All posts by Валентина Нотева

What Is Chronic Kidney Disease (CKD) and Why Is It Often Diagnosed Late?

Chronic kidney disease is a condition in which kidney function gradually declines over time. It encompasses a broad range of structural and functional abnormalities in the kidneys that persist for more than three months, regardless of the cause. CKD is a serious global health problem affecting millions of people and is among the leading causes of increased mortality, especially in patients with cardiovascular disease.

How Do the Kidneys Work and What Happens in CKD?

The kidneys are vital organs that filter waste products from the blood, regulate fluid and electrolyte balance, control blood pressure, produce red blood cells, and manage calcium and phosphorus metabolism. In chronic kidney disease, these complex processes begin to fail. Most often, CKD progresses without symptoms in its early stages, which makes timely diagnosis particularly challenging.

Causes and Risk Factors

The most common causes of CKD include:

• Diabetes mellitus – the leading cause worldwide.

• High blood pressure (hypertension) – damages the small blood vessels in the kidneys.

• Glomerulonephritis and pyelonephritis.

• Polycystic kidney disease and other inherited disorders.

• Prolonged use of nephrotoxic drugs (e.g., NSAIDs).

• Systemic autoimmune diseases such as lupus.

Other risk factors include older age, family history of kidney disease, smoking, obesity, and sedentary lifestyle.

Why Is CKD Often Diagnosed in Its Later Stages?

One of the main challenges with CKD is the lack of specific symptoms in the early stages. The kidneys can compensate for lost function over a long period, creating a “false sense” of health. Patients typically experience no noticeable changes until kidney function drops below 30–40%.

Some possible symptoms in later stages include:

• fatigue and weakness,

• swelling in the legs or face,

• high blood pressure,

• frequent urination, especially at night,

• loss of appetite, nausea, anemia.

The absence of routine screening in high-risk groups (e.g., those with diabetes or hypertension) also contributes to late diagnosis. Many patients discover the disease only after serious deterioration or when kidney failure occurs, requiring dialysis.

How Is CKD Diagnosed?

The key methods for diagnosing CKD include:

• Serum creatinine testing and estimated glomerular filtration rate (eGFR) – a primary indicator of kidney function.

• Urine testing for albumin or protein – early markers of kidney damage.

• Kidney ultrasound – to evaluate kidney structure.

• Monitoring of blood pressure and other lab parameters (electrolytes, hemoglobin, etc.).

What Can Be Done?

Early detection of CKD is essential to prevent its progression. This includes:

• regular kidney function screening in at-risk patients,

• optimal management of diabetes and hypertension,

• avoiding nephrotoxic medications,

• healthy lifestyle – balanced diet, physical activity, smoking cessation.

Patient education and proactive prevention by primary care physicians and specialists are crucial in the fight against this “silent killer,” as CKD is often referred to.

How to Slow the Progression of Chronic Kidney Disease: Guidelines and Strategies

Chronic kidney disease (CKD) is a slow and progressive decline in kidney function that can lead to kidney failure if not managed properly. Slowing the progression of CKD is key to preventing serious complications and improving the quality of life for patients. In this article, you can explore what steps to take to prevent the progression of the disease.

1. Early detection and diagnosis

One of the most important aspects of managing CKD is early diagnosis. Unfortunately, many people do not experience symptoms in the early stages of the disease, making it difficult to detect. Early testing through:

Blood tests for creatinine levels

Checking for albumin in the urine (proteinuria)

Measuring glomerular filtration rate (GFR)

is essential to identify the condition early and start treatment that can slow its progression.

2. Control blood pressure

High blood pressure is a major risk factor for the development and progression of CKD. Maintaining blood pressure within normal limits is crucial. It is recommended to aim for values ​​below 130/80 mmHg, and in certain cases this is done with the help of specific medications.

3. Control diabetes

Diabetes is one of the leading risk factors for the development of chronic disease. It is especially important for diabetics to control blood sugar levels. Excessive levels of glucose in the blood can damage the kidney vessels and accelerate the progression of the disease. For good control of diabetes, it is important to regularly monitor blood sugar levels and take prescribed medications (insulin or oral antidiabetic drugs).

4. Healthy diet

Proper nutrition plays an important role in the management of chronic kidney disease. Key dietary recommendations include:

Reducing salt intake: Excess salt can increase blood pressure and put strain on the kidneys.

