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Chronic Kidney Disease

Chronic kidney disease is a disease that causes kidney problems. It is better known by the name of chronic renal failure. Since high blood pressure and diabetes are the most important and common causes, regular checkups are more important than anything else.


There are two kidneys, one left and one right, hidden by the ribs on the back. Kidney is a Chinese character and is called kidney in Korean. The kidneys are not in the abdominal cavity, but exist in a region called the retroperitoneal cavity behind the abdominal cavity. It depends on the person, but there is a kidney about 3cm from the skin on the back. Therefore, if you hurt your side or back, your kidneys can be damaged. The kidneys are connected to large blood vessels such as abdominal aorta and inferior vena cava through the renal artery and renal vein, as the main function is to filter waste in the blood. Urine made by filtering blood from the kidneys is stored in the bladder through the ureter and discharged out of the body during urination.


If there is an abnormality in the kidneys, it was previously called chronic kidney failure, but these days, the term chronic kidney disease is used as it is gradually organized and supplemented in detail. Chronic kidney disease refers to a case where a functional or structural abnormality in the kidney persists for more than three months. It may be suspected if proteinuria above the normal range appears to be continuous for more than 3 months in urine tests, or if kidney function is degraded for more than 3 months in blood tests. In the case of hepatitis, it is said to be chronic if it lasts more than 6 months, but in the case of kidney disease, it is called chronic because it is fixed if it lasts more than 3 months. In addition, if an abnormality in the kidney is found in an imaging test or biopsy, it can be said to be chronic kidney disease.


Kidney disease often progresses, so early detection and management can prevent progression to end-stage renal failure that requires kidney transplantation or dialysis treatment. The two most important and common causes of chronic kidney disease are diabetes and high blood pressure. Diabetes accounts for about 50% and hypertension accounts for about 20% of terminal renal failure. The third most common cause is glomerulonephritis, and other causes are genetic diseases such as polycystic kidney disease, congenital deformities, autoimmune diseases, and drug misuse. Since diabetes and high blood pressure are important causes, chronic kidney disease occurs very often in old age. It is known that about 40% of people in their 70s and more than 60% of people in their 80s have chronic kidney disease. In some ways, it is often a problem in the elderly population to the extent that it can be regarded as a disease of old age. If you have diabetes, high blood pressure, or kidney disease in your family, especially in the case of the elderly, you need to be careful and regularly check your kidneys.


If the cause of chronic kidney disease can be treated, it is the most effective and important treatment, and if the cause disease of chronic kidney disease is diabetes or high blood pressure, thorough management is the most important to slow the occurrence or progression of chronic kidney disease. High blood pressure is also the second most important cause of chronic kidney disease, but when kidney disease occurs, high blood pressure is very common. High blood pressure secondary to kidney disease is an important cause of the progression of chronic kidney disease, just like essential hypertension, so thorough control is needed like essential hypertension. Among the blood pressure drugs, there is a relatively favorable system for kidney disease, so it is much more advantageous for kidney disease to control blood pressure by selecting these drugs. If you have chronic kidney disease, you need to be careful when using medicine, health foods, and nutritional supplements, and if it is not necessary, you are more likely to cause unexpected problems than the general public, so it is better to avoid it. Commonly used analgesic anti-inflammatory drugs can also cause kidney disease or worsen kidney function, so caution is needed, and contrast agents used during CT scans can sometimes cause nephrotoxicity, so people with poor kidney function need special attention. If the kidney function is severely poor, it is recommended to avoid the contrast medium used for MRI tests because it is not toxic to the kidney, which may cause serious problems in our body due to the possibility of not excreting.


Chronic kidney disease often has no severe symptoms that we feel until it progresses considerably, so we often don't know until just before terminal renal failure without proper testing. Symptoms of chronic kidney disease include low fatigue, lack of energy, and poor concentration for no particular reason, decreased appetite, sleep disorders, frequent cramps, swollen eyelids or swollen feet and ankles in the morning, and worse at night. As these symptoms progress little by little over a long period of time, they often ignore the changes in their bodies without being aware of them.


One of the common complications of chronic kidney disease is that our bodies may have edema without sufficient sodium (salt) and moisture excreted from our kidneys. Diuretics are used when edema occurs, and diuretics used at this time are to relieve edema by releasing sodium into urine. Eating less salt is very helpful in treating edema by reducing salt in the body, similar to using diuretics. Among the foods enjoyed in Korea, soup, stew, salted seafood, or salted foods contain a lot of salt, so avoiding this alone can reduce salt intake by nearly half. Eating less soup, stew, or pickled food than eating side dishes blandly is much more advantageous in reducing sodium intake. Hematopoietic hormones are also made in the kidneys, but anemia can occur due to a lack of hematopoietic hormones as kidney function decreases. Osteoporosis can worsen due to metabolic acidosis caused by chronic kidney disease, and various bone problems can occur due to bone metabolism abnormalities as phosphorus control problems occur in the kidneys. In the case of severe chronic kidney disease, problems in electrolyte control may occur and cause arrhythmia, which may be dangerous. In the case of severe chronic kidney disease, problems with potassium excretion through the kidneys may cause arrhythmia due to hyperkalemia, which is also a type of electrolyte abnormality. Since fruits, vegetables, and raw vegetables contain a lot of potassium, doctors sometimes advise people to avoid this type if hyperkalemia occurs in blood tests.


It would be nice if the causes of chronic kidney disease could be treated and fully recovered, but diseases that are the main causes of chronic kidney disease, including diseases such as diabetes and high blood pressure, which are the most common causes, often need continuous management. Just as the expression of continuous management is more appropriate than the expression of complete recovery of diabetes and high blood pressure, chronic kidney disease can be prevented from progressing to terminal renal failure that requires kidney transplantation or dialysis.


Health check-ups are very active in our country. If you receive a result that there may be a kidney problem in a medical examination, do not ignore it and make sure to visit the hospital to check it. Due to the characteristics of the examination test or the test method, there may be cases where there is no problem with the kidney, but there are many cases of chronic kidney disease, so please check for kidney disease. You can check for abnormalities with simple urine and blood tests and blood pressure measurements, and the cost is very low, so don't ignore it because you are busy and make sure to test it.


Writer: Yeyoung Jeon


(Picture from Unsplash)

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