CKD Symptom Tracker: App For Logging Chronic Kidney Disease

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.^[1][2][3]

Why are the Kidneys Important?

Your kidneys are imperative to the overall health of your body. Located on either side of your body, beside 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.^[4]

What Your Kidneys Do in the Body

The kidneys are remarkable organs that perform multiple important functions in the body. They help maintain the body's fluid and electrolyte balance, regulate blood pressure, and remove waste and toxins from the blood. Additionally, the kidneys play a key role in the production of red blood cells, which carry oxygen throughout the body. Understanding the vital functions of the kidneys underscores the importance of self-care in managing chronic kidney disease.

One of the primary functions of the kidneys is to maintain the body's fluid and electrolyte balance. They do this by filtering the blood and removing excess water, electrolytes, and waste products. This balance is crucial for the proper functioning of various bodily systems, including the heart, muscles, and nerves.

In addition to fluid and electrolyte balance, the kidneys also play a crucial role in regulating blood pressure. They do this by releasing a hormone called renin, which constricts blood vessels and increases blood pressure when necessary. This mechanism helps ensure that blood flow to vital organs, such as the brain and heart, remains constant even in challenging situations.

Another important function of the kidneys is the removal of waste and toxins from the blood. As blood circulates through the kidneys, waste products, such as urea and creatinine, are filtered out and excreted in the form of urine. This process helps maintain the overall health and well-being of the body by preventing the accumulation of harmful substances.

Furthermore, the kidneys are responsible for the production of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. Red blood cells are essential for carrying oxygen to all parts of the body. Without an adequate number of red blood cells, a person may experience fatigue, weakness, and shortness of breath.

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.^[5][6]

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.^[7][8][9]

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. Use a CKD Symptom Log and CKD Activity Log to track symptoms and the 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 complications as 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.^[10]

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.^[11][12][13]

Chronic Kidney Disease Self-Care

Self-care plays a crucial role in managing chronic kidney disease and slowing its progression. By making certain lifestyle changes and adopting healthy habits, individuals can effectively manage their condition and improve their overall quality of life.

Chronic kidney disease (CKD) is a condition that affects the kidneys, impairing their ability to filter waste products and excess fluid from the blood. It is a progressive disease that can lead to serious complications if not properly managed. While medical interventions such as medication and dialysis are important in treating CKD, self-care strategies are equally vital in maintaining kidney health and preventing further damage.

How Lifestyle Affects Kidney Health

Your lifestyle choices have a significant impact on your kidney health. By adopting a healthy diet, engaging in regular physical activity, managing stress, and getting enough restful sleep, you can support the health of your kidneys and reduce the risk of complications associated with chronic kidney disease.

A healthy diet for individuals with CKD typically involves limiting the intake of sodium, phosphorus, and potassium. This may mean reducing the consumption of processed foods, fast food, and high-sodium condiments. Instead, focusing on fresh fruits, vegetables, lean proteins, and whole grains can provide essential nutrients while minimizing the strain on the kidneys.

Regular physical activity is also beneficial for kidney health. Exercise helps improve blood flow, strengthen the cardiovascular system, and maintain a healthy weight. Engaging in activities such as walking, swimming, or cycling for at least 30 minutes a day can have positive effects on overall kidney function.

Managing stress is another important aspect of self-care for individuals with CKD. Chronic stress can contribute to high blood pressure, which is a common risk factor for kidney disease. Finding healthy ways to cope with stress, such as practicing relaxation techniques, engaging in hobbies, or seeking support from loved ones, can help reduce the impact of stress on kidney health.

Lastly, getting enough restful sleep is crucial for kidney health. During sleep, the body undergoes important processes of repair and regeneration. Lack of sleep can lead to increased inflammation and impaired immune function, which can negatively affect kidney function. Establishing a regular sleep routine and creating a relaxing sleep environment can promote better sleep quality and support overall kidney health.

CKD Diet: Foods to Include and Limit

A healthy diet is essential for managing chronic kidney disease and supporting kidney function. By following the right dietary recommendations, you can help slow down the progression of the disease and improve your overall health. Here are some important guidelines to consider:

Foods to Include in Your Diet

When it comes to choosing the right foods for your kidney health, focus on incorporating the following into your meals:

• High-quality protein sources: Including lean meats, poultry, fish, eggs, and plant-based proteins like beans, lentils, and tofu in your diet can provide you with the necessary amino acids without putting excessive strain on your kidneys. These protein sources are also low in phosphorus, making them ideal choices for individuals with chronic kidney disease.
• Fruits and vegetables: A wide variety of colorful fruits and vegetables should be a staple in your diet. Not only are they rich in vitamins, minerals, and antioxidants, but they also provide much-needed fiber. However, it's important to note that some fruits and vegetables, such as oranges and tomatoes, are high in potassium, so it's crucial to monitor your intake if you have potassium restrictions.
• Whole grains: Opt for whole grains like brown rice, quinoa, and whole wheat bread instead of refined grains. Whole grains are a great source of fiber and can help regulate blood sugar levels, which is particularly important for individuals with diabetes, a common comorbidity of chronic kidney disease.
• Healthy fats: Including sources of healthy fats such as avocados, nuts, and olive oil in your diet can provide essential nutrients and help maintain heart health. However, it's important to consume these fats in moderation, as they are high in calories.

Foods to Avoid or Limit

While there are many foods that can support kidney health, there are also certain foods that should be avoided or limited to prevent further damage to your kidneys. Here are some key considerations:

• Sodium: Limiting your intake of sodium is crucial, as it can contribute to fluid retention and increase blood pressure. To reduce your sodium intake, avoid processed foods, canned soups, and condiments high in sodium. Instead, opt for fresh ingredients and use herbs and spices to add flavor to your meals.
• Phosphorus: Individuals with chronic kidney disease may need to limit their phosphorus intake, as high levels of phosphorus can lead to bone and heart problems. Avoid high-phosphorus foods like dairy products, processed meats, and cola drinks. It's also important to read food labels carefully, as phosphorus can be found in many processed foods under different names.
• Potassium: If your kidneys are not able to regulate potassium properly, it is important to limit your potassium intake. High levels of potassium can disrupt the electrical signals in your heart and lead to irregular heart rhythms. Avoid high-potassium foods like bananas, oranges, tomatoes, and potatoes. Instead, choose lower-potassium alternatives like apples, berries, and green beans.
• Fluids: Depending on your stage of kidney disease, you may need to limit your fluid intake. Excessive fluid consumption can lead to fluid overload and put additional strain on your kidneys. It's important to follow your healthcare provider's recommendations regarding fluid restrictions and monitor your fluid intake closely.

Remember, managing chronic kidney disease through diet is a lifelong commitment. It's essential to work closely with a registered dietitian who specializes in kidney disease to develop a personalized meal plan that meets your specific nutritional needs. By making the right food choices and following your healthcare provider's recommendations, you can take control of your kidney health and improve your overall well-being.^[17]

Exercise Guidelines for Chronic Kidney Disease

Regular physical activity is beneficial for managing chronic kidney disease and improving overall health. However, it is important to choose exercises that are safe and appropriate for your condition. Here are some exercise and physical activity guidelines to consider:

Exercise is not just about staying fit; it plays a crucial role in managing chronic kidney disease. Engaging in regular physical activity can help improve your kidney health and overall well-being. By incorporating exercise into your routine, you can enhance cardiovascular fitness, strengthen your muscles, improve flexibility, and boost your overall quality of life.

Safe and Beneficial Exercises for Kidney Health

When it comes to exercising with chronic kidney disease, it's essential to focus on activities that are safe and beneficial for your condition. Here are some exercises that you can incorporate into your routine:

• Aerobic exercises: Engage in low-impact aerobic exercises like walking, swimming, and cycling to improve cardiovascular fitness. These activities help increase your heart rate, improve blood circulation, and enhance your lung capacity. They are gentle on your joints and muscles, making them ideal for individuals with kidney disease.
• Strength training: Incorporate resistance exercises to improve muscle strength and overall body composition. Start with light weights or resistance bands and gradually increase intensity. Strength training not only helps build muscle mass but also improves bone density, which is crucial for individuals with chronic kidney disease.
• Flexibility exercises: Include stretching exercises to improve flexibility and joint mobility. Yoga and tai chi are also beneficial for overall well-being. These activities help relax your mind and body, reduce stress, and improve your balance and coordination.

By incorporating a combination of aerobic exercises, strength training, and flexibility exercises into your routine, you can experience a wide range of benefits. These exercises not only improve your physical health but also positively impact your mental well-being.

Understanding Your Physical Limitations

It is important to be mindful of your physical limitations and listen to your body while exercising. Every individual's condition is unique, and what works for one person may not work for another. Therefore, it is crucial to consult with your healthcare provider or a qualified exercise professional to develop a personalized exercise plan that takes into account your specific needs and restrictions.

Your healthcare provider or exercise professional will assess your current health status, evaluate your kidney function, and consider any other medical conditions you may have. They will help you determine the appropriate intensity, duration, and frequency of exercise that suits your individual needs. They may also provide guidance on modifications or adaptations to exercises to ensure your safety.

Remember, exercising with chronic kidney disease is not about pushing yourself to the limit; it's about finding a balance that allows you to reap the benefits of physical activity while taking care of your health. With the right guidance and a personalized exercise plan, you can embark on a journey towards improved kidney health and overall well-being.

Stress Management for Chronic Kidney Disease

Chronic kidney disease can be a challenging condition to manage, which can cause stress. However, stress can negatively impact kidney function and overall health. Therefore, it is important to incorporate stress management techniques into your self-care routine. Here are some mindfulness and relaxation practices to consider:

Mindfulness and Relaxation Practices

• Meditation: Set aside a few minutes each day to practice meditation. Focus on your breath and allow your thoughts to come and go without judgment.
• Deep breathing exercises: Practice deep breathing exercises to activate the body's relaxation response. Breathe in slowly through your nose, hold for a few seconds, and exhale slowly through your mouth.
• Yoga and tai chi: Engage in gentle stretching and mindful movement practices like yoga and tai chi. These practices can help reduce stress and promote a sense of calm.

The Impact of Stress on Kidney Disease

Excessive stress can lead to high blood pressure, which can further damage the kidneys. By incorporating stress management techniques into your self-care routine, you can not only improve your overall well-being but also support kidney health.^[18][19]

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.^[14][15][16]