Moderate protein intake: Excessive protein intake can put strain on the kidneys. Patients with CKD are often advised to limit the amount of protein in their diet.

Emphasizing certain types of fruits and vegetables: They are sources of vitamins and minerals that are beneficial for kidney health.

Controlling potassium and phosphorus: Patients with advanced CKD may have problems regulating these minerals, which is why it is important to contact a dietitian.

5. Quitting smoking

Smoking has a number of negative effects on kidney function, damaging blood vessels and increasing the risk of cardiovascular disease, which can also worsen patients’ condition. Complete cessation of smoking is extremely important in slowing the progression of CKD.

6. Physical activity

Regular physical activity has a positive effect on kidney health, as it helps control blood pressure, blood sugar and weight. At least 150 minutes of moderate physical activity per week, such as walking, swimming or yoga, is recommended.

7. Treatment of comorbidities

Many patients with CKD also have other chronic diseases, such as cardiovascular disease or dyslipidemia (high cholesterol levels). Treatment of these comorbidities is important to prevent the progression of kidney disease. Medications to control cholesterol (such as statins) and regulate fat levels are often prescribed in these cases.

8. Follow-up by specialists

Patients with chronic kidney disease should be treated regularly by a nephrologist and undergo regular examinations that combine kidney function tests and monitoring of the condition. Early detection of complications can lead to more effective treatment.

Conclusion
Slowing the progression of chronic kidney disease requires a comprehensive approach that includes early diagnosis, controlling major risk factors such as blood pressure, diabetes, and lifestyle. With proper medical care and careful patient monitoring, patients can significantly improve their quality of life and prevent the progression of the disease.

Healthy habits, such as a balanced diet, regular physical activity, quitting smoking, and good control of comorbidities, play a crucial role in the success of use.

THE RIGHT DIET CAN HELP FIGHT KIDNEY DISEASE

In the following sections, we will explore how kidney diseases can impact the heart, bones, nervous system, and other organs.

The kidneys play a crucial role in maintaining the overall health of the body. Not only do they filter waste products and excess fluid, but they also regulate important functions such as blood pressure, electrolyte balance, and red blood cell production. When the kidneys are not functioning properly, these functions can be seriously disrupted, leading to negative effects on many other organs and systems.

1. Impact on the Heart

Kidney diseases are closely linked to the development of cardiovascular diseases. One of the primary mechanisms is the disruption of blood pressure regulation. Chronic kidney failure often leads to high blood pressure (hypertension), which is a major risk factor for heart diseases such as heart attack, stroke, and heart failure.

Kidney failure also leads to the accumulation of toxins and waste products in the blood (uremia), which can damage the heart muscle and blood vessels. These damages increase the risk of atherosclerosis (reduced oxygen supply to the heart) and other cardiovascular issues.

2. Impact on the Bones

Kidney diseases can have a serious impact on bone health. The kidneys play an important role in regulating calcium and phosphorus levels in the body, as well as in activating vitamin D, which is essential for calcium absorption in the intestines. In kidney failure, these functions can be disrupted, leading to:

• Hypocalcemia (low calcium levels in the blood): This can result in osteoporosis, increased fracture risk, and bone pain.
• Hyperphosphatemia (high phosphorus levels in the blood): This is also a risk factor for bone diseases and can lead to the deposition of calcium deposits in blood vessels, further worsening heart conditions.
• Rickets and osteomalacia: In chronic kidney failure, vitamin D deficiency is common, leading to weak and soft bones.

These bone issues can lead to serious consequences such as fractures and decreased quality of life for patients.

3. Impact on the Nervous System

Neurological problems are also a common side effect of kidney failure. As waste products accumulate in the body, which the kidneys can no longer filter, uremic toxicity can develop. This damages the nervous system and may cause various symptoms, including:

• Neuropathy: Nerve damage that leads to pain, numbness, or weakness in the limbs.
• Cognitive functions: Individuals with advanced kidney failure may experience difficulties with concentration, memory, and cognitive function, leading to depression, anxiety, and confusion.
• Mental disorders: Uremia can cause mental symptoms such as hallucinations and delirium, which appear in the later stages of kidney disease.

4. Impact on the Immune System

In chronic kidney failure, the immune system can also be weakened. This is partly due to the elevated levels of toxins in the body, which suppress the function of immune cells. Kidney disease patients are often more susceptible to infections and experience slower recovery from them.

