Kidney function, symptoms and treatment

Chapter 2

Kidney disease

The following table provides an overview to help you understand CKD at different stages, including potential symptoms and treatment. The amount of kidney function (GFR) you have remaining, your symptoms, your overall health and other factors (such as the amount of albumin in your urine) will be used to help you and your care team to manage your health, monitor your kidney function and determine the type of treatment that’s best for you.

There are different stages of CKD that your care team may refer to. Each stage refers to the level of kidney function and kidney damage.

Kidney function, symptoms and treatment

NORMAL* MILD MODERATE SEVERE KIDNEY FAILURE

Amount of Kidney Function >60%* 45% - 59% 30% - 44% 15% - 29% < 15%

Symptoms No symptoms observed No symptoms observed In some people, early symptoms may occur and could include tiredness, poor appetite, and itching In some people, tiredness, poor appetite and itching Symptoms may include fatigue, nausea, swelling, difficulty breathing and itchiness

Treatment Options

Identify cause and try to reverse it Monitor urine ACR, eGFR** , blood pressure, general health and well-being Monitor urine ACR, eGFR, and blood pressure and continue to try to stop or slow the worsening of kidney function Monitor urine ACR, eGFR, and blood pressure and continue to try to stop or slow the worsening of kidney function Monitor eGFR and blood pressure and continue to try to stop or slow the worsening of kidney function

Monitor urine ACR and eGFR Try to stop or slow down the worsening of kidney function Learn more about CKD and treatment options Discuss and plan for treatment choice: dialysis access, assessment for transplant, or information about conservative kidney management Plan for dialysis or kidney transplant or continue conservative kidney management*** (depending on symptoms)

Chapter 2

Kidney disease

The amount of estimated kidney function (eGFR) you have remaining, your symptoms, your overall health and other factors (such as the urine ACR) will be used to help you and your care team to:

• Manage your health

• Monitor your kidney function

• Determine the type of treatment that’s best for you

Sometimes kidney failure occurs rapidly and this is called acute kidney injury. This may be a result of a variety of causes including infection, diseases that specifically attack the kidney filters, disease in other parts of your body that affect the kidney, or other causes. If acute kidney injury is very severe, dialysis treatment may be urgently needed for a period of time, but kidney function often recovers. Acute kidney injury may occur in people who have normal kidney function, but also in people with CKD.

HELPFUL TIP

More information about the classification of CKD, eGFR and urine ACR is available at kidney.ca. Strategies for protecting your kidney function are included in the following chapters.

Risk factors for CKD

There are a number of risk factors for the development of CKD – some that you can control such as smoking, and others that you cannot, such as aging. They include:

• Diabetes

• High blood pressure

• A family history of kidney disease

• Children who are born with kidneys that did not develop properly

• Indigenous people (First Nations, Inuit and Métis), Asian, South Asian,

Pacific Island, African/Caribbean and Hispanic ethnicity

It is important to remember that CKD can also occur in people without risk factors.

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