hello welcome to the chronic kidney
disease program at University ofCalifornia San Diego my name is Danuta
Trzebinska and I’m a nephrologist inour clinic in this module we’ll talk
about symptoms of chronic kidney diseaseor CKD the symptoms associated with
chronic kidney disease worsen as youprogress from the least severe stage
stage one to most severe stage Stagefive patients will have chronic kidney
disease stage one usually have nosymptoms the only exception is patients
who are spilling a massive amount ofprotein in the urine because they can
subsequently develop swelling in thelegs or other parts of the body now
chronic kidney disease stage two isusually associated with no symptoms
either just like stage one you don’tknow the vast majority of patients with
CKD stage one and two are not aware ofhaving kidney disease unless they
undergo specific blood and urine testingso most of the time it’s incidental
finding you are not even looking for itnow chronic kidney disease stage three
this is the most common stage of kidneydisease this is middle road your GFR is
between 30 and 59 since this stage isassociated with moderate reduction in
level of kidney function a proportion ofpatients might develop some symptoms and
what kind of symptoms some of thosesymptoms like fatigue or more frequent
urination at night are nonspecific andoverlooked by patients or attributed to
some other things going on in theirlives think about it there is a very
long list of causes for fatigue andkidney diseases certainly not number one
some patients who are in chronic kidneydisease stage three can experience
swelling in the legs now we are movingon to stage 4 stage 4 is associated with
fartherreduction in the level of kidney
function is considered severe GFR isbetween 15 and 29 thus as you can expect
there will be more patients havingsymptoms in this stage symptoms can be
similar to those with stage 3 butthey’re just more obvious there might be
some additional symptoms like decreasingappetite or some patients will
experience shortness of breath now weare moving to stage 5 chronic kidney
disease and this is the most severestage if you recall in stage 5 GFR is
less than 15as with other stages various patients
will experience different amounts ofsymptoms there are certainly many people
in this stage who continue to workfull-time and live a pretty much normal
life you look at them and you wouldnever guess that they have chronic
kidney disease stage 5 they ask me docare you sure I feel just fine
I cannot tell in general however in thisstage there are more symptoms than in
any other previous stages on top ofpreviously mentioned symptoms like
fatigue swelling in the legs patientsmight suffer from some other symptoms
like skin itching metallic or bittertaste in the mouth sometimes I ask
patients do you feel like you swalloweda coin now that I know what it tastes
like but it’s just your taste is offsometimes patients experience nausea or
even vomiting and this naughty andvomiting vomiting might be most more
pronounced in the morning when you arein stage 5 you can expect further
worsening in energy level and some sleepdisturbances some patients will require
we require more sleep at night forexample instead of your previous six
seven hours which was enough to feelrefreshed now you will need nine hours
to feel rested or semi rested or maybeyou’re going to have a reverse sleeping
pattern that means that you will stay upat night you’re just not sleepy you
cannot sleep and then you will want tosleep all day long
or some patients they sleep at nightjust fine but they also required a nap
during the day that will tell me doc Igo to work I can get through work but
then when I got come home I really needthis nap and they didn’t need it a year
agomany patients when they are in Stage
five chronic kidney disease they are indenial all those changes are very slow
it’s not like one day you have hundredpercent of kidney function and the next
day you wake up and your level of kidneyfunctions down to ten percent so you
really have to pay attention to yourbody how you feel we tend to adapt if I
have less energy all right I’m not goingto run I’m going to do less I might
sleep more oh I don’t have an appetiteso I will eat less but sometimes people
don’t notice so when you come to see usin clinic especially when you’re in
chronic kidney disease stage five we’llask you very pointed questions how much
do you sleep how many hours well howmany hours did you sleep a year ago
how much do you eat well is it up or isit down all those questions are helpful
some patients in chronic kidney diseasestage five suffer from muscle cramps
even when measured electrolytes in theblood are normal sodium is normal
potassium magnesium so please do notself medicate yourself don’t just start
taking magnesium supplements when youget cramps because you might overdo it
you might notice worse concentration oractually you might not notice but
somebody else around you will noticethat you’re not as sharp as you used to
be some patients might feel more coldthan usual than previously your urine
volume eyedrop you’ll be peeing lessthan you did previously and may be
swelling in your legs will get worsesometimes when you are in stage five
chronic kidney disease blood pressurecontrol becomes more difficult we have
to add another agent and blood pressurekeeps creeping up patients who have
diabetes might have more episodes withlow instead of high sugar that’s one of
the findings of advanced kidney diseaseto summarize please remember that
chronic kidney disease is a silentdisease and some patients will have just
nonspecific symptoms only which areoften
north or overlooked till kidney diseaseis quite advanced let us go through a
couple of questions to check yourunderstanding of this module question
number one which stage of chronic kidneydisease is associated with most symptomsthe correct answer is chronic kidney
disease stage 5 is associated with mostsymptoms this is the most advanced stage
of kidney disease if symptoms are severeenough and or some of your labs are
dangerously abnormal you might need tostart either dialysis or undergo kidney
transplantationin stage 5 let’s do one more question
which symptom would you not expect tooccur in chronic kidney disease is it a
fatigue or B leg swelling or C increasein appetite or D muscle cramps let’s
think about this and which symptomswould you not it’s a tricky question and
the correct answer is C increase inappetite if anything there is decrease
in appetite in advanced kidney diseasesome people lose weight all other
symptoms often occur in patients withchronic kidney disease so you will
experience fatigue leg swelling andmuscle cramps alright congratulations to
you guys you have completed the moduleon symptoms of kidney disease please
check our website for additionaleducational modules on kidney health
thank you


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