Chronic Kidney

Disease
(kidney failure, kidney disease, dialysis)

Diet, Treatment, Prevention and Detection

Prepared by Swetha Peiris
 Welcome
Welcome to the guide on Chronic Kidney Disease (CKD).
Whether you are living with CKD, supporting a loved one, or
simply looking to learn more, this booklet is designed to provide
clear, easy-to-understand information about kidney health.

In this guide, will explain:

• What Chronic Kidney Disease is.

• The common causes and risk factors.
• Early signs and symptoms to watch out for.
• How CKD is diagnosed and managed.

This book’s goal is to empower you with knowledge so that you

can make informed decisions about your health. With the right
care and lifestyle changes, many people with CKD are able to
slow its progression and lead full, active lives.

I hope this guide helps you understand CKD better and supports
you on your health journey.

Thank you for taking the time to learn more about Chronic
Kidney Disease. Let’s get started!
contents
List of

[Link]
What is the chronic
kidney disease ?

[Link]
MANIFESTATION
Symptoms of chronic
kidney disease
[Link]
What are the causes
of chronic kidney
disease ?

[Link] AND MANAGEMENT

What are the treatments for chronic kidney disease
and how to management chronic kidney disease ?
 Chronic Kidney Disease
[Link]
We have two kidneys, each about the size of our fist. Their main
job is to filter waste and excess water out of our blood to make
urine. They also kidneys maintain the body's chemical balance,
and help control blood pressure.

Chronic Kidney Disease (CKD) refers to the gradual loss of kidney

function over time. When kidneys become damaged, they lose
their ability to effectively filter waste and excess fluids from the
blood. CKD is classified into stages based on the severity of
kidney damage, from mild (Stage 1) to end-stage renal disease
(Stage 5), where dialysis or a kidney transplant may be required.

You can take steps to keep your kidneys healthier

longer:

Keep your blood pressure below 140/80

(which is read as "140 over 80")

Choose foods with less salt (sodium)

If you have diabetes, control your blood

sugar

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How do we know that we have Chronic Kidney Disease?

Chances are you feel normal.

Chronic kidney disease is called
a "silent" disease, because many
people don't have any
symptoms until their kidneys are
about to fail. The only way to
know how our kidneys are doing
is with blood and urine tests.

A blood test checks our GFR.

GFR stands for glomerular
(glow-MAIR-you-lure) filtration
rate. This tells how well your
kidneys are filtering.

A urine test checks for albumin.

Albumin is a protein that can
pass into the urine when the
kidneys are damaged.

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 02. Etiology
Diabetes and high blood pressure are the most common
causes of kidney disease but there are other causes too.
Doctor may do other tests to figure out what is causing our
chronic kidney disease.

• Diabetes: High blood sugar can harm the

small blood vessels in the kidneys over time.

• High Blood Pressure: When blood pressure

stays high for a long time, it can damage the
blood vessels in the kidneys.

• Kidney Inflammation (Glomerulonephritis):

Inflammation in the kidneys can damage their
filters.

• Polycystic Kidney Disease: This is a genetic

condition where fluid-filled sacs (cysts) grow
in the kidneys, causing damage.

• Blocked Urinary Tract: Things like kidney

stones or an enlarged prostate can block the
flow of urine and hurt the kidneys.

• Repeated Kidney Infections: Frequent

infections in the urinary system can leave
scars on the kidneys.

• Autoimmune Diseases: Diseases like lupus,

where the body attacks its own tissues, can
also damage the kidneys.

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[Link] Manifestations
Early stage CKD (one to three)
Most people do not have symptoms in the early stages of CKD,
as even damaged kidneys can still work well enough to prevent
any noticeable symptoms.
Early stage kidney disease is often diagnosed because of a blood
or urine test for a different condition.

Late stages of CKD (four to five)

Symptoms include:

weight loss and poor appetite.

an increased need to wee,especially at night
swollen ankles, feet or hands
difficulty sleeping
puffiness around the face,especially in the morning
shortness of breath
muscle cramps or weakness
itchy skin
Blood in urine
Feeling sick
Tiredness,low energy levels
Headaches

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eGFR levels and stages of chronic kidney
disease
CKD is divided into five stages based on your glomerular filtration rate
(GFR).
Glomeruli are the network of tiny blood vessels inside the kidneys that
separate out waste products and excess fluid from your blood.
Your GFR shows how well your kidneys filter your blood, by indicating how
much blood passes through the glomeruli every minute.
Getting an accurate measurement of your GFR is difficult, so your blood
test results normally give an estimated filtration rate, or eGFR.
It's calculated based on your age, sex, ethnicity and your creatinine blood
level.
Sometimes the calculation formula includes your weight and height, too.
Your eGFR may be listed as a measurement of ml/min or as a percentage.
So, an eGFR of 50ml/min means your kidneys are functioning at about
50%.
Most people with CKD stages one to three manage the condition
themselves with support from their GP and do not need any specialist
care from kidney doctors.

