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CKD is a partial or complete reduction in renal function and is characterized by five stages. The disease progresses slowly and is determined by the extent to which renal function is reduced. An indicator of this is the so-called “Glomerular filtration”.

First stage of CKD – initial and still reversible phase of the disease with glomerular filtration> 90 ml (normal). At this stage, there is a very slight impairment of renal function, which is asymptomatic. At this stage, the kidneys function normally, but a change in urine results is possible – for example presence of protein.

Second stage of CKD – glomerular filtration between 60 and 89 ml. In second-stage of CKD, there is a slight impairment of renal function. The kidneys are still functioning well, which in turn does not cause symptoms.

Third stage of CKD – glomerular filtration between 30 and 59 ml, regardless of whether there are other symptoms suggesting the presence of kidney disease. During this period of the disease there is a moderate impairment of renal function.

This phase is divided into two stages:

– with glomerular filtration between 45 and 59 ml.

– with glomerular filtration between 30- and 44-ml.

Common symptoms are: swelling of the legs and arms, back pain, more or less urination than usual, high blood pressure, anemia.

Fourth stage of CKD – ​​glomerular filtration between 15- and 29-ml

Moderate to severe renal impairment is already observed here. Characteristic of this condition is that it is the last stage before the complete cessation of renal function. At this stage of the disease there are symptoms such as: swelling of the legs and arms, back pain, more or less urination than usual and the consequences of the accumulation of waste products from the metabolism in the blood. Water-electrolyte homeostasis is disturbed. Pathologies in the endocrine function of the kidneys are observed and the synthesis of erythropoietin in the kidneys is reduced.

Fifth stage of CKD – ​​glomerular filtration <15 ml

In grade 5 of CKD, the kidneys have stopped working or are functioning very little. At this stage of the disease there are always symptoms caused by the accumulation of fluids and waste products in the body: itching, muscle cramps, nausea and vomiting, swelling of the legs and arms, back pain, often complete cessation of urination, shortness of breath, insomnia. In laboratory tests are typical high levels of urea and creatinine, an increase in serum phosphate and potassium. High levels of protein, red blood cells, sediments and others can be observed.

After the kidneys have failed to function, the patient must undergo hemodialysis, as well as discuss the possibility of transplantation. Transplantation eliminates the need for hemodialysis, but in turn requires a strict control and medication against immune rejection of the organ.





There are two types of dialysis – hemodialysis and peritoneal dialysis.

HD uses an out-of-body filter called a dialyzer. With the help of the hemodialysis machine, the blood from the body is filtered through an artificial membrane – “dialyzer”, or “artificial kidney” to clear toxins that the kidneys can no longer remove. Peritoneal dialysis is a way to remove waste products from the blood in a different way from the more common blood filtration procedure called hemodialysis.

A peritoneal catheter is required before initiating PD. PD uses the lining of the abdominal cavity, called the peritoneal membrane, which serves as a natural filter to remove fluids and harmful substances from the blood. This is achieved by periodically infusing a special solution into the abdominal cavity. The lining of the abdomen (peritoneum) acts as a filter to remove waste products from the blood. Your doctor can tell you which type of dialysis may be the best option for you.

Factors to consider are:

– Your kidney function – Overall health

– Your personal preferences

– Your way of life

Peritoneal dialysis may be a better option if:

– You want to minimize the interruption of your daily activities

– You want to work or travel easier

– You have some residual kidney function

Peritoneal dialysis may not work if you have:

– Adhesions and mechanical defects of the abdominal wall also complicate the procedure.

– Inflammatory bowel disease or frequent attacks of diverticulitis

– Impossibility to observe strict hygienic measures

Advantages of peritoneal dialysis

– No vascular access with fistula or catheter is required;

– Patient mobility

– The therapy is carried out at home

– Lower risk of transmitting dangerous viral infections.

Disadvantages of peritoneal dialysis:

– Risk of infections

– Risk of obesity

– Impaired fat metabolism

– Cleansing from nitrogenous bodies (urea and creatinine) is not so good