The Silent Threat of Kidney Disease

Chronic Renal Failure: 5 things to know

The Silent Threat of Kidney Disease
By DAVID TULLER
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Chronic kidney disease is a leading cause of illness and death but remains far less well known to the public than other major ailments. Doctors and health officials say that patients should know the following five things about kidney disease.

1. Chronic kidney disease is a potentially fatal illness that can progress to advanced stages with few or no symptoms. If there are symptoms, they are often general, like fatigue, lack of concentration or headaches. As a result, most adults suffering from chronic kidney disease are unaware that they have it.
2. The leading causes of chronic kidney disease are untreated diabetes and high blood pressure, which together account for two-thirds of new cases. Because these conditions disproportionately affect African-Americans and Latinos, these demographic groups generally experience higher rates of chronic kidney disease than do whites.
3. Treatment consists primarily of pharmaceutical and lifestyle interventions to lower blood pressure and control diabetes, which can prevent chronic kidney disease from progressing. Treatment may also be necessary for some of the conditions that can accompany chronic kidney disease, including anemia, bone disorders and nutritional deficiencies.
4. The fifth and final stage of chronic kidney disease is chronic kidney failure, also called end-stage renal disease. Only patients in this stage undergo dialysis or receive a transplant. Many patients stay on dialysis for years before a kidney becomes available for transplant. Dialysis regimens can vary greatly, with many more options available to patients than in previous decades.
5. Advances in kidney transplantation continue to raise long-term success rates. An emerging strategy for the significant percentage of patients with either high antibody levels to other people’s tissue or with blood-type incompatibility is a process called "desensitization." Centers researching and implementing these desensitization protocols, including Cedars-Sinai in Los Angeles and Johns Hopkins in Baltimore, have been able to successfully transplant patients who were told at other centers that they were poor candidates for receiving a kidney.