Chronic kidney disease (CKD) affects approximately one in ten adults, equating to around 7.2 million people in Britain, and contributes to an estimated 45,000 deaths each year, surpassing the combined fatalities from breast and prostate cancer. Despite its significant impact, the condition is largely unknown to the public, with most individuals unaware they have it.
CKD is characterized by a gradual decline in kidney function, impacting the body's ability to filter waste and excess water from the blood. Unlike many other serious illnesses, CKD typically does not present obvious symptoms in its early stages. The body's ability to compensate for reduced kidney function means that the disease often goes unnoticed until it is advanced or discovered incidentally through routine blood or urine tests.
When symptoms do emerge, they are often vague and can include fatigue, brain fog, and itchy skin. As the disease progresses, individuals may experience weight loss, swelling in the extremities, breathlessness, blood in the urine, increased urination frequency, or muscle cramps. By the time these signs become apparent, the disease may have been present for years. Importantly, CKD is irreversible; the damage cannot be healed, though its progression can be managed.
Causes and Risk Factors
The primary drivers of CKD are closely linked to diabetes and high blood pressure, with a reciprocal relationship where these conditions damage the kidneys, and damaged kidneys can exacerbate diabetes and hypertension. Lifestyle factors such as unhealthy diet, lack of physical activity, excessive alcohol consumption, and smoking are significant contributors to the development of these underlying conditions.
Diagnosis typically relies on two key tests administered by a general practitioner. A blood test measures creatinine levels, a waste product that indicates kidney efficiency, while a urine test checks for albumin, a protein that leaks into the urine when kidney damage occurs. Individuals with diabetes or high blood pressure are strongly advised to request these tests from their GP.
Managing and Halting Progression
While CKD cannot be cured, early diagnosis is crucial for halting its progression. Key management strategies include controlling blood pressure and blood sugar levels through lifestyle modifications such as weight management, a balanced diet rich in fruits, vegetables, and whole grains, and reduced intake of salt and sugar. Regular physical activity is also vital, as it benefits cardiovascular health, and CKD is fundamentally linked to heart disease.
For individuals who smoke, quitting is recommended. Limiting alcohol intake to below 14 units per week is also advised. In addition to lifestyle changes, significant therapeutic advancements have been made. A class of medications known as SGLT2 inhibitors, including dapagliflozin and empagliflozin, originally developed for diabetes, have shown in clinical trials to substantially slow the decline of kidney function and reduce the risk of heart failure and mortality in CKD patients, regardless of their diabetes status.
Importance of Health Checks
Many individuals with CKD remain undiagnosed, highlighting the importance of proactive health screenings. People aged between 40 and 74 without pre-existing health conditions are eligible for an NHS health check every five years, which includes assessments for blood pressure, blood glucose, and cholesterol. If high blood pressure is detected, kidney function is also evaluated. Health professionals urge individuals not to wait for symptoms to appear, as this may indicate advanced disease or lead to serious complications like a heart attack, emphasizing the need for regular check-ups.