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Is chronic kidney disease curable?

Wednesday, 10 June 2009
Answered by: Dr. Ashutosh Singh
Consultant Nephrologist
Knoxville,
USA
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Q. I am a 31 years old man who has been diagnosed with right small kidney with 7.9 cm in full length. My KFT report states: creatinine - 1.9 mg/dl, uric acid -10.70 mg/dl and albumin - 4.9 g/dl. In urine examination, proteins were - present 2+ (100 mg/dl), RBC - 2-3 RBC/HPF, epithelial cells - few, casts - 1/8-10/hpf, microalbumin - 3800 mg/L, creatinine - 99.80 mg/dl, microalbumin: creatinine ratio - 3.808. GFR - 49.1 ml/min. Is my condition serious and can it be cured? Which kidney disease am I suffering from? My toes have been swollen since two days before this diagnosis. Please advise.

A.  You have chronic kidney disease, which essentially means irreversible damage to kidneys resulting in loss of more than 50% of normal kidney function at your age. In addition, you have increased protein leakage into the urine, a sign of kidney damage. The next step should include extensive blood tests to find out the cause of kidney disease at a young age of 31 years. You may need a kidney biopsy to ascertain the exact cause. Specific treatment is based upon the cause of kidney damage. Treatment is intended to prevent or delay further progressive damage based upon the type of kidney disease one has. In addition, one would focus on strict blood pressure (target BP goal being <130/80 mmHg) and blood sugar (if diabetic) control, and avoidance of kidney toxic medications like daily continuous intake of common pain medicines like voveran, brufen and nimulid. These measures help to prevent further damage to the kidneys. You should be evaluated by a Nephrologist in your city. Review of your labs also suggest elevated serum uric acid level along with toe swelling which indicates you suffering from gouty arthritis, namely uric acid crystal deposition into the joints with resulting swelling and pain. Hence, you require intervention with medications both to treat the gout related joint swelling of the toes and also prevent recurrent attack in future by keeping uric acid level under control.

A.  You have chronic kidney disease, which essentially means irreversible damage to kidneys resulting in loss of more than 50% of normal kidney function at your age. In addition, you have increased protein leakage into the urine, a sign of kidney damage. The next step should include extensive blood tests to find out the cause of kidney disease at a young age of 31 years. You may need a kidney biopsy to ascertain the exact cause. Specific treatment is based upon the cause of kidney damage. Treatment is intended to prevent or delay further progressive damage based upon the type of kidney disease one has. In addition, one would focus on strict blood pressure (target BP goal being <130/80 mmHg) and blood sugar (if diabetic) control, and avoidance of kidney toxic medications like daily continuous intake of common pain medicines like voveran, brufen and nimulid. These measures help to prevent further damage to the kidneys. You should be evaluated by a Nephrologist in your city. Review of your labs also suggest elevated serum uric acid level along with toe swelling which indicates you suffering from gouty arthritis, namely uric acid crystal deposition into the joints with resulting swelling and pain. Hence, you require intervention with medications both to treat the gout related joint swelling of the toes and also prevent recurrent attack in future by keeping uric acid level under control.

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