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Internees elaborate on CKD

Internees elaborate on CKD

Group C internees of American International School Chennai have prepared this research paper on Chronic Kidney Disease. The 13 interns were divided into four groups by TANKER Foundation.

Kudos to Nandini (grade 9) Hyeonguk (grade 12) and Lokeswar (grade 11) on this exhaustive piece!

Chronic Kidney Disease

By Nandini, Hyeonguk and Lokeswar

The kidney is an exceedingly vital organ that works to remove excess waste and toxins from the body, regulates blood pressure and electrolytes, initiates the production of red blood cells, and keeps your bones healthy. The functional unit of a kidney is called a nephron, a filtering unit in the kidney. They filter blood and release it back into the bloodstream. [3] However, this crucial part of the human body is threatened by Chronic Kidney Disease (CKD), which is the gradual loss of kidney functions, or an irreversible, rapidly progressing scar/inflammation in the kidney. Globally, about 679.5 million cases of CKD were recorded in the year 2017. [2] Firstly, in the early stages of CKD, not many symptoms are shown. These symptoms include swelling in legs/ankles/feet, for instance, when too much fluid is unable to be filtered by the kidneys and accumulates in the legs/ankles, feet. Excess fluid also may collect in the lungs, causing shortness of breath. Also, due to waste accumulating in the body (and swelling up), severe itching is caused by CKD. [9] Causes of CKD include diabetes [3], high blood pressure, smoking (the nicotine in tobacco products narrows your blood vessels and increases heart rates, which lead to blood pressure which [as mentioned before] is another cause of CKD), and drinking too much alcohol (another way blood pressure can be increased). [7]

Certain other diseases can also be indicators or symptoms of CKD. An example is Autoimmune disease, which is a condition in which your immune system mistakenly attacks your body. This immune system normally guards against germs like bacteria and viruses. When it senses these foreign invaders, it sends out an army of fighter cells to attack them. Moving on is Glomerulonephritis. This is basically an inflammation of the glomeruli. Glomeruli are extremely small structures inside the kidneys that filter the blood. Glomerulonephritis can be caused by infections, drugs, or congenital abnormalities (disorders that occur during or shortly after birth).

The next disease is called Polycystic kidney disease. Widely known as a genetic disorder that causes numerous cysts (small sacs of fluid) to grow in the kidneys. These cysts can interfere with kidney function and cause kidney failure. It’s important to note that individual kidney cysts are fairly common and almost always harmless. Polycystic kidney disease is a separate, more serious condition. Lastly, Urinary Tract infections are bacterial infections of any part of the urinary system. Infections in the bladder and urethra are the most common. They are easily treatable and rarely lead to more health problems. However, if left untreated, these infections can spread to the kidneys and cause kidney failure. [9]

As detailed above, chronic kidney disease (CKD) is deadly when not diagnosed early on. Even though CKD cannot be cured, treatment can be done to stop the disease from getting worse, relieving the symptoms. One of the main forms of treatment for CKD is dialysis, a type of treatment which removes waste products and excess fluid from the blood when CKD is diagnosed, according to the National Health Service UK. Dialysis works by diverting blood to a certain machine, where it undergoes cleaning. Under dialysis itself, there are two main types, hemodialysis and peritoneal dialysis.
Hemodialysis is the most common type of dialysis, and it uses an artificial kidney, known as a hemodialyzer in order to remove the waste and extra fluid from the blood, cleaning it. In hemodialysis, the blood is filtered using this artificial kidney. On the other hand, peritoneal dialysis involves surgery in order to work. Under this type of dialysis, a peritoneal dialysis catheter is implanted into the abdomen, through will dialysis fluid is filled to the abdomen and wastes are removed through the peritoneal membrane. [5] These types of dialyses, though have numerous benefits to treating CKD, can also have harmful effects like anemia, low blood pressure, sepsis, sudden cardiac death, and high blood sugar among others. [4]

