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Stage 3 Kidney Disease Symptoms

The goal of this post is to think about kidney disease and the conditions that can affect kidney function in a very different way. Why is this so important? Because as doctors and scientists study kidney disease, they are learning about the significance of inflammation; they are finding that it plays a major role in worsening kidney disease.

Stage 3 Kidney Disease Symptoms

Inflammatory changes in the kidneys are not caused only by medical conditions that affect kidney function, but also by the kidneys themselves. I'll focus on the following three important themes:
  • Chronic kidney disease itself is a state of inflammation.
  • The conditions that cause chronic kidney disease, such as hypertension, diabetes, and obesity, are themselves inflammatory conditions and should be thought of as such.
  • The inflammation of kidney disease is not limited to the kidneys; it can affect other organs as well, specifically the heart. A vicious cycle ensues where worsening kidney function can affect heart function and vice versa. 
The current research and future treatment of kidney disease will involve not only treating the specific condition affecting the kidneys, but also managing and reducing the associated inflammatory component as well. Therapies aimed at preventing progression of CKD will be focused on how to reduce the level of inflammation affecting the kidneys. In order to understand how to reduce the inflammatory response, we need to first review what inflammation is and what stimulates the inflammatory response.

Inflammation is basically how the body normally responds to any type of illness, disease, or trauma. A cut in the skin, for example, sets in motion a rapid inflammatory response. The body immediately makes proteins called cytokines (site-o-kynes) that begin the healing process. Over time, a scar made of strong fiber-type tissue will form to protect and minimize further injury to the site. This is what the body is supposed to do - work to heal itself.
What if, however, the injury was inside of you and you couldn't see it? For example, what if there was ongoing scar formation going in the kidneys that you couldn't see or feel? What if the inflammatory response was never really turned off? How would such a process get started? The answer to this last question is something called oxidative stress. Oxidative stress refers to damage that is occurring inside the cells of your body. It is this continued stress within the cells that stimulates and perpetuates the body's inflammatory response.
The body is designed to maintain harmony and balance, especially at the cellular level. The cell is the tiniest, most basic unit of life. Each cell performs its tasks in perfect harmony with the body's other cells. Knowing this is important because oxidative stress and inflammation begin at the cellular level.
Our cells normally exist in a natural or "reduced" state. Any disturbance in the natural state of the cell causes the production of toxic materials called free radicals. Examples of disturbances could include any type of illness or injury. When this happens, our cells make antioxidants whose job is to stabilize the cells and "defuse" these toxic oxygen radicals. But the more free radicals that are formed, the more damage that is caused to the cell. 

If the disturbance to the cell is continuous and severe enough, too many free radicals are formed and the damage to the cell is significant. The cells themselves become "oxidized," which means the checks and balances within the cells deteriorate, and individual cells are no longer able to effectively repair the damage.

As this cellular domino effect happens, the body's inflammatory response is over-stimulated. These toxic oxygen radicals are catalysts for even more inflammation. Cytokines, or pro-inflammatory proteins, are produced. Examples of these include endothelin (en-doethiel-ien), interleukins, and transforming growth factor (TGF)-beta. Many cytokines can go on to produce chronic inflammatory changes in the body, including scarring that begins at a microscopic level.

Several conditions, such as diabetes, hypertension, glomerulonephritis (glom-are-ulo-nef-ritis), nephrotic (nef-rot-ik) syndrome, and CKD itself, can cause oxidative stress to the cells and are potent simulators of the inflammatory response. This can lead to scarring of the kidneys because the inflammatory response is never really turned off. Therefore, treating the underlying condition affecting the kidneys will ultimately preserve kidney function and decrease the level of inflammation. To find out more, you can check out Stage 3 Kidney Disease Symptoms.