Chronic kidney disease is not a rare disease. The incidence of chronic kidney disease in China is about 10.75%, but less than 13% of them know they are ill. Many families and patients themselves cannot accept the fact that they cannot be cured after learning of their illness. However, in fact, except for some more dangerous chronic kidney diseases such as progressive nephritis, many types of chronic kidney diseases can be detected early and treated correctly, and their quality of life can not be greatly affected for a lifetime. The editor's mother often said, "People who eat grains and cereals can't be sick.". Indeed, everyone can get sick. Although everyone can be very nervous when they get sick, and nervousness can easily lead to medical emergencies, in the long battle of life, the optimistic and calm will only laugh to the end. For myself and for my family, I must work harder to live a good life every day.
To get to the point, many people know that they have chronic kidney disease, but they are not clear about the stage of their kidney disease. So how do you distinguish which stage kidney disease has reached?
There are simple staging criteria for renal diseases from renal function to renal pathology. Renal function is primarily staged based on measured or estimated glomerular filtration rate. In China, the United States Kidney Foundation (NKF) divides chronic kidney disease into five stages based on renal filtration (glomerular filtration rate, or GFR). (GFR value calculated by age, gender, and creatinine)
The following table is extracted from the Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines in the United States.
Five stages of kidney disease
Diagnose and treat kidney related problems and/or other diseases to slow the development of chronic kidney disease
Teaching patients how to manage themselves
Reduce the risk of heart disease
Mild decrease in GFR
Evaluate progress and treat morbid conditions
Moderate decrease in GFR
Evaluate and treat complications
GFR severely reduced
Preparing for alternative treatment
Renal replacement and dialysis
GFR unit: mL/min/1.73m2 Picture 8. png
According to the table above, you can know which stage of chronic kidney disease belongs to. Some kidney diseases can be staged or classified according to the pathological results of renal biopsy, which is relatively complex and needs to be interpreted by a kidney specialist.
Most kidney diseases are chronic and difficult to reverse. The goals of medical treatment are:
1. Slow down the progress of the disease.
2. Treat potential causes and contributing factors.
3. Relieve symptoms and treat disease complications.
4. Reduce the risk of cardiovascular disease.
5. Delay the need for dialysis or transplantation.
What advice do doctors usually give?
"Most chronic kidney diseases cannot be eradicated, but the good news is that if kidney disease is discovered early, there are many ways to make your life less affected and delay the progression of the disease.". Important advice that a doctor may give you, such as:
Using drugs - such as blood pressure drugs such as "ACEI" or "ARBs" - is not only a function of reducing blood pressure, but also helps protect renal function. (If you want to learn more about these two types of drugs, please check our previous issue of "Doctor, Are You Sure You Didn't Prescribe Me the Wrong Drug".)
Treating Anemia - Anemia (lack of red blood cells) occurs in the early stages of renal failure, which can make you feel very tired (refer to previous issues of "Star Blood Transfusion Is Due to This").
Check blood pressure and blood sugar regularly - hypertension and diabetes can cause or accelerate renal failure.
Avoid using certain pain relievers - Overusing over-the-counter pain relievers that contain certain ingredients can cause kidney damage, such as ibuprofen, naproxen, acetaminophen, and caffeine.
Change diet - Control salt intake (less than 6g/day). A high-quality low-protein diet can help slow down the development of kidney disease (see "Introduction to Series II and III of IgA Nephropathy Treatment Mistakes" for details).
Reduce smoking or quit smoking - Smoking can exacerbate kidney problems.