Tahap Awal Penyakit Ginjal

End-stage renal disease, also called end-stage kidney disease or kidney failure, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys no longer work as they should to meet your body's needs.

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When your kidneys lose their filtering abilities, dangerous levels of fluid, electrolytes and wastes can build up in your body.

With end-stage renal disease, you need dialysis or a kidney transplant to stay alive. But you can also choose to opt for conservative care to manage your symptoms — aiming for the best quality of life during your remaining time.

Signs of Kidney Disease

1. You're more tired, have less energy or are having trouble concentrating.
2. You're having trouble sleeping.
3. You have dry and itchy skin.
4. You feel the need to urinate more often.
5. You see blood in your urine.
6. Your urine is foamy.
7. You're experiencing persistent puffiness around your eyes.
8. Your ankles and feet are swollen.
9. You have a poor appetite.
10. Your muscles are cramping.

Treatments for Kidney Failure

The two treatments for kidney failure are kidney transplantation and dialysis. Two different types of dialysis can be done - hemodialysis and peritoneal dialysis.

• Kidney Transplantation. This is an operation that places a healthy kidney into your body. The kidney can come from someone who has died or from a living donor. A new kidney will usually function immediately. You will need special medicines to prevent your body from rejecting the new kidney. If rejection happens, dialysis is needed and you can consider a second transplant. A kidney transplant is a treatment, not a cure. Kidney transplant recipients still have chronic kidney disease, and you may still need some of the other medicines they took before the transplant.
• Hemodialysis (HD). Hemodialysis is a treatment that removes wastes and extra fluid from your blood. It can be done at home ("home hemodialysis") or in a dialysis center. During hemodialysis, your blood is pumped through soft tubes to a dialysis machine where it goes through a special filter called a dialyzer (also called an artificial kidney). As your blood is filtered, it is returned to your blood stream. Only a small amount of blood is out of your body at any time. In-center treatment time is 3-5 hours, 3 times a week. People who do home hemodialysis have more flexibility about how often it can be done. If done daily, treatment time would be 1½ to 2 hours.

Prevention

If you have kidney disease, you may be able to slow its progress by making healthy lifestyle choices:

• Achieve and maintain a healthy weight
• Be active most days
• Limit protein and eat a balanced diet of nutritious, low-sodium foods
• Control your blood pressure
• Take your medications as prescribed
• Have your cholesterol levels checked every year
• Control your blood sugar level
• Don't smoke or use tobacco products
• Get regular checkups

If you have a family member with a history of kidney disease, it is important to have regular screening with medical check-ups as there is usually a higher risk factor for developing kidney stones.

It is also important to take care of various preventable factors such as food, supplements and medications consumed. It is highly recommended to inform your doctor if you have any of these risk factors to be taken into consideration before administering medication.

References

Chapter 1: Definition and classification of CKD. Kidney Int Suppl (2011). 2013 Jan;3(1):19-62.

Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, Kurella Tamura M, Feldman HI. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014 May;63(5):713-35.

Webster AC, Nagler EV, Morton RL, Masson P. Chronic Kidney Disease. Lancet. 2017 Mar 25;389(10075):1238-1252.

Aeddula NR, Bardhan M, Baradhi KM. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Sep 4, 2023. Sickle Cell Nephropathy.

Textor SC. Ischemic nephropathy: where are we now? J Am Soc Nephrol. 2004 Aug;15(8):1974-82.