Chronic diseases are characterized by conditions that occur for a year or more. These conditions also require continuous medical intervention and can limit activities of daily life. As such, activity and symptom trackers like a CKD Activity Log and CKD Symptom Tracker can prove beneficial.
Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States causing them to be the leading drivers of the nation’s $3.8 trillion in annual health care costs. This stated, while Chronic Kidney Disease (CKD) is less prevalent in the United States, it is no less debilitating. Furthermore, CKD can lead to additional health issues like those stated above.
Through this article, the CareClinic team hopes to enlighten you on the importance of healthy kidneys, the effects of CKD, its multiple stages, how to measure your kidney function, the possible medical interventions for CKD and the preventative actions you can take to ensure good kidney health. With this information, this article will also go over how to use the CareClinic app to achieve and track your kidney health by using it as a CKD Symptom Log and CKD Activity Log.
Why are the Kidneys Important?
Your kidneys are imperative to the overall health of your body. Located on either side of your body, besides the spine, inside the lowest level of the rib cage, the kidneys filter waste and excess fluids from your blood. Excess fluids are then excreted through your urine. Each kidney weighs approximately 160 grams and removes between one and one-and-a-half litres of urine per day. The two kidneys together filter 200 litres of fluid every day.
What is CKD?
Chronic Kidney Disease, also called Chronic kidney failure, describes the gradual loss of kidney function over time. Seen as a condition that mainly affects the elderly, CKD can affect anyone at any age. According to the American Kidney Fund, approx. 37 million people are living with CKD. Lowered kidney function is not always evident immediately. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred during the advanced stages of the disease.
Managing CKD Symptoms
Signs and symptoms of CKD develop over time as the kidney damage progresses slowly. Signs and symptoms of CKD can include:
- Nausea
- Vomiting
- Loss of appetite
- Fatigue and weakness
- Sleep problems
- Changes in how much you urinate
- Decreased mental sharpness
- Muscle twitches and cramps
- Swelling of feet and ankles
- Persistent itching
- Chest pain, if fluid builds up around the lining of the heart
- Shortness of breath, if fluid builds up in the lungs
- High blood pressure (hypertension) that’s difficult to control
Signs and symptoms of kidney disease are often nonspecific. To be clear, they can also be caused by other illnesses. Due to this and the fact that the CKD is progressive, it is a great idea to keep track of the symptoms you are experiencing. The CareClinic app can easily do this for you.
Using the Symptom Check module, the CareClinic app can be easily used as a CKD Symptom Log. With a CKD Symptom Log, tracking the signs and symptoms of CKD can be easily logged daily, allowing you to track the potential progression of CKD.
Causes of CKD
CKD occurs when a disease or condition impairs kidney function. This impairment causes kidney damage to worsen and kidney function to decrease over a period of time, eventually resulting in kidney failure if left untreated.
Diseases and conditions that cause chronic kidney disease include:
- Type 1 or Type 2 Diabetes
- High blood pressure
- Glomerulonephritis: Inflammation of the kidney’s filtering units
- Interstitial nephritis: Inflammation of the kidney’s tubules and surrounding structures
- Polycystic kidney disease
- Prolonged obstruction of the urinary tract from conditions such as enlarged prostate, kidney stones and some cancers
- Vesicoureteral reflux, a condition that causes urine to back up into your kidneys
- Pyelonephritis: Recurrent kidney infection
Risks of CKD
As previously stated, while CKD is known to mainly affect those who are deemed as elderly, anyone can suffer from decreased kidney function. This stated, there are many factors that may increase your chances of suffering from CKD symptoms:
- Diabetes
- High blood pressure
- Heart and blood vessel (cardiovascular) disease
- Smoking
- Obesity
Managing the symptoms and effects of the factors above may decrease your chances of experiencing decreased kidney function. This stated, there are also a few, uncontrollable genetic factors that can also play a role in chances of experiencing decreased kidney function:
- Having African, Native American or Asian heritage
- Family history of kidney disease
- Abnormal kidney structure
Complications of CKD
The effects of CKD can cause issues across the entire body, further highlighting the important role that your kidneys play in regulating your body’s chemical levels. These complications are best to be tracked using a CKD Symptom Log and/or CKD Activity Log if any action is taken to remedy them. The following is a list of potential complications that CKD can cause over time:
- Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs
- **A sudden rise in potassium levels in your blood, which could impair your heart’s ability to function and may be life-threatening
- Cardiovascular disease
- Weak bones
- Anemia
- Decreased sex drive, erectile dysfunction or reduced fertility
- Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
- Decreased immune response, which makes you more vulnerable to infection
- Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium)
- Pregnancy complications that carry risks for the mother and the developing fetus
- Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival
**Potassium Tracking & Its Importance
One of the underrated silent dangers of CKD is simple potassium. The potassium that is found in our foods! Your body will ultimately utilize the amount of potassium that it needs. Then the kidney’s function is to get rid of excess via the urine. However, people with CKD are unable to do so. Which can lead to this buildup of potassium or “hyperkalemia”. For more information on nutritional guides for CKD, visit the post on Renal Tracker.
