Let’s start with the basics!
In the following text, you will learn how your kidneys work in general, how to best protect them from potential damage and what to do if your kidney function is already impaired. Hopefully, learning about the basics will make the kidneys a bit easier to understand and will enable you to have a confident discussion about disease-related topics with your healthcare team.
Chronic kidney disease is defined as abnormalities of kidney structure or function, present for more than three months, with implications for health.
Perhaps you have already noticed physical changes yourself: Do you often feel tired or fatigued? Do you have less appetite than usual? Are you having trouble falling asleep or are you unable to concentrate? Do you often experience nausea? These signs could indicate the gradual loss of kidney function.
With appropriate treatment, your healthcare team can find ways to relieve these symptoms. Having an open discussion with your physician about how you’re feeling is crucial. Learn how to cope with your illness while still enjoying life.
Diagnosis of chronic kidney disease
Your general practitioner or a medical specialist, the nephrologist, will carry out various tests to determine whether you have chronic kidney disease. Blood will be drawn so that the nephrologist can check certain laboratory values. In addition, a urine test is usually carried out. This examines which substances are excreted into the urine and the level of excretion.
Protein in the urine
The question of whether there is protein (albumin, a certain protein) in the urine plays a crucial role. If there is an increased amount of albumin in the urine (also referrred to as proteinuria or albuminuria), this could indicate that the kidneys’ filtering function has deteriorated.
Determining the Glomular Filtration Rate (GFR)
CKD stage 1 describes a slightly reduced function of the kidneys and CKD stage 5 indicates there may be a need to replace some of the kidneys function with treatments such as transplantation or dialysis. Your physician calculates the Glomerular Filtration Rate (GFR) for classification. It indicates how well the kidneys cleanse the blood of toxins and excrete them into the urine. The GFR is expressed in millilitres per minute. The lower the GFR, the worse your kidneys are functioning.
For example, a GFR between 60 and 89 indicates slightly decreased kidney functioning. This corresponds to CKD stage 2. A GFR between 15 and 29 suggests severely impaired kidney function, with CKD stage 4.
If the GFR is lower than 15, there may be a need for kidney replacement therapy due to inadequate kidney function. At this stage, you and your physician will decide on when the most ideal time to start a replacement therapy is.
KDIGO Guidelines (KDIGO-CKD-Guideline-Manila_Kasiske.pdf -> slide 25
Establishing a treatment plan
If you have been diagnosed with chronic kidney disease, the second step is to develop a treatment plan that suits your personal situation. It aims to slow down the progression of the disease, to alleviate any symptoms and reduce complications. Your treatment can target problems, such as:
- High blood pressure (hypertension): Checking whether the blood pressure is in the correct range for you
- Kidney-related anaemia: Checking whether there are enough red blood cells in your blood
- Diabetes: Checking blood sugar levels
We appreciate that you may have a lot of concerns and thoughts in your head.
If you stick to the following principles:
- I am not alone!
My healthcare team and my family are at my side
- All the necessary steps can be learned!
Others did it, so I can do it, too
- My symptoms can be alleviated!
With the right therapy, I'll feel better
Be brave and believe in your strength! Being open about your problems with the healthcare team will help you find the treatment that suits your situation best. Let loved ones engage in conversations, too. Address your fears and worries openly.
Find out how your kidneys work in the next section
What is an Adverse Event (AE)
Any untoward medical occurrence in a patient or clinical trial subject administered a medicinal product and which does not necessarily have a causal relationship with this treatment [Dir 2001/20/EC Art 2(m)].
An adverse event can therefore be any unfavourable and unintended sign (e.g. an abnormal laboratory finding), symptom, or disease temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product (Annex 4 Guideline on good pharmacovigilance practices (GVP) Rev 4).
Reporting Side Effects
If you get any side effects, talk to your Doctor, Pharmacist or Nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.
By reporting side effects, you can help provide more information on the safety of this medicine.
Report an Adverse Event
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Fresenius Medical Care on 01623 445 215 and via medinfo-uk(at)fmc-ag.com.
Call 01623 445 100 (please choose option 5). Opening times are Monday-Friday 9am-5pm.
UK/HEMA/FME/0922/0002 – Date of Preparation September 2022.