There are five stages of kidney disease. To determine the stage of kidney disease, your doctor will do blood tests to check your glomerular filtration rate (GFR). Glomerular filtration rate (GFR) measures the amount of blood the kidneys filter each minute, recorded in milliliters per minute (ml/minute). The lower your glomerular filtration rate, the lower your kidney function.
When the kidneys are no longer able to function at the level required for daily living, then kidney disease is in its last stage. End-stage kidney disease usually occurs when kidney function is less than 10 percent of normal.
The doctor may also test for protein in the urine as part of staging kidney disease.
Kidney disease stages
Glomerular filtration rate (GFR), mL/min, renal function
Stage 1: 90 or higher The kidneys are functioning normally or near normalطبيع
Stage 2: 60 to 89 slight loss of kidney function
Stage 3: 45 to 59 Mild to moderate loss of kidney function
Stage 3: 30 to 44 moderate to severe loss of kidney function
Stage 4: 15 to 29 severe kidney failure
Stage 5: less than 15 kidney failure
National Kidney Foundation
Possible future treatments
Regenerative