Chronic kidney disease (CKD) is the condition when the kidneys are no longer able to filter blood as required because of progressive damage. Wastes accumulation in the body will be the result, in addition to other problems that can harm the health. Diabetes and high blood pressure are the two main leading causes of chronic kidney disease which result in up to two-thirds of chronic kidney disease cases.

Some of the factors that increase the risk for kidney disease are: Family history of kidney failure and being older. The chronic renal failure develops in three stages. In the first stage, only 75% of the functioning nephrons are lost, the person may show no signs or symptoms. The person enters the second stage once 75% of the nephrons are lost and renal insufficiency condition occurs. The third stage of chronic renal failure characterized by losing about 90% of the nephrons with presenting of oliguria.

Some signs and symptoms of the disease could include tiredness and loss of power, nausea and headache, weight loss without intention to lose weight, and puffiness around the eyes in morning. Three simple tests can be conducted if the doctor suspects chronic kidney disease, those are Blood pressure test, urine albumin, serum creatinine.When considering treatment options for chronic kidney disease, the doctor might begin with treating the problems that damaged the kidneys and may recommend medications such as ACE inhibitors and angiotensin-II receptor blockers that can be helpful if high blood pressure determined as the source of the problem. If diabetes determined as the source of the problem, the doctor might recommend the patient to maintain a normal level of blood sugar. In addition, the doctor might recommend quitting smoking and specific type of diet.

The chronic kidney disease still has no precise cure. The chronic kidney disease can worsen to end-stage kidney disease. In most of the cases, dialysis will be performed when only 10 to 15% of the kidney function left.According to a systematic review done by a study funded by National Institute for Health Research (NIHR) in England, higher rates of chronic kidney disease prevalence are reported in developed regions such as Europe, USA, Canada and Australia while regions where economies are growing such as sub Saharan Africa, India, etc, the disease rates show decreasing in prevalence. With the exception of Iran that has a similar high rate of chronic kidney disease prevalence. Furthermore, chronic kidney disease is more common in women than in men.

Chronic kidney disease (CKD) is the condition when the kidneys damaged and no longer can filter blood as required. This damage can allow the accumulation of wastes in the body in addition to other problems that can harm the health. The two main leading causes of CKD are diabetes and high blood pressure. Chronic kidney disease (CKD) is manifesting by gradual loss of kidney function over time. Removing wastes and excess water from the body is kidneys main job.

Chronic kidney disease (CKD) is a kidney disease that manifesting by gradual loss and damage of kidney function over time. If the damage is very bad, the kidneys may stop working. This is called kidney failure, or end-stage renal disease (ESRD).

Diabetes and high blood pressure are the two main leading causes of chronic kidney disease which result in up to two-thirds of chronic kidney disease cases. High blood sugar that caused by diabetes can results in damage to many organs in the body, including the heart and kidneys, as well as eyes, blood vessels, and nerves. Increasing the pressure of blood against the walls of blood vessels will lead to the condition that called “hypertension” or high blood pressure. The poor monitoring of high blood pressure can lead to heart attacks, strokes, and chronic kidney disease. Other conditions that affect the kidneys are:

• Glomerulonephritis: This group of disorders is the third most common type of kidney disease that can result in inflammation and damage to the kidney's filtering units.
• Inherited diseases: A good example related to this category is the polycystic kidney disease which results in large cysts that build up in the kidneys and causing damage to the surrounding tissue.
• Backward flow of urine into the kidneys (reflux nephropathy).
• Kidney stones, tumors or an enlarged prostate gland in men that lead to obstructions.
• Malformations that occur during pregnancy (before birth).
• Immune system diseases such as lupus.
• Recurrent urinary infections.

Kidney disease can occur at any age. However, some people are more vulnerable to develop kidney disease than other. Some of the factors that increase the risk for kidney disease are:

• Diabetes: High blood sugar could increase the possibility of having such disease.
• High blood pressure: Damaging blood vessels walls can contribute to forming this disease.
• A family history of kidney failure: Having a relative or past experience for relatives concerning kidney problems can increase the possibility of having CKD.
• Being older: Advancing in age can increase the possibility of having kidney problems.
• Some population groups that have a high rate of diabetes or hypertension, such as American Indians, African Americans, Asian, Pacific Islanders, and Hispanic Americans.

Traumatic loss of kidney tissue, chronic glomerulonephritis, pyelonephritis, or polycystic kidney disease, all can cause chronic renal failure (CRF) or chronic kidney disease (CKD).The chronic renal failure develops in three stages. In the first stage, although 75% of the functioning nephrons are lost, the person may show no signs or symptoms because the remaining nephrons enlarge and take over the function of those that have been lost.