Stage 1
eGFR remains within a normal range,
but other test results suggest signs of
kidney damage
Stage 2
Slightly reduced kidney function with
other tests suggesting kidney damage
Stage 3
Moderately reduced kidney function
Stage 4
Severely reduced kidney function
Stage 5
Very severe or end-stage kidney
failure
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 If your CKD progresses to stage four, you will be referred to a
kidney doctor (nephrologist) at a hospital for further
treatment.

CKD can get worse over time, although in the majority of

people it will not progress to stage four. Only one in 50
people with CKD will need dialysis or a transplant.

In some cases kidney function can drop suddenly and then

improve.

This is known as acute kidney injury (AKI) and normally

happens as a complication of another condition.

AKI is usually temporary and often gets better without

causing any long-term problems, in contrast to CKD which
does not get better, but can be slowed or managed with
treatment.

How common is CKD?

CKD is very common. It affects around one in ten people in Sri

Lanka. The vast majority of people with CKD do not have any
symptoms.

Who gets CKD?

CKD can affect people of all ages, including babies and children.
It can run in families and is more common in people from Asian
and Black backgrounds

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 04. Treatment & Management

Treatment for Chronic Kidney Disease (CKD) focuses on slowing

down the disease, managing symptoms, and preventing
complications. The approach depends on the cause and how
advanced the disease is.

[Link] Changes:
• Diet: Reduce salt, potassium, phosphorus, and protein to ease
the kidneys’ workload.
• Quit Smoking: Helps improve heart health and reduces further
kidney damage.
• Exercise: Keeps blood pressure in check and helps maintain a
healthy weight.

Less

2. Medical Treatment
• Control Blood Pressure: Medications like ACE inhibitors or
ARBs are often prescribed.
• Manage Blood Sugar: Especially for diabetics, controlling sugar
levels is important.
• Treat Anemia: Medications or iron supplements may be given
to improve red blood cell levels.
• Bone and Mineral Balance: Phosphate binders and Vitamin D
are used to keep bones healthy.
• Diuretics: These help remove excess fluid from the body.

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3. Monitoring and checkups
• Regular testing of kidney function, electrolyte levels, blood
pressure, and heart health.

4. Advanced Treatment
• Dialysis: This removes waste and extra fluid when the kidneys
are no longer able to.
• Hemodialysis: A machine filters the blood outside the body.
• Peritoneal Dialysis: The body uses its natural membrane to
filter the blood.
• Kidney Transplant: Replaces the damaged kidney with a
healthy one from a donor, which is the most effective solution
for end-stage CKD.

[Link]
• Early detection through regular screenings, especially for
people at risk (like those with diabetes or high blood pressure).
• Vaccinations (e.g., for hepatitis B and flu) to prevent infections
that could worsen kidney health.

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“As a nursing assistant, how should I handle
and care for a patient with chronic kidney
disease?”
As a nurse assistant caring for a patient with chronic kidney
disease (CKD), your role is vital in providing support and
ensuring the patient’s comfort and well-being. Here are key
aspects to focus on:

1. Monitoring and Observing

• Vital signs: Regularly monitor blood pressure, pulse, and

respiratory rate, as patients with CKD are prone to hypertension
and fluid overload.
• Fluid balance: Keep track of fluid intake and output. CKD
patients often have fluid restrictions to prevent overload.
• Weight monitoring: Daily weight checks can help detect fluid
retention or loss.

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2. Personal Care

• Hygiene: Assist with bathing, oral care, and grooming. Skin

integrity is crucial since CKD patients can develop dry, itchy skin.
• Comfort measures: Help position the patient to avoid pressure
sores and relieve discomfort, especially if they are on bed rest.

[Link] Support

• Restricted diet: CKD patients often need low-sodium, low-

potassium, and low-phosphorus diets. Assist with meal prep and
ensure compliance with dietary restrictions.
• Fluid restrictions: Help the patient manage fluid intake by
measuring and documenting their water, juice, or any liquid
consumption.

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4. Medication Assistance

• Administer medication: Assist with or remind the patient to

take prescribed medications, such as antihypertensives or
phosphate binders, as directed by a nurse or doctor.
• Side effects: Be alert for side effects of medications, such as
dizziness or nausea, and report them to the nurse.

5. Emotional Support

• Psychosocial care: CKD can cause emotional stress due to the

chronic nature of the disease and the potential for dialysis or
transplant. Offer a listening ear and compassionate care.
• Patient education: Reinforce teaching from nurses or
healthcare providers about lifestyle changes, such as diet,
exercise, and medication adherence.

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6. Assisting with Dialysis

If the patient is undergoing dialysis (peritoneal or

hemodialysis), you may need to:

• Help with transportation to and from dialysis appointments.

• Provide post-dialysis care, including ensuring the patient rests
and monitoring for signs of hypotension or infection.

7. Reporting and Documentation

• Report changes: Always observe and report any changes in

the patient’s condition, such as swelling, difficulty breathing,
changes in urine output, or unusual fatigue, to the nurse
immediately.
• Accurate records: Keep detailed records of vital signs, fluid
intake/output, and patient’s complaints or symptoms for the
healthcare team.

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“Your Health, Your
Future,Take Control of
CKD Today”
Early detection and the right treatment can
help you manage Chronic Kidney Disease
and lead a healthy, fulfilling lifed .

- Thankyou -