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Keep yourselves informed!

Chronic kidney disease has multiple causes, from primary kidney diseases (e.g. Glomerulonephritis) to other diseases (e.g. hyperglycemia, systemic lupus eritematos, gout) and congenital or genetic diseases (e.g.: polycystic kidney).

The main causes of the chronic kidney disease are:

1. Glomerulonephritis

2. Hypertension/high blood pressure

3. Diabetus mellites/hyperglycemia

4. Polycystic diseases

5. Urologic causes: renal lithiasis, retroperitoneal fibrosis, gall bladder malformations, urethral strictures, a.s.o.

6. Collagen diseases: systemic lupus erythematous, polyreumatoid arthritis, a.s.o.

7. Other causes: chronic pyelonephritis, endemic Balkan nephropathy

Whatever the causes might be, they generate organic injuries that are irreversible for the kidneys, causing the appearance of chronic kidney disease.
Consequently, if you suffer of one of the above mentioned symptoms, inform your family doctor so that he can send you to a specialist in nephrology. The doctor will  consult and  record your data and you will be requested to undergo certain laboratory tests (urea, creatinine, complete blood count, urine chemistry, proteinuria, serum ionogram, a.s.o.), as well as certain investigations such as abdominal ultrasonography, X-rays, CT , a.s.o., in order to establish the cause  and the degree of this kidney disease.
Further on, you will be advised about the living, the nutrition, the medication and the necessity of periodically undergoing medical investigations, depending on the degree of kidney disease. In order to obtain optimum results, it is compulsory to be advised about the disease, the diet, the medication and the agents which could aggravate your disease.

One has to follow a few steps in the current treatment of the kidney disease, as follows: firstly, a conservatory treatment is done to stop the disease progression – through diet and medication; then, a substitution (replacement) treatment of the kidney (which does not perform its functions) is done through dialysis or through kidney transplant.

Suffering from chronic kidney disease, especially in the advanced phase, implies keeping a strict diet, sometimes a severe diet before starting the dialysis. Some restrictions are absolutely necessary: some foods and, especially, some liquids, considering the diuresis.  

Your kidneys must eliminate blood toxins. If they don’t function properly, the toxins may cumulate, having as a result symptoms like: tiredness, lack of appetite, nausea, respiratory problems, itching, focusing difficulties etc. A diet would reduce the level of some toxins and the severity of some symptoms. It is important for you to have a healthy nutrition and to maintain yourself well fed.

The necessity of changes in your diet is based primarily on the results of your laboratory tests. You are not allowed to change your diet without the doctor’s approval – a nephrologist or a nutritionist. The diet will be individualized, taking into consideration the medical and social agents, as well as your nutrition habits.
Once your kidney disease progresses, your diet may become restrictive (diet lacking proteins) and may have an increased impact over your daily activities, but the nephrologist and the nutritionist will help you in making this transition easier for you.

You must keep a daily evidence of your weight and it is absolutely necessary to understand that, in case you gain weight, you have to inform your doctor.
At the same time, you will be advised to make less effort than usual, to give up sports, to avoid the exposure to cold and the weather changes and to stop smoking.
It is necessary for you to be informed that any medical act, even though it has nothing to do with your kidney disease, must be done with the nephrologist’s approval: teeth extraction, surgical interventions. The use of „salt without sodium”, which brings a potassium supplement that could be dangerous, the use of some drugs which could have some toxic effects for the kidney, as anti-inflammatory drugs and some antibiotics should also not be done without your doctor’s approval.            

When the measures of conservatory treatment (living, diet, medication) are not efficient anymore, these being visible in your clinical state and in the results of your laboratory tests, it is necessary to start the substitution treatment through these two methods of dialysis: haemodialysis and peritoneal dialysis. The kidney’s substitution treatment through haemodialysis or peritoneal dialysis improves the nutritional constraints, but it does not extend completely the liberty in your nutrition. Still, some restrictions from some foods (avoiding the food rich in potassium and the use of salt) and, especially, the use of liquids, taking into consideration the diuresis are absolutely necessary; you should inform your doctor on the exact urine quantity you eliminate in 24 hours so that he can establish the exact quantity of liquids you may drink within one day.
At this phase, unlike the initial phase of the conservatory treatment, you will be advised to consume a normal quantity of proteins.

An efficient haemodialysis implies good vascular access, which can be done using the fistulas and the catheters.