Having too much potassium in your blood can be extremely dangerous. Potassium affects the way your heart’s muscles work. People who get the death penalty by “lethal injection” are receiving huge amounts of potassium in order to stop the heart!
Using the CareClinic Platform allows you to keep track of all your measurements, including potassium levels (mmol/L). Simply use the + button to add “potassium” and it will be added to your measurement function. From there, you can keep a virtual log of all of your bloodwork potassium levels (which will be ordered after your conversation with your healthcare team). Normal values are 3.6-5.2 mmol/L. This can be a personalized method to track potassium levels as these need to be tightly monitored.
How to Measure CKD Progression
There are two main ways to evaluate your kidney function:
Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate (GFR) is the best way to measure your level of kidney functionality and even determine the stage of kidney disease you may be experiencing. The value can be estimated by your doctor using the results from a blood creatinine test, your age, body size, and sex.
The estimated Glomerular Filtration Rate (eGFR) can aid in your doctor’s creation of a treatment plan. Low eGFR values are evidence of lowered kidney function relative to how efficiently they should be working. Using this test to identify the stage of CKD early is pivotal to ensure timely treatment.
Normal eGFR values for your age can be seen on the National Kidney Foundation’s website.
Urine Albumin Levels
Your doctor may want to perform tests on your urine to evaluate the amount of Albumin that is present within it. Albumin is a protein that passes into the urine when the kidneys are damaged and can be helpful in determining whether or not your symptoms are stemming from CKD.
CT and/or Ultrasound Scans
These imaging tests may be performed in order to view your kidneys as well as your urinary tract. From these images, your doctor can evaluate whether your kidneys are too large or too small if you have a problem like a kidney stone or tumor and/or whether there are any problems in the structure of your kidneys and urinary tract.
Kidney Biopsy
In certain cases of CKD, a kidney biopsy is needed to accurately evaluate and treat the CKD progression. In order to perform the biopsy, a doctor will remove a small piece of your kidney (usually through the back) and analyze it through a microscope. From these analyses, doctors can further understand the level of kidney damage that has taken place and then create a tailored treatment plan.
Measuring CKD
The CareClinic app’s Measurements module is a great way to track the changes in your eGFR. Using the app to track eGFR is easy. Simply open the app, select “Check-in”, then “Measurements”, and search for GFR. From this screen, you can log the GFR you receive from your doctor. This can also be done via selecting the “Plan” icon and scheduling reminders as frequently as you would like.
You can also track the Urine Albumin levels the same way!
Keeping track of these metrics through a CKD Symptom Log will not only give you peace of mind in understanding your CKD progression, it can also be imperative if you were to ever switch medical providers. Often medical records are hard to transfer from one care provider to another. Starting and keeping your own personal health record is extremely beneficial to ensure your doctor has the proper information to treat you.
CKD Stages
CKD and its symptoms are caused by the underlying decrease of kidney function. As previously stated, kidney function worsens over time if not treated. Due to the nature of the progression of CKD, there are multiple stages of the disease, each having its associated symptoms. Using a CKD Symptom Log and CKD Activity Log to track the symptoms and actions you take to manage them. Below is a list of each stage along with its symptoms:
CKD Stage 1
Someone dealing with Stage 1 Chronic Kidney Disease has kidney damage with a GFR at a normal or high level greater than 90 mL/min. As previously stated, there are usually no symptoms to indicate the kidneys are damaged. In fact, most people with Stage 1 CKD do not know that their kidneys are damaged. If they do find out they are in Stage 1, it’s usually because they were being tested for another condition such as diabetes or high blood pressure (the two leading causes of kidney disease).
CKD Stage 2
Someone with Stage 2 CKD has kidney damage with a small decrease in GFR of approx. 60-89 mL/min. Similar to Stage 1 CKD, there are usually no symptoms to indicate the kidneys are damaged. Because kidneys are adaptable, they can function well even when there is damage. Because of this, most people will still not know they have CKD at Stage 2. If they do find out they have Stage 2, it is normally through the same test as Stage 1: diabetes or high blood pressure.
