Chronic Kidney Disease: A Primer
The Aimedis Team is commencing a new feature where we introduce common diseases and — in addition to providing healthcare education for the masses — demonstrate how Avalon and other platform features tackle commonly associated problems using our novel technology. We begin with one of the most common, silent, and devastating illnesses: chronic kidney disease. Let us know what you think of our new feature and how we can help move your health forward by reaching out to us with your feedback.
Chronic kidney disease (CKD) is a serious medical condition that affects more than 15% of the human population worldwide. That’s an estimated 40 million people in the United States and over 800 million people across the globe! CKD is frequently a silent but slow process since symptoms are often unnoticeable until late stages and severe, and recovery is impossible. In order to better understand the effects of chronic kidney disease on the human body we have to first understand the important job of the kidneys in the body and how they are an integral part of human life and a key to everyday survival.
Role of the kidneys:
Most humans are born with two kidneys that are located in the back of the lower abdomen. The primary job of the kidneys is to filter blood and remove waste and other toxins from the body. It is because of this vital role that when one’s kidneys experience injury, multiple organ systems are affected in a domino-like effect and the cohesive equilibrium we are accustomed to goes awry.
Acute versus Chronic kidney disease:
Acute kidney injury, or AKI, is a severe, sudden process that is often reversible unlike CKD which is characterized by kidney disease or damage that lasts longer than 3 months and is progressive. In other words: while AKI may resolve and patients may return to baseline kidney function, CKD only gets worse with time and treatment focus is on maintaining current kidney parameters and avoiding worsening of disease. CKD is particularly dangerous because it often remains dormant for a long time and only rears its ugly face when the kidneys are so diseased that they are beyond recovery. The most common causes of CKD are diabetes (high sugar levels) and hypertension (high blood pressure). Both diabetes and hypertension are a significant factor in the disease in most cases and early control is critical to avoid or halt worsening CKD.
5 stages of Chronic Kidney Disease:
Before we dive into the stages of kidney disease we have to understand how these stages are determined. There is a blood test that physicians conduct for their patients that appear to have kidney disease to test their level of kidney function. This test determines the estimated glomerular filtration rate(eGFR) of the kidneys. An eGFR of greater than 60 is considered a normal range of function. Stage 1 (eGFR 90 or higher) is classified as patients having mild kidney disease in which the kidneys still function as normal. Stage 2 (eGFR 60–89) is classified as mild kidney damage but kidneys still work well. Stage 3a (eGFR 45–59) is classified as mild to moderate kidney damage and kidneys do not work at ideal capacity. Stage 3b(eGFR 30–44) is classified as moderate to severe kidney damage and kidneys do not work at ideal capacity. Stage 4 (eGFR 15–29) is classified as severe kidney damage in which the kidneys are barely working at all. Stage 5 (eGFR less than 15) is classified as severe kidney damage, kidneys are very close to failing or have already failed.
Treatment options for patients with CKD:
Currently there are no curative options for CKD patients but there are a number of treatments that can help relieve or control symptoms and stop or delay disease progression, thereby making living life with the disease more manageable. The least invasive treatment option is lifestyle changes such as diet, exercise, and weight loss, especially early in the disease process (these are less effective in late-stage CKD). Another option is medication (including for diabetes, hypertension, and disease-specific medications such as ACEI or SGLT2i) to keep the disease at bay and control symptoms. If the above treatments are ineffective or if over time the disease progresses to its later stages, patients are encouraged to proceed with a kidney transplant or dialysis.
A kidney transplant is a surgical procedure by which one receives a kidney that is transplanted into their abdominal cavity and performs the regular functions of a kidney, albeit with only one kidney. One kidney is generally sufficient to survive which explains how one is able to donate one of their two kidneys and still survive to tell the tale. While waiting for a kidney, or if one is ineligible for transplant, or if one will not be able to receive a kidney transplant in time, dialysis is an acceptable alternative.
Dialysis is a procedure by which a machine performs the work of the kidneys and cleans the blood mechanically. While mortality benefits are subpar to kidney transplant, transplantation is not always an option and dialysis quite literally saves the lives of patients who otherwise would die from end stage kidney failure.
Socioeconomic factors that contribute to CKD:
The prevalence of CKD is higher in lower income populations since people from lower income communities often have higher rates of obesity, hypertension, and diabetes. The cause of this includes lack of health education in these communities and the unfortunate reality of living in a food desert which heavily contributes to unhealthy diet habits that are hard to break. Studies have also found links to smoking and air pollution also causing CKD. Research is ongoing in this area and we are hopeful that strides will be made to improve the healthcare outcomes of all our patients.
Now that we introduced CKD and developed a basic understanding of the disease process, our next article will discuss how Aimedis Avalon can tackle some of the issues our CKD patients face. A digital twin research study is in development planning stages whereby patients take note of symptoms, are followed over a predetermined period of time, and we investigate the metaverse’s role in healthcare.