Kidney Disease

Functions of the Kidneys:

           1. Elimination of waste products, particularly those derived from protein.

           2. Maintenance of water and salt balance.

           3. Regulation of acid-base balance.

           4. Production of hormones, such as erythropoietin and vitamin D.

Chronic Kidney Disease:

• Chronic kidney disease refers to conditions characterized by reduced kidney function and/or kidney damage, lasting for more than 3 months.
• It is classified into five stages, ranging from stage 1 (structural abnormalities without decreased kidney function) to stage 5 (chronic renal failure requiring renal replacement therapy).

Indicators of Chronic Kidney Disease:

           1. Presence of protein in the urine (proteinuria).

           2. Presence of red blood cells in the urine (hematuria).

Assessment of Kidney Function Levels:

           Kidney function can be evaluated by measuring creatinine levels in the blood and calculating the Glomerular Filtration Rate (GFR).

Risk Factors for Chronic Kidney Disease:

           1. Age and family history of kidney disease.

           2. Conditions or factors that can cause kidney damage, such as diabetes, high blood pressure, autoimmune diseases, urinary tract infections, urinary tract obstruction, and exposure to nephrotoxic substances.

           3. Factors that contribute to disease progression, including uncontrolled proteinuria, poorly managed high blood pressure, poorly controlled diabetes, and smoking.

Screening for Chronic Kidney Disease:

           1. The goal of screening is to identify and provide care for individuals with chronic kidney disease, particularly in the early stages, to either manage reversible causes or prevent rapid deterioration.

           2. Individuals with risk factors mentioned above should undergo screening.

           3. Screening methods may include measuring blood pressure, conducting a general physical examination, performing blood tests to assess creatinine levels, and analyzing urine samples. Kidney ultrasound may also be recommended when necessary.

Treatment Guidelines to Slow Kidney Disease Progression:

            1. Lifestyle modifications, such as weight loss for overweight patients, smoking cessation, reducing salt intake, and regular exercise.

            2. Achieving appropriate blood pressure control.

            3. Maintaining optimal blood sugar levels.

            4. Managing proteinuria with medication.

            5. Restricting dietary intake of protein.

            6. Lowering blood lipid levels.

            7. Avoiding substances or medications that can have a negative impact on the kidneys, particularly nonsteroidal anti-inflammatory drugs (NSAIDs).

                          Information provided by: Dr. Thatchai Wutchamnong, Nephrologist."