various pictures or images may include:

  • sound waves are ‘bounced’ off the kidneys to create a picture. Ultrasound may be used to check the size of the kidneys. Kidney stones
  • blood vessel blockages may be visible on ultrasound – x-rays
  • digital computer technology are used to create an image of the urinary tract
  • including the kidneys – a strong magnetic field
  • radio waves are used to create a three-dimensional image of the urinary tract
  • including the kidneys

A biopsy means that a small piece of tissue is taken for testing in a laboratory. Biopsies used in the investigation of kidney disease may include:

  • the doctor inserts a special needle into the back under local anaesthesia to obtain a small sample of kidney tissue

A kidney biopsy can confirm a diagnosis of chronic kidney disease. – the doctor inserts a thin tube (cystoscope) into the bladder via the urethra. This allows the doctor to view the inside of the bladder and check for abnormalities.

This procedure is called a cystoscopy

The doctor may take a biopsy of bladder tissue for examination in a laboratory. Your doctor may arrange other tests, depending on the suspected cause of your kidney disorder. Medication and changes to lifestyle, along with an early referral to a kidney specialist (nephrologist), can prevent or delay kidney failure.

Heathy lifestyle choices to keep your kidneys functioning well include:

  • including legumes (peas or beans)
  • grain-based food such as bread
  • pasta noodles
  • rice. Eat lean meat such as chicken
  • fish each week. Eat only small amounts of salty or fatty food. instead of other drinks

Minimise consumption of sugary soft drinks

Maintain a healthy weight

Take your blood pressure medication prescribed by your doctor and maintain your blood pressure at your target range.

A range of medication is available for high blood pressure. Different blood pressure medications work in different ways, so it is not unusual for more than one type to be prescribed.

The dose may change according to your needs

Tel. Symptoms of kidney disease blood in your urine (haematuria) changes in the appearance of your urine or persistently frothy urine puffiness around your legs and ankles (oedema) pain in your back (under the lower ribs, where the kidneys are located) pain or burning when you pass urine high blood pressure tiredness and inability to concentrate generally feeling unwell loss of appetite nausea and vomiting shortness of breath itching Treatment for kidney disease kidney transplant Risk factors for kidney disease have high blood pressure have diabetes have established heart problems (heart failure or past heart attack ) or have had a stroke are obese (a body mass index of greater than 30) are over 60 years of age have a family history of kidney failure smoke have a history of acute kidney injury High blood pressure and kidney disease H igh blood pressure (hypertension) Also, high blood pressure can develop as a result of kidney disease or renal artery stenosis Diabetes and kidney disease About 20 to 30 per cent of people with diabetes develop a type of kidney disease called diabetic nephropathy Diabetic nephropathy is the main cause of kidney failure Kidney disease and cardiovascular risks Cardiovascular disease angina heart attack stroke heart failure high blood pressure high blood pressure stiff arteries increased blood fats (hyperlipidaemia) blood clots Diagnosis of kidney disease Urine tests for kidney disease Blood tests for kidney disease high levels of acids (acidosis) anaemia high levels of potassium (hyperkalaemia) low levels of salt (hyponatraemia) Imaging tests for kidney disease x-rays – to check the size of the kidneys and look for kidney stones cystogram – a bladder x-ray voiding cystourethrogram – where the bladder is x-rayed before and after urination ultrasound computed tomography (CT) magnetic resonance imaging (MRI) Biopsy for kidney disease kidney biopsy bladder biopsy Prevention of kidney disease Eat lots of fruit and vegetables Drink plenty of water Stay fit.

Do at least 30 minutes of physical activity If you don’t smoke , don’t start.

If you do, quit. Call the Quitline Limit your alcohol Have your blood pressure Do things that help you relax and reduce your stress Where to get help Your GP (doctor) Kidney Health United States 1800 454 363 Kidney Health United States - Types Of Kidney Disease factsheet Quitline 13 78 48.

Key Points

  • Kidney disease is called a ‘silent disease’ as there are often few or no symptoms
  • In fact, you can lose up to 90 per cent of your kidneys’ functionality before experiencing any symptoms
  • If detected early enough, the progress of kidney disease can be slowed and sometimes even prevented
  • (narrowing of the main artery to one or both kidneys)
  • is the most common cause of death in people with chronic (ongoing) kidney disease