The person enters the second stage once 75% of the nephrons are lost and renal insufficiency condition occur, characterized by increasing the blood levels of nitrogen-containing wastes and creatinine and decreasing in GFR (glomerular filtration rate). Also, the kidneys are no longer can concentrate or dilute the urine effectively.

The third stage of chronic renal failure characterized by losing about 90% of the nephrons and GFR diminishes to 10–15% of normal. Oliguria is present at this stage and increasing blood levels of nitrogen-containing wastes and creatinine could be observed. Dialysis is needed for people with end-stage renal failure and they are possible candidates for a kidney transplant operation.

Severe symptoms may never present in most people until their kidney disease is advanced. However, some signs and symptoms could take the form of:

• Tiredness and loss of power,
• Nausea and headache,
• Weight loss without intention to lose weight,
• Troubles regarding concentrating and sleeping disturbances,
• Poor appetite,
• Muscle cramping at night,
• Swollen feet and ankles,
• Dry and itchy skin,
• Frequent urination at night,
• Puffiness around the eyes in morning.

The healthcare giver might recommend three simple tests if suspect chronic kidney disease:

• Blood pressure test: For most people, a normal blood pressure has to be less than 120/80.
• Urine albumin: A test to check how much protein is in the urine. Finding protein in the urine means there might be a kidney disease.
• Serum creatinine: A test to check how much creatinine is in the blood. Abnormal levels of creatinine might indicate renal function problem.

Another test that can be used is eGFR (estimated glomerular filtration rate) which is a sign of how well the kidneys functioning in regard to cleaning the blood of the body. In case eGFR is less than 60 for a period of three months or more, that might indicate a kidney disease. 

The doctor might begin with treating the problems that damaged the kidneys:

• Medications:  ACE inhibitors and angiotensin-II receptor blockers can be helpful if high blood pressure determined as the source of the problem. These medicines can play a role in decreasing blood pressure and stopping kidney disease from getting worse.
• If diabetes determined as the source of the problem, the doctor might recommend the patient to maintain a normal level of blood sugar. Changing diet and maintaining a good level of physical activity exercise and/or take certain medicines may be recommended as well.

If the person smoke, he-she must quit. Smoking damages the kidneys and interferes with medicines used to treat high blood pressure.The doctor may also recommend less protein diet because a large quantity of protein intake can make the kidneys work harder.

In addition, regular checkups are necessary to allow the doctor to have better knowledge regarding kidneys working and to treat relevant problems associated with chronic kidney disease. Dialysis may be recommended for people with end-stage renal failure and it is possible to arrange kidney transplant operation for them.

Chronic kidney disease can get worse over time even with the proper treatments. When the kidneys stop working, kidney failure occurs. If this case, waste can be accumulated in the body and acts like a poison in the long run. The resulted poisoning can cause vomiting, weakness, confusion, and in some cases, it can lead to coma. Some of the common complications associated with chronic kidney disease include high calcium, fluid accumulation, anemia, bone disease, heart disease, and high potassium.

Adopting healthy lifestyles can draw the line for best prevention and control measures for high blood pressure, diabetes, and kidney disease. The following tips can lower the risk for kidney disease and the problems that cause it:

• Performing physical activities at least 30 minutes on most days of the week,
• Adopting a low-salt and low-fat diet,
• Having regular check-ups with doctor,
• Limiting alcohol consumption.
• Quitting smoking.

The majority of people lost most of their kidney function before diagnosed with chronic kidney disease.The chronic kidney disease still has no precise cure. The chronic kidney disease can worsen to end-stage kidney disease. This process depends on the cause of kidney damage and the person’s case self-management.The last stage of chronic kidney disease is kidney failure. This is when the kidneys are ineffective in supporting the body's needs.In most of the cases, dialysis will be performed when only 10 to 15% of the kidney function left. Dialysis is also could performed for people who are waiting for a kidney transplant.

• According to a systematic review done by a study funded by National Institute for Health Research (NIHR) in England, higher rates of chronic kidney disease prevalence exist in the developed regions such as Europe, USA, Canada and Australia. While regions where economies are growing such as sub Saharan Africa, India, the rates tend to be lower with the exception of Iran that has a higher rate of chronic kidney disease prevalence. In addition, chronic kidney disease is more common in women than in men.
• According to the American Kidney Fund, more than 31 million people in the United States are diagnosed with chronic kidney disease.
• According to the National Kidney Foundation in the United States, Heart disease is the major cause of death for all people diagnosed with chronic kidney disease.