Chronic kidney disease (CKD) is a long-term condition where the kidneys do not work effectively.
CKD does not usually cause symptoms until it reaches an advanced stage. It is usually detected at earlier stages by blood and urine tests. Main symptoms of advanced kidney disease include:
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- tiredness
- swollen ankles, feet or hands (due to water retention)
- shortness of breath
- nausea
- blood in the urine
Chronic kidney disease is most frequently diagnosed through blood and urine tests.
If you are at a high risk of developing CKD, you may be screened annually. Screening may be recommended if you have:
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- high blood pressure (hypertension)
- diabetes
- a family history of CKD
Why does it happen?
The kidneys are two bean-shaped organs, the size of your fist, located on either side of the body, just beneath the ribcage. The main role of the kidneys is to filter waste products from the blood before converting them into urine. The kidneys also:
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- help maintain blood pressure
- maintain the correct levels of chemicals in your body which, in turn, will help heart and muscles function properly
- produce the active form of vitamin D that keeps bones healthy
- produce a substance called erythropoietin, which stimulates production of red blood cells
Chronic kidney disease is the reduced ability of the kidney to carry out these functions in the long-term. This is most often caused by damage to the kidneys from other conditions, most commonly diabetes and high blood pressure.
Who is affected?
CKD is common and mainly associated with ageing. The older you get, the more likely you are to have some degree of kidney disease. It is estimated that about one in five men and one in four women between the ages of 65 and 74 has some degree of CKD.
CKD is more common in people of south Asian origin (those from India, Bangladesh, Sri Lanka and Pakistan) and black people than the general population. The reasons for this include higher rates of diabetes in south Asian people and higher rates of high blood pressure in African or Caribbean people.
Treating chronic kidney disease
There is no cure for chronic kidney disease, although treatment can slow or halt the progression of the disease and can prevent other serious conditions developing. People with CKD are known to have an increased risk of a heart attack because of changes that occur to the circulation. In a minority of people, CKD may cause kidney failure, also known as established renal failure (ERF) or end-stage kidney disease. In this situation, the usual functions of the kidney stop working.
To survive, people with ERF may need to have artificial kidney treatment, called dialysis, or a kidney transplant.
Despite advances in management of chronic kidney disease (CKD) with medications and renal replacement therapy, CKD remains a significant health issue. The regenerative ability of the kidney is limited, and usually inefficient to prevent progression of fibrosis. Unfortunately, currently available pharmacologic agents cannot halt tissue injury in CKD. So, CKD may finally progress toward end-stage renal disease, and morbidity and mortality of patients with CKD remains high . Much effort to identify novel therapies, to retard kidney damage in CKD, has been made. Of such efforts, mesenchymal stem cells (MSCs) are of interest, because of their potential therapeutic effects, regarding kidney disease from a few years ago. The effectiveness of MSCs in treatment of kidney disease, has been extensively investigated in pre-clinical models, and systemic review of data, suggested that results are promising . Therapeutic potential of MSCs is mediated by multiple mechanisms, such as immunomodulatory effects through secretion of regulatory cytokines, activation of regulatory immune cells, and the capacity to increase cellular repair through secretion of anti-apoptotic, anti-fibrotic, and up-regulation of renal developmental markers as well . These multiple functions of MSCs, supposedly lead to multifaceted strategies in various models of kidney disease.