Chronic Kidney Disease

Chronic kidney disease (CKD) is the gradual, long-term loss of kidney function, in which the kidneys become progressively less able to filter waste and excess fluid from the blood. It is a growing health problem in Nigeria, closely linked to the rising rates of hypertension and diabetes, and is often diagnosed late because early stages produce few or no symptoms. Left untreated, CKD can progress to kidney failure, requiring dialysis or transplantation.

CKD is often silent in its early stages. As the disease progresses, symptoms may include: • Fatigue and weakness • Swelling of the legs, ankles, or feet (oedema) • Puffiness around the eyes, especially in the morning • Foamy or bubbly urine (a sign of protein in the urine) • Changes in urination: more or less frequent, or at night • Persistent itching • Loss of appetite and nausea • Muscle cramps • Difficulty concentrating • High blood pressure that is difficult to control • Shortness of breath (in advanced disease, from fluid buildup or anaemia)

CKD develops when the kidneys are damaged over months or years and lose their ability to function properly. The most common causes are: • Diabetes mellitus (diabetic nephropathy) — the leading cause worldwide • Hypertension, which damages the small blood vessels in the kidneys • Glomerulonephritis (inflammation of the kidney's filtering units) • Recurrent urinary tract infections or kidney infections • Polycystic kidney disease (an inherited condition) • Prolonged use of certain medications, including some painkillers (NSAIDs) and unregulated herbal preparations • Obstruction of the urinary tract (e.g. from kidney stones or an enlarged prostate)

• Diabetes mellitus • Hypertension • Family history of kidney disease • Age above 60 • Obesity • Cardiovascular disease • Recurrent use of NSAIDs or unregulated herbal/traditional medicines • Smoking • African ancestry, associated with a higher risk of certain kidney conditions

• Kidney failure (end-stage renal disease), requiring dialysis or transplant • Anaemia • Bone disease from mineral imbalances • Cardiovascular disease, including heart attack and stroke • Fluid buildup leading to swelling and, in severe cases, fluid around the lungs or heart • High potassium levels (hyperkalaemia), which can cause dangerous heart rhythm problems • Weakened immune system

• Control blood pressure and blood sugar if you have hypertension or diabetes • Avoid regular or prolonged use of NSAIDs and unregulated herbal remedies without medical advice • Stay well hydrated and treat urinary tract infections promptly • Maintain a healthy weight and balanced, lower-salt diet • Avoid smoking • Have regular check-ups, including kidney function tests, if you are in a high-risk group • Exercise regularly