What is Chronic Kidney Disease (CKD)?
As essential organs in the human body, kidneys are vital to filter and cleanse the blood via the removal of waste and for the production of extra water to create urine. This process occurs using filtering units named nephron, which then excretes urine through the bladder. Kidneys are also responsible for controlling the fluids in the body that helps maintain blood pressure, controls minerals and produces hormones that are necessary to generate red blood cells and vitamin D.
When the kidneys fail to carry out these operations, it implies kidney disease. Chronic Kidney Disease (CKD) is when kidney disease surpasses a period of three months, which results in a fatal and incurable health condition. The body may not always indicate CKD during its primitive stages, challenging early identification and treatment. It is likely to develop over a period of time.
This article will address the complication of Chronic Kidney Disease, it’s prevention, diagnosis and treatment in the Sri Lankan perspective.
CKD has five stages, and each stage requires varying states of medical attention. Stages one to three implies mild to moderate condition, whilst the fifth and last is the most severe of them all, leading to what is called the End Stage Renal Disease (ESRD). In other words, kidney failure. Generally, this takes place over many years but in certain instances, sudden ESRD is known to occur over causes such as drug allergy, snake bite, trauma or severe blood loss. Dialysis or a kidney transplant are the only two options for a patient diagnosed with ESRD.
Why is the prevalence of CKD higher Sri Lanka?
According to the WHO, Sri Lanka ranks high in terms of the number of people with diabetes and hypertension, which are some of the significant causes of CKD. As of 2015, 69, 258 patients out of the 21 million were taking medicines for CKD. Out of them, CKD G3 stood at 31.8%, CKD G4 was at 40% and CKD G5 was at 24.5%. CKDu, which is attributed to unknown causes is also high in the nation.
- Race and ethnicity – Observations prove that Asians have greater chances of CKD compared to their white counterparts.
- Access to water – One is the contamination of water in areas that rely on water tanks, shallow dug wells and streams as opposed to the regions that are abundant in fresh water. Another factor revolves around the consequences of dehydration at instances where people work long hours under the sun without consuming adequate water. Consistent dehydration worsens kidney condition.
- Access to healthcare and screening facilities – Fewer options to obtain healthcare, especially among the middle and low income groups of the population results in greater CKD associated deaths. This also applies to lack of tests necessary for early detection, which could aid prevention.
- Pre-existing health conditions – diabetes mellitus, or simply diabetes and chronic or severe hypertension have been identified as the two most prominent causes of CKD.
Glomerulonephritis damages the filtering function of the kidneys. It may occur rapidly or gradually, and is on certain occasions linked to other diseases such as diabetes or lupus. Glomerulonephritis or urological diseases such as kidney or ureteral stones can be contributing factors for kidney disease although the latter is a less common cause of CKD.
What are the effects of CKD?
- As the kidneys can no longer handle the fluids in the body there can be a fluid buildup, causing Oedama. This causes swelling in the limbs, which is likely to lead to heart problems.
- Lack of red blood cell production results in anaemia, causing weakness, exhaustion and pale skin.
- Arteries may harden, which develops cardiovascular diseases, increasing the chances of heart failure, heart attack and stroke.
- Causes bones disease and raises the potential for bone fractures.
- Uremic syndrome may take place as a result of toxic residue in the blood. It affects the nerves, intestines and the heart, creating issues such as insomnia, nausea and loss of appetite.
What are the symptoms of kidney failure?
Many people do not identify signs of deteriorating kidneys, which could improve their condition if recognized during the early stages. The following symptoms require medical advice if one or many of them persist:
- Loss of appetite causing weight loss
- Oedama, causing swelling in the face, hands, legs, ankles or feet
- Fatigue and exhaustion
- Dizziness or headache
- Frequent urination, especially during the night, change in its colour or blood in the urine
- Cramping muscles
- Itching skin, nausea or vomiting
- Erectile dysfunction (for men)
- Insomnia causing sleep troubles
- Shortness of breath or chest pain
- Metallic taste in the mouth
- Pain on the sides between the ribs and the hip
Prevention of Chronic Kidney Disease
- Keep your blood sugar levels under control. A healthy diet, physical activity together with normal HbA1c (<6.5%) ensures you’re at less risk from CKD caused by diabetes. If you have diabetes, take your medicine and insulin on time. Use an online pharmacy that offers prompt refill reminders and medicine delivery in Colombo to reduce the risk of delaying your essential long term medicine.
- Manage your hypertension and cholesterol levels. This comes from proper medical treatment and lifestyle changes along with a disciplined adherence to your cholesterol medicine and heart related medicine.
- quitting smoking, reducing alcohol intake
- keeping your weight in check.
- Include more fruits and vegetables in your meals while avoiding salt, red meat, processed food and sugar. Read more about these 6 Sri Lankan food to keep effects of diabetes at bay.
Diagnosis of Chronic Kidney Disease
Three methods of diagnosis are available in the country.
- The Glomerular Filtration Rate (GFR), which reflects how well the kidneys are working. Higher this rate, the better.
- Blood pressure test
- Urine test.
The results will determine the type of treatment a patient requires.
Treatments available for Chronic Kidney Disease
There are a variety of treatments at the last two stages but they all involve some form of dialysis, which is the process of artificially eliminating waste and excess fluids from the body. Dialysis will be necessary life long and can be of two different types.
- Hemodialysis uses a machine to filter the blood before being sent back to the body while Peritoneal dialysis uses dialysis fluid to pump out waste from your blood.
- Kidney transplant. Sri Lanka has an active system to support kidney transplantation but expects patients to comply with proper legal and ethical guidelines.
Chronic Kidney Disease is a life long journey that takes your family along with you. Start prevention at an early age by preserving healthy eating habits and lifestyles. Avoid excessive alcohol, smoking, sweets and lifestyles that compromises the health of your body.
NHS (2019) Chronic kidney disease. Available at:
Mayo Clinic (2020) Diseases and conditions. Available at:
O’Connell, K. (2016) Urological diseases. Available at:
Wedro, B (2019) Kidney (renal) failure. Available at:
NHS (2019) High blood pressure (hypertension). Available at:
Web MD (2020) Combination treatment for hypertension. Available at: