World Medical Hospital (WMC), Thailand


‘Chronic Kidney Disease’ and How to Defend Yourself

Kidney is a bean-shape retroperitoneal visceral organ located both sides of the lumbar spine. It has vary in size depend on age, gender and race. The average kidney size is about 12 cm although men have larger kidney size than women, and adults have larger kidney size than children. Right kidney sits lower than left kidney and each of them has a small tube called ureter connecting the kidney to urinary bladder. Kidney’s main functions are removal of byproducts and excess fluid from the body while regulating chemical system, bone & mineral system, and hormonal system which relate to red blood cell production and blood pressure control.


Knowing “Chronic Kidney Disease”
Chronic kidney disease is kidney damage from any etiology that causes kidney abnormalities at least one of the following:

1.  Kidney damage has been presented more than 3 months with normal or reduce glomerular filtration rate (GFR).

             Kidney damage means abnormal at least one of the following:

1.1 Abnormal urine examination found at least twice in 3 months                                                                   

 - Proteinuria (microalbuminuria 30-300 mg/gm) in DM patients                                   

Proteinuria > 500 mg/day or protein dipstick ≥ 1+in non-DM patients                                                                                  

 - Red blood cell in urine (hematuria)

1.2 Abnormal kidney radiology such as kidney cyst, urinary tract stone, small or single kidney

1.3  Abnormal kidney pathology from kidney biopsy

2. Glomerular filtration rate (GFR) < 60 ml/min/1.73m2 for more than 3 months

There are 5 stages of chronic kidney disease according to GFR as shown below:

Stage of Chronic Kidney Disease



Glomerular Filtration Rate


Kidney damage with normal GFR



Kidney damage with mild decrease in GFR



Moderate decrease in GFR



Severer reduction in GFR



End stage kidney Failure



Will I have Chronic Kidney Disease?
The risk of the disease depends on many factors including family history, age, lifestyle, and etc.  What you need to realize is that you can lower the risk, receive an early diagnose, and be cured of the disease.

The most two common causes of chronic kidney disease are hypertension and diabetes. The less commons are glomerulonephritis (kidney inflammation), cystic kidney disease, urinary tract stone, urinary tract infection, hereditary disease, or drugs and toxins usage.


How to detect chronic kidney disease?
1. Know the signs. You may have at least one of these following symptoms:

·       Hypertension

·       Proteinuria and/or hematuria (blood in urine)

·       Reduce in kidney function (GFR<60)

·       Increase in urination especially at night

·       Puffy eyes, hands and feet

2. Chronic Kidney Disease Screening.
There are many options for detecting chronic kidney disease as following:

·       Blood pressure monitoring: even though high blood pressure is a cause of chronic kidney disease, it is also a clinical manifestation of chronic kidney disease.

·       Urine examination: looking for protein and red blood cell in urine that are affected by damage kidney.

·       Glomerular filtration rate (GFR): Blood test for Creatinine is calculated with age, sex and race to estimate your GFR number showing how much your kidney function have.

·       Blood sugar test: Getting diabetes test after 8 hours fasting with no consumption of food and other liquid than water. Diabetes is one of the most frequent causes of chronic kidney disease although it may lie within your body undetected.


Risk Factors

Despite being a common disease in people of all ages and genders, high risk groups listed below should have early or regular test.

·       Age 65 years old or older

·       Patients with diabetes

·       Patients with hypertension

·       Patients with family history of diabetes, hypertension, or chronic kidney disease

·       African American, Hispanic American, Asian, or American Indian


(What you can do)
How to prevent chronic kidney disease
Even with risk factors, you can lower your chance of having the disease by

1.    Taking an annual check up

2.    Taking medicines regularly as prescribed by doctor.

3.    Exercise regularly at least 30 minutes a day for at least five days a week.

4.    Quit smoking.

5.    Consuming low salt, low sugar and low fat diet.

6.    Avoid taking longstanding over-the- counter painkillers.

7.    Consulting medical professionals before taking any medicine.


(Doctor’s Corner)

Q: Can kidney disease be successfully treated?
A: Yes, some of kidney diseases, such as, urinary tract stone and urinary tract infection, can be treated while others, such as, diabetes and hypertension, cannot. Nevertheless, we can slow kidney disease progression by controlling blood sugar and blood pressure. Medications called Angiotensin Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) can slow the progression as well. There is no specific treatment in some kidney disease with unknown cause. Further research will be required for treatment in the future.
However, if your kidney function loss with GFR number lower than 15, you will need renal replacement therapy (peritoneal dialysis, hemodialysis or kidney transplantation) in order to live.