Additionally, CKD itself can cause many other diseases. The first disease is the mineral and bone disorder. This disease occurs when damaged kidneys and abnormal hormone levels cause calcium and phosphorus levels to be out of balance in a person’s blood. Mineral and bone disorder commonly occurs in people with CKD and affects most people with kidney failure receiving dialysis. [8] CKD can also cause anemia, which is a blood-based disease, and it happens when the bloodstream has a shortage of red blood cells. When the kidneys’ functions are disrupted, the production of erythropoietin (a hormone) is slowed. This hormone is responsible for signaling your bone marrow to produce red blood cells, so not as many will be created if said hormone is not produced. [1] Along with the diseases listed above, CKD is linked to heart disease, because several complications of CKD can lead to heart disease, one of them being anemia. This is since without the necessary amount of red blood cells, less oxygen is traveling into the tissues and organs, which increases the risk of heart disease. Furthermore, CKD can also cause an excess of homocysteine (a type of protein) in the body. Large amounts of this protein leads to coronary artery disease. [6]

Chronic Kidney Disease can be fatal when patients do not receive proper treatment, since, (as previously mentioned) it is a progressive disease, and the damage will get worse over time, and can eventually stop working. It is also irreversible, as there is no direct cure, and since dialysis can only prevent the disease from progressing. Therefore, it is exceedingly critical that cautionary measures are taken to prevent this life-threatening disease. There are many ways to avert this disease, such as staying away from habits such as smoking, which can disrupt blood pressure medications, and ultimately worsen the kidney. Another essential measure that should be taken is to always monitor blood pressure, no matter how old, since CKD can affect anyone. Thirdly, physical activity is also beneficial when fighting this disease, since it helps regulate blood sugar levels and improves circulation. Although there are treatments such as dialysis that reduce the disease, the dire consequences of CKD must be addressed, and every measure must be taken to ensure CKD is not contracted. [3]

Citations:
  1. “Anemia in Chronic Kidney Disease.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, www.niddk.nih.gov/health-information/kidney-disease/anemia.
  2. Arora, Pradeep. “What is the global prevalence of chronic kidney disease (CKD)?” Edited by Vecihi Batuman. medscape.com, 2 Apr. 2021,https://www.medscape.com/answers/238798-105274/what-is-the-global-pre valence-of-chronic-kidney-diseaseckd#:~:text=In%202017%2C%20697.5%20mil lion%20cases,died%20from%20CKD%20in%202017 . Accessed 21 June 2021.
  3. “Chronic Kidney Disease Basics.” cdc.gov, www.cdc.gov/kidneydisease/basics.html . Accessed 21 June 2021.
  4. “Dialysis.” healthline.com, www.healthline.com/health/dialysis #risks. Accessed 21 June 2021.
  5. “Dialysis.” nhs.uk, www.nhs.uk/conditions/dialysis/ . Accessed 21 June 2021.
  6. “Heart Disease & Chronic Kidney Disease (CKD).” Heart Disease (CVD) & Chronic Kidney Disease (CKD) – American Kidney Fund (AKF),  www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/complications/h eart-disease/.
  7. “High Blood Pressure.” aapf.org, 15 Oct. 2004, https://www.aafp.org/afp/2004/1015/p1542.html . Accessed 21 June 2021.
  8. Information, Health et al. “Mineral & Bone Disorder In Chronic Kidney Disease | NIDDK”. National Institute Of Diabetes And Digestive And Kidney Diseases, 2021, https://www.niddk.nih.gov/health-information/kidney-disease/mineral-bone-disord er.. Accessed 11 June 2021.
  9. “Kidney Health And Kidney Disease Basics: Causes And Questions”. Healthline, 2021, https://www.healthline.com/health/kidney-disease#types-and-causes. Accessed 11 June 2021.
  10. “Symptoms of Kidney Disease.” https://www.davita.com/education/kidney-disease/symptoms#:~:text=Shortness% 20of%20breath%20%E2%80%94%20kidney%20failure,to%20protein%20foods%20like%20meat

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