CKD Stage 3
Someone with Stage 3 CKD has moderate kidney damage. This stage is broken up into two sub-stages characterized by the decrease in GFR. The GFR for Stage 3A is 45-59 mL/min and the GFR for Stage 3B is 30-44 mL/min. As kidney function continues to decline, waste products build up in the blood. This causes a condition known as Uremia. In Stage 3 a person is more likely to develop complications of kidney disease such as high blood pressure, anemia and/or early bone disease.
CKD Stage 4
Someone with Stage 4 CKD has progressed kidney damage with a large decrease in GFR to 15-30 mL/min. When Stage 4 CKD is achieved, patients will often require dialysis and potentially a kidney transplant in the near future. From this stage, Uremia can continue to worsen. In stage 4, a person is likely to develop the same complication Stage 3 CKD in addition to heart disease and other cardiovascular diseases.
CKD Stage 5
Someone with Stage 5 CKD has End-Stage Renal Disease (ESRD) with a GFR of 15 ml/min or less. At this advanced stage of kidney disease, the kidneys have been damaged to nearly having all their ability to do their job effectively, and eventually, dialysis or a kidney transplant is needed to live.
Possible Medical Interventions for CKD
Damage to your kidneys is usually permanent. The damage cannot be fixed, but you can take steps to keep your kidneys as healthy as possible for as long as possible. Since kidney damage is usually a result of a different underlying condition (IE diabetes or high blood pressure), managing these conditions can be greatly beneficial. This can include controlling your blood sugar if you have diabetes and keeping your blood pressure in a normal range through lifestyle and/or medications. Ultimately, you should consult with your doctor and implement their advice and care plan to ensure that your kidneys stay healthy for as long as possible.
How to Take Care of Your Kidneys (Preventative Action)
With the actions, you can take to manage Chronic Kidney Disease established, let’s talk about what you can do to prevent CKD and the underlying diseases that can cause it. Below is a list of preventative actions you can implement to ensure good kidney health. Using CareClinic as a CKD symptom tracker and a CKD Activity Log is simple. To further help, we have also grouped any action noted into buckets that can be achieved by a specific CareClinic module.
Measurement Log
The following are preventative actions that can be facilitated using the Measurement module within the CareClinic app. Using a Measurement tracker as part of your CKD Symptom Log and a CKD Activity Log can be extremely beneficial as it allows you to see the progression of kidney damage, as well as understand when more hands-on approaches need to be taken. The following are great metrics to track within your CKD Symptom Log and a CKD Activity Log from the CareClinic app.
- Keep your blood pressure below 140/90 or the goal your doctor sets for you
- If you have diabetes, stay in your blood sugar range as much as possible
- Aim for a relatively healthy weight
Managing CKD Medication Log
Medication adherence is the key to treating any chronic disease. Chronic Kidney Disease is no different. Ensuring that you take your medicines as prescribed by your healthcare provider is pivotal to consistently managing your symptoms and preventing further kidney damage. CareClinic understands this. Our Medication Tracker module can easily keep you on track with your medications. See this article to learn more about Medication Alerts and Medication Adherence.
Keeping a Nutrition Log 
You are what you eat! Working with a dietitian to develop a kidney-healthy eating plan can play a huge role in minimizing the progression of kidney damage. Furthermore, if you have diabetes, eating well works two-fold: managing both diabetes and CKD. More on this feature and how it can be effectively used as part of your CKD Activity Log can be found in this article.
Activity Logs
In addition to your diet, your activity levels play an important role in your overall health. Physical activity helps control blood pressure and blood sugar levels. The Activity tracking module is a great addition to your CKD Activity Log. Allowing you to select an exercise and then track the calories burnt and sets completed, the Activity tracking module makes tracking your exercise regimen easy and accurate.
Sleep Logs
Sleep is arguably the most important aspect of any person’s health. Good sleep hygiene can make or break a healthy lifestyle and have a large impact on your ability to cleanse toxins from your body. Understanding how lack of sleep affects your health is important. Tracking your sleep and trying to optimize it is a great way of improving your overall health. The CareClinic app offers a Sleep tracking module that allows you to track the quality of your sleep, factors that may have affected your sleep that night, and set sleep reminders. Using our premium subscription, we have a variety of sleep sounds that can be helpful for those who require some stimulus while sleeping.
Create a CareTeam
At the end of the day, working with your healthcare provider to create a tailored medical intervention is key to managing any chronic disease. This intervention should include all of the aspects this article talks about and may even include more. Keeping track of the intervention can be difficult. Using CareClinic’s CareTeam function, your doctor is able to monitor your updates within the CareClinic app. To learn more about creating a CareTeam and the roles they can play.
Ultimately, CareClinic is the best app to use for a CKD Activity Log and CKD Symptom Log. Enabling you to have a comprehensive tracking solution that can be shared with your healthcare provider, CareClinic makes managing a chronic disease easy.
