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Chronic Kidney Disease

Chronic Kidney Disease ('CKD') is a condition where kidneys are unable to adequately filter the blood to remove normally-occurring toxins and waste that accumulate in the body. Conditions that can occur as a result of declining kidney function include high blood pressure, anemia, weak bones, neurological issues, nutritional deficiencies and heart and blood vessel disease.

Source: Fresenius Kidney Care
Yikes!

The top cause of CKD is Diabetes. I used to think that preventing Diabetic CKD was as simple as controlling your blood sugar but my nephrologist set me straight. Just like with PKD, there are genetic predispositions to developing it. So if your family health history includes Diabetes combined with CKD, be proactive with your health and actively work to control blood pressure and maintain normal blood glucose levels.

High blood pressure is the #2 risk factor for CKD. It weakens blood vessels in the kidneys, making it difficult to remove waste and liquid from the blood. Water retention raises blood pressure even more and suddenly you have all the makings for a vicious circle. Healthcare recommendations are similar to a Adam Ant song - don't drink, don't smoke... Actually, you're advised to control your blood pressure to under 140/90 (with meds if necessary), exercise, eat healthy, DON'T SMOKE and reduce stress.

Is that all?!?

Number three is Glomerular Disease (say what?) which is when the tiny filters within the kidney are damaged. As with everything else, the ability to filter waste is compromised, fluid builds up and you may leak protein and red blood cells into your urine. How attractive... Treatment is to control your blood pressure, remove excess fluid with diuretics and possibly treat the immune system with corticosteriods.

Number four is near and dear to my heart - Polycystic Kidney Disease - so we'll take a look at that on a separate page.

What are the symptoms of CKD you may ask?

  • lack of energy / fatigue
  • difficulties concentrating
  • lack of appetite
  • water retention - including swollen legs & ankles as well as a puffy morning face
  • sleep issues - including not being able to, having to get up to pee and leg muscle cramping
  • dry, itchy skin
Don't those sound like fairly generic symptoms?

The failsafe way to know is to go to your doctor and have lab work performed. Your main metric - at least at the beginning - is going to be eGFR which stands for Estimated Glomerular Filtration Rate. The general idea is that it represents the percent of kidney function that you have. So a result of 100 is cause for celebration whereas a result of 30 (my current level) is cause for concern. This table helps you to determine where you are on the 'bad kidney' scale:

Source: National Kidney Foundation
Follow up tests (once you get a low eGFR) may include an ultrasound, CT scan, MRI and/or a kidney biopsy. Family health history (grandmother, mother and maternal uncle) and an ultrasound were all it took for my confirmed ADPKD diagnosis.

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Round 2 deja vu

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Artificial kidney

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Truly blessed

For all the medical issues I have, for all the uncertainty that exists in my future, for all the modifications I need to make to my lifestyle... I feel honestly and truly blessed. Yes. I have an incurable disease that can possibly lead me down a path towards  dialysis, organ transplant, lifelong immunosuppressive drugs and early death. But... I don't have diabetes. I don't have a history of aneurysms in my family. My blood pressure is well-managed. My risk for cardiovascular events is low. I work for a company with good healthcare. My job allows me the flexibility to go to doctor appointments and labs.  I have friends and family who love and support me. Could be much, much worse.

Test tube kidneys?

While I'm sure that Miromatrix would shudder at my description, it looks like they're developing the equivalent of a test tube kidney which could be used for transplant. While the science and bioengineering behind it is extremely complex, this is how I understand it. Miromatrix uses decellularization and recellularization technology to create a transplantable kidney. Huh? They take an dead organ - it doesn't even need to be human - and using detergents (I'm guessing they're stronger than Dawn ;-) ) they strip away all the cells. What remains is the kidney's extracellular matrix (collagen, enzymes and glycoproteins) and all its chemical cues. Then the "generic" organ is repopulated with the transplant candidate's cells, eliminating the risk it will be rejected upon implantation. Early studies have shown that it takes from four to eight days to culture the transplantable kidney and, even better, the new organ produces urine when tested. B...