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Chronic Kidney Disease

What is Chronic Kidney Disease?

Chronic kidney disease (CKD) is a long-term condition characterised by the gradual loss of kidney function over time. The kidneys play a crucial role in filtering waste products and excess fluids from the blood, regulating electrolyte balance, and producing hormones that help regulate blood pressure and stimulate red blood cell production. In CKD, the kidneys become damaged and are no longer able to perform these functions effectively.

 

CKD is typically diagnosed based on the presence of kidney damage or a decreased glomerular filtration rate (GFR) persisting for three months or more. The severity of CKD is classified into five stages based on GFR:

 

- Stage 1: Kidney damage with normal or increased GFR (≥90 mL/min/1.73 m²)

- Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m²)

- Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m²)

- Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m²)

- Stage 5: Kidney failure (GFR <15 mL/min/1.73 m² or on dialysis)

Risk factors

  1. Diabetes: Diabetes is the leading cause of CKD, particularly in developed countries. High blood sugar levels can damage the small blood vessels in the kidneys over time, leading to kidney damage and dysfunction.

  2. Hypertension (high blood pressure): Chronic hypertension can damage the blood vessels in the kidneys and impair kidney function, leading to CKD.

  3. Glomerulonephritis: Glomerulonephritis is inflammation of the glomeruli, the filtering units of the kidneys, which can result in kidney damage and impairment of kidney function.

  4. Polycystic kidney disease (PKD): PKD is a genetic disorder characterized by the growth of fluid-filled cysts in the kidneys, which can gradually replace healthy kidney tissue and lead to CKD.

  5. Other causes: Other conditions and factors that can contribute to the development of CKD include autoimmune diseases, kidney infections, kidney stones, urinary tract obstructions, and long-term use of certain medications.

Symptoms

Symptoms of CKD include:

  • Fatigue

  • Swelling (edema) in the legs, ankles, feet, or face

  • Changes in urine output (increased or decreased)

  • Difficulty concentrating

  • Loss of appetite

  • Nausea and vomiting

  • Itching

  • Muscle cramps

Treatment options

Early detection and management of chronic kidney disease are crucial for slowing disease progression, preventing complications, and preserving kidney function. Treatment may include lifestyle modifications, medications to control blood pressure and manage symptoms, dietary changes, and, in advanced cases, dialysis or kidney transplantation. Regular monitoring and follow-up with a healthcare provider are essential for managing CKD effectively and optimising outcomes.

Can exercise help?

Exercise can play a beneficial role in managing chronic kidney disease by:

 

  1. Improving cardiovascular health: Regular exercise helps to improve cardiovascular fitness, lower blood pressure, and reduce the risk of heart disease, which is elevated in individuals with CKD.

  2. Reduce symptoms: Exercise can help alleviate symptoms commonly associated with CKD, such as fatigue, muscle weakness, and depression, by improving overall physical function and mental well-being.

  3. Maintain muscle strength and function: Strength training exercises help to maintain muscle mass, strength, and function, reducing the risk of muscle wasting (sarcopenia) and weakness associated with CKD.

  4. Enhance bone health: Weight-bearing and resistance exercises help to maintain bone density and strength, reducing the risk of osteoporosis and fractures, which are common complications of CKD.

  5. Promote weight management: Regular physical activity helps to control body weight and reduce excess body fat, which is important for managing complications such as diabetes and cardiovascular disease that often coexist with CKD.

  6. Improve mental well-being: Exercise releases endorphins, which are natural mood-boosting chemicals that help reduce stress, anxiety, and depression, improving overall mental well-being in individuals with CKD.

  7. Enhance quality of life: Regular exercise has been shown to improve overall quality of life, increase energy levels, and promote a sense of independence and empowerment, despite the challenges of living with CKD.

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