5. Impact on the Skin

Impaired kidney function can lead to the buildup of toxins in the body, resulting in skin problems. These include itching, dry skin, and even pigmentation changes. In advanced stages of kidney failure, a condition called “uremic frost” can develop, where the skin takes on a grayish hue.

6. Impact on the Gastrointestinal Tract

Kidney failure can also affect the gastrointestinal system. Many patients suffer from nausea, vomiting, loss of appetite, and inflammation of the stomach. This is part of the process of toxin accumulation in the body and is one of the symptoms of advanced kidney failure.

Conclusion

Kidney diseases can have serious and far-reaching effects on the body. They not only disrupt the primary functions of the kidneys but also lead to a range of health problems that affect the heart, bones, nervous system, and other organs. This highlights the importance of timely diagnosis and treatment of kidney diseases to prevent these serious complications. For individuals with chronic kidney disease, regular monitoring and appropriate therapy are crucial to maintaining good health and quality of life.

STAGES OF CHRONIC KIDNEY DISEASE

Urinary tract infections are a common condition, especially in women.

They occur when bacteria enter the urinary tract and begin to multiply, the most common cause being the bacteria Escherichia coli that normally inhabit the intestines.

Although they can affect anyone, some people are more susceptible to them.

Symptoms of a urinary tract infection can vary, but most commonly include:

• Frequent urination: More frequent urge to urinate, even with small amounts of urine.
• Pain or burning when urinating: A sharp sensation when passing urine.
• Sensation of incomplete emptying: A feeling that the bladder is not emptying completely.
• Blood in the urine: Sometimes the urine may have a pink or red tint.
• General weakness and fatigue: In some cases, the infection can cause fever, chills and lower abdominal pain.

Causes of urinary tract infections

They may include:

• Anatomical Features: Women are more prone to urinary tract infections due to their shorter urethra compared to men.
• Immune system disorders: Diseases that weaken the immune system can increase the risk of infections.
• Kidney stones: Stones can block the flow of urine and create a breeding ground for bacteria.

Diagnosis and treatment

• Urine analysis

Treatment usually involves taking antibiotics, which are selected depending on the type of infection causing the infection.

Can we prevent a urinary tract infection?

Here are the actions we may take.

• Good intimate hygiene
• Adequate water intake: Increasing fluid intake helps flush bacteria from the urinary tract.
• Avoid urinary retention: When you feel the urge to urinate, go to the toilet.
• Wearing cotton underwear: Cotton allows the skin to breathe and reduces the risk of irritation.

Important: If you have recurring urinary tract infections, consult a doctor to determine the cause and receive appropriate treatment.

ВОДА И БЪБРЕЧНА ФУНКЦИЯ – ВЗАИМОВРЪЗКА

Kidney stone disease is a common condition that affects millions of people worldwide. Kidney stones can be painful and debilitating. The good news is that there are many things you can do to reduce your risk of developing kidney stones.

What is kidney stone disease?

Kidney stone disease is a condition in which hard deposits, called stones, form in the kidneys. Kidney stones can be as small as a grain of sand or as large as a golf ball. They can be composed of a variety of substances, including calcium, oxalate, urate, and phosphate.

Symptoms of kidney stone disease

The most common symptom of kidney stone disease is severe pain in the lower back or side. This pain may radiate down to the groin or thighs. Other symptoms may include:

• Bloody urination
• Nausea and vomiting
• Frequent urination
• Need to urinate urgently
• Pain or burning during urination
• Sensation that the bladder is not emptying completely

Causes of kidney stone disease

The exact cause of kidney stones is unknown, but there are a number of factors that can increase your risk, including:

• Dehydration: Not drinking enough fluids can make your urine more concentrated, making it easier for stones to form.
• Diet: A diet high in animal protein, oxalates, salt and sugar can increase your risk of kidney stones.
• Obesity: People who are overweight or obese are more likely to develop kidney stones.
• Certain medical conditions: Certain medical conditions, such as inflammatory bowel disease and hyperparathyroidism, can increase your risk of kidney stone disease.
• Family history: If you have a family history of kidney stones, you are more likely to develop the condition.

Prevention of kidney stone disease

There are many things you can do to reduce your risk of developing kidney stones, including:

• Drink plenty of fluids: Aim to drink eight glasses of water or other calorie-free beverages a day.
• Eat a healthy diet: Eat a diet rich in fruits, vegetables and whole grains. Limit intake of animal proteins, oxalates, salt and sugar.
• Maintain a healthy weight: If you are overweight or obese, losing weight can help reduce your risk of kidney stones.
• Control your medical conditions: If you have a medical condition that increases your risk of kidney stones, work with your doctor to control it.

