Chronic Kidney Disease Stage 1
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Each of the five stages of chronic disease is associated with a level of function and impairment.
Chronic Kidney Disease Stage 1
Depending on the stage of the disease, the results of the tests will vary. You will also have different ways to manage your health. While each person’s experience is unique, we’ve prepared some guidelines for what you can expect below.
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You may not know that you have an illness at an early stage because you feel completely normal. There are no obvious symptoms because of this. If you are not sure, talk to your doctor. Your eGFR result will be 60-90 or higher.
At this stage, it is most likely that you will be diagnosed. As waste builds up in your body and blood pressure rises, you may start to feel unwell. Your eGFR result will be 15-59.
If you have been diagnosed, your doctor will recommend a change. For example, you may start taking blood pressure pills and be asked to check your levels regularly. You may be advised to increase your physical activity and reduce your salt and sugar intake. It may be best to avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as Nurofen and Voltaren and check with your doctor before starting any new medications (including vitamins and natural or herbal supplements). Everyone experiences the disease differently, and there is no universal cure.
Even with the best management, the disease can sometimes lead to failure, which can be life-threatening. Unsuccessful patients require dialysis or transplantation to stay alive. Your eGFR result will be less than 15.
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It is normal to feel tired, sad, or fearful during this stage. But with the right treatment, you can still live a fulfilling life. Surround yourself with people who can support you physically and emotionally.
No matter what stage you’re at, knowing how you’re feeling, along with effective treatment, can slow the progression of the disease and reduce the chance of other complications.
If you would like to know more, Health Australia is here to help. You can call our helpline and speak with a doctor on 1800 454 363 from 9:00 am to 5:00 pm EST. This is a free call.
You can also chat with your doctor or download our My Health e-book or app from the Apple Store and Google Play Store.
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Diagnosis can be difficult and confusing. Our support team is always ready to help you understand the diagnosis and connect you to information and support services. This guideline provides recommendations for the evaluation, evaluation, and management of adults at risk for or with chronic kidney disease (CKD). These recommendations and treatment goals may not be appropriate for all cases, as many patients with CKD are complicated by advanced age and comorbidities. Communication between primary care providers and specialists is highly recommended.
*Adapted from ckdpathway.ca and Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. 2012 KDIGO Clinical Guidelines for the Evaluation and Management of Chronic Kidney Disease.
CKD is associated with other common chronic diseases such as diabetes, hypertension and cardiovascular disease (CVD)1 and approximately 1 in 10 British Columbians have some form of significant kidney disease2.
CKD markedly increases the risk of: cardiovascular disease, adverse drug reactions, acute kidney injury, and prolonged hospitalization.
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. Patients with CKD are at risk of developing end-stage renal disease (ESRD), often requiring dialysis or kidney transplantation.
. Most patients with chronic kidney disease die from other comorbidities before progression of renal failure. Many dialysis patients have poor outcomes with an annual mortality rate of 10 percent; The overall 5-year survival rate is worse than most cancers.
Available data clearly indicate that control of hypertension and proteinuria can prevent or delay deterioration in kidney function4-12. This highlights the importance of early detection, evaluation and treatment of people with kidney disease.
CKD is defined as impairment of kidney structure or function that persists for more than 3 months13.
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The two key parameters for classification are the estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (uACR). eGFR is the best marker of kidney function and is calculated from creatinine. All laboratories in British Columbia (British Columbia) automatically report eGFR when ordering creatinine. Note. The recommended eGFR equations may change over time and are only estimates. See page 3 for more information.
For diagnostic purposes, other signs of kidney damage include: urinary disorders such as hematuria; Structural problems on imaging studies, such as polycystic kidney disease on ultrasound; Histological findings on kidney biopsy.
The two most common causes of CKD are hypertension and diabetes, and they often coexist13. Even if the cause seems obvious (eg, diabetes), the possibility of serious primary kidney disease (eg, glomerulonephritis) should be considered in patients:
Risk groups should be screened every 1-2 years depending on the clinical situation (for example, annually for people with diabetes) using:
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The risk stage for kidney disease is important for treatment planning and patient management. Because risk is determined based on eGFR and uACR or CGA. See fig. 1. More information on risk assessment is available in the Guidelines for CKD Treatment that Improves Overall Outcomes of Kidney Disease (KDIGO) at kdigo.org/home/guidelines13.
The Kidney Failure Risk Equation (KFRE) is an equation designed to estimate the likelihood of needing dialysis within 2 or 5 years. The equation is derived from 4 variables and can be calculated using QxMD: qxmd.com. Risk > 10–20% indicates high risk (similar to the Framingham Risk Scale). KFRE is a useful predictive tool, but its role in routine clinical practice has not yet been established.
Low to moderate risk kidney disease (patients who can be followed for a longer period of time, such as 6 months)
The time of the first consultation depends on individual circumstances. When in doubt, it is recommended that you discuss with your local nephrologist the timing of a referral for an individual.
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Iron saturation <20% indicates iron depletion. Ferritin is not a reliable test in patients with CKD and should not be used to diagnose iron deficiency.
Patients with very advanced stages of CKD are less likely to seroconvert after hepatitis B vaccination. Immunity should be ensured after vaccination, which may need to be repeated (in consultation with a specialist).
Support patient self-care with available resources in your community. CKD patients benefit from a multidisciplinary renal team that can help patients make beneficial changes to diet, smoking, and physical activity, as well as understand medications, and the insecurities and emotional stress experienced by patients with chronic conditions. Denial, often associated with sadness, is common in patients with chronic diseases that affect vital organs.
Encourage patients with CKD to plan ahead for treatment and their goals for future care, including at the end of life.
Chronic Kidney Disease (ckd)
* The listed complications are not specific to CKD, but are increasing in frequency and are more directly responsible for the more severe decline in kidney function. If complications occur in the early stages of CKD, investigation of alternative causes is recommended (eg, profound anemia at an eGFR of 55 ml/min cannot be attributed solely to poor kidney function). Kidney damage is defined as markers of injury, including pathologic abnormalities (eg, kidney biopsy findings) or abnormalities in blood or urine tests (eg, protein/albumin in urine, erythrocytes, leukocytes, or casts) or imaging studies.13
Protective in diabetic nephropathy and cardiovascular disease, but may reduce renal perfusion in volume depletion
For more information on DOAC dosing in kidney disease, see the 2018 European Heart Rhythm Association guidelines (Fig. 4). Available at Academic.oup.com/eurheartj/article/39/16/1330/4942493.
Adapted from: Acute Kidney Failure – Potentially Problem Medications and Early Steps to Take. Think Kidney Initiative of the UK Kidney Registry in partnership with NHS England. Available at: thinkkidneys.nhs.uk/aki/wp-content/uploads/sites/2/2016/07/Primary-Care-Advice-for-medication-review-in-AKI-.pdf
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This guideline was developed by the Guidelines and Protocols Advisory Committee, endorsed by the British Columbia Medical Association and accepted by the Medical Services Commission.
For more information on how BC Guidelines are developed, see the GPAC Handbook available at BCGuidelines.ca: GPAC Handbook.
Disclaimer The Clinical Practice Guidelines (the “Guidelines”) were developed by the Guidelines and Protocols Advisory Committee on behalf of the Medical Services Commission. The guidelines are intended to provide an understanding of the clinical problem and describe one or more preferred methods for investigating and treating the problem. The guide is not intended to replace the advice or professional judgment of a healthcare professional, nor is it intended to be used as the sole method for solving clinical problems. We cannot respond to requests for advice on matters relating to patients or their advocates. medical conditions. If you need medical advice, please contact your healthcare professional.