Treatment of kidney stone disease

Treatment for kidney stones depends on the size and location of the stone. Small stones can often be passed in the urine on their own with plenty of fluids and pain relievers. Larger stones may need to be broken up with shock waves or laser treatment or removed by surgery.

Kidney function and water: What do we need to know?

The kidneys are vital organs responsible for filtering the blood, removing waste products, and maintaining the balance of fluids and electrolytes in the body. Water plays a key role in these functions, providing the necessary medium for filtering and transporting waste products.

How water affects kidney function:

Blood filtration: Water is needed to thin the blood, making it easier for it to pass through the glomeruli – tiny filters in the kidneys. These filters remove waste products, toxins and excess fluid from the blood, forming urine.

Elimination of waste products: Water is the transport medium through which waste products are removed from the body. Adequate hydration ensures that the urine is diluted, which facilitates the elimination of waste substances and prevents the formation of kidney stones.

Electrolyte regulation: The kidneys play a key role in maintaining the balance of electrolytes, such as sodium, potassium and chlorine, in the body. Water is essential to this process as it allows the kidneys to absorb or excrete electrolytes according to the body’s needs.

Preventing dehydration: Dehydration can lead to a decrease in blood volume, which makes it harder for the kidneys to work. Adequate water intake is essential for maintaining hydration and normal kidney function.

How much water is needed?

Recommended daily water intake varies by age, gender, activity level and climate. In general, healthy adults should aim to consume about 2 liters of water per day.

How do we know if we are drinking enough water?

• Urine Color: Light yellow urine is an indicator of good hydration. Dark urine may indicate dehydration.
• Urinary frequency: Urinating every 2-4 hours is normal. Urinating less often can be a sign of dehydration.
• Feeling thirsty: Thirst is the body’s natural signal to need water. You don’t have to wait until you feel thirsty to drink water.
• Dry mouth: Dry mouth, sticky lips and sunken eyes can be signs of dehydration.

Tips for drinking more water:

• Carry a water bottle with you: This way you’ll have water handy wherever you go.
• Drink water before, during and after meals:
• Add flavor to your water: Add slices of lemon, lime, cucumber or mint to make your water tastier.
• Eat foods with high water content: Fruits and vegetables are a great source of water and nutrients.
• Limit caffeine and alcohol: These drinks can have a dehydrating effect.

Conclusion:

Water is essential for maintaining kidney health. Adequate water intake is important for proper blood filtration, elimination of waste products, regulation of electrolytes and prevention of dehydration. By drinking enough water, you can keep your kidneys healthy and enjoy good general health.

HYPERVOLEMIA

Why the proper kidney function is important for bone health?

Healthy kidneys perform many important tasks. They remove waste and extra fluid from your body, help produce red blood cells, regulate the amount of minerals, and keep your bones healthy. In turn, minerals are nutrients that your body needs to stay healthy.

With advanced kidney disease or kidney failure, your kidneys can’t perform all of these important functions well. As a result, you may develop mineral and bone disorders, a common problem in people with kidney disease and affecting almost everyone with kidney failure.

What is a mineral and bone disorder?

Mineral and bone disorder associated with kidney disease occurs when there is an imbalance in the levels of calcium and phosphorus in the blood. This mineral imbalance can affect your bones, heart and blood vessels.

How do kidney disease and kidney failure lead to bone and heart disease?

When kidney function is impaired, your kidneys can no longer filter excess phosphorus and remove it from the body through urine. Over time, phosphorus from the foods you eat can build up to high levels in your blood.

Healthy kidneys also convert vitamin D from sunlight and foods into active vitamin D that your body can use. When the kidneys fail, there is a lack of active vitamin D. This imbalances the ratio of calcium and phosphorus in the blood.

When blood phosphorus levels rise and vitamin D levels fall, your body begins to produce too much parathyroid hormone (PTH). High levels of PTH cause calcium to move from your bones into your blood. The consequence of this is that your bone system becomes weaker and more brittle.

How are mineral and bone disorders treated?

Diet with low phosphorus content, supplements with Vitamin D. Taking of Calcimimetics – medicaments that are often used when the levels of PTH, calcium and phosphorus in the blood are too high in people on dialysis. Start a training plan – exercises to strengthen the bone system.

MYTHS AND FACTS FOR DIALYSIS TREATMENT

Q: The only option to receive dialysis treatment is to travel to the center at least three times a week for hours. Is it right?

A: Dialysis can be done in many ways: You can have dialysis in a hospital or outpatient clinic, or in your own home. Hemodialysis in the dialysis center is performed three days a week for 3-4 hours each time. The other option is peritoneal dialysis at home. Educate yourself about each option and talk to your healthcare professional about which type of dialysis is best for you.

Q: Is Dialysis procedure painful?

A: Dialysis treatment doesn’t have to be painful. If you feel pain during or after, notify your attending physician or team. Some patients may experience a drop in blood pressure that may lead to nausea, vomiting, headache or cramps. However, by making your diet and fluid restrictions, these types of side effects can be avoided.

Q: Is dialysis absolutely needed to live?

A: Dialysis is a treatment that helps clean your blood of fluids and toxins when your kidneys can no longer function properly. The need to undergo dialysis may sound overwhelming and scary, but dialysis treatment allows you to live.

Q: Can Dialysis patients travel?

A: You can travel on dialysis! But this is some necessary planning. Before your trip, you must make an appointment for dialysis treatment at another center and submit information about your medical treatment and history. The dialysis journey means being prepared – click here to learn more.

Q: Should I stop working? Dialysis patients don’t have the time or energy to maintain normal life.

A: Many dialysis patients continue to work or study. Some of you took time off when you first started dialysis treatment and returned to work or school after getting used to the process.

Q: As a dialysis patient, you worry that you will be a burden on your family.

A: Many people with chronic illness feel this way at some point. Your role in your family may change over time, but it’s important to remember that you have more than just your kidney or dialysis treatment! Seek help when you need it and help others when you can. Be open and honest with your loved ones about how you feel and give yourself the space and time you need to adjust to dialysis treatment. Once you adjust to your ‘new normal’ of dialysis, you will find that you will be able to recover to take on new roles and responsibilities at home.

WHAT CONDITIONS REQUIRE DIALYSIS IN CHILDREN?

Dialysis, often considered a life-saving procedure for adults with kidney failure, is just as important for children facing similar health challenges.

There are various scenarios where dialysis may be necessary for the youngest patients. Among them are:

1. Acute kidney injury (AKI). In children, it can occur due to conditions such as severe infections, dehydration, or under the influence of toxins (eg unintentional ingestion of drugs, poisons, alcohol). The most common cause of acute kidney injury in children is hemolytic uremic syndrome. It usually occurs after infectious gastroenteritis caused by E.coli. It is characterized by hemolytic anemia, a reduced amount of platelets (thrombocytopenia) and elevated residual nitrogen bodies in the blood (urea and creatinine). In these cases, temporary dialysis may be necessary until the kidneys recover their function.
2. Chronic kidney disease (CKD): Children with progressive kidney damage from congenital anomalies, genetic disorders, autoimmune diseases may eventually reach end-stage chronic kidney disease, where dialysis becomes necessary to sustain life. Some of them are: renal polycystosis, renal dysplasia, Alport syndrome.
3. Children can develop glomerulonephritis due to immune system dysfunction or infections (eg, poststreptococcal glomerulonephritis). In severe cases, this can lead to significant deterioration of kidney function and the need for dialysis.

SYMPTOMS OF CHRONIC KIDNEY DISEASE IN CHILDREN

1. Swelling and/or puffiness around the eyes, feet and ankles

2.Frequent headaches caused by high blood pressure

3. Frequent urination
4. Delayed growth
5. Loss of appetite and chronic nausea
6. Fatigue
7. Anemia and pale skin

Of course, these symptoms can also be a sign of other conditions. It is important not to ignore them and, when you have concerns, to seek timely medical help.

WHAT ARE THE DIALYSIS OPTIONS?

As in adults, hemodialysis (HD) or peritoneal dialysis (PD) is possible. The advantage of PD is that it can be performed at home, which can significantly reduce the stress associated with hospital visits. The pediatric nephrologist will help you choose the best option for your child that meets their needs and is consistent with their health condition.

The decision to start dialysis in children is based on a variety of factors, including the severity of kidney dysfunction, symptoms, underlying cause, general health, and the child’s age. The goal is to optimize the child’s health and quality of life while minimizing the risks and complications associated with kidney failure.

CKD (CHRONIC KIDNEY DISEASE) IN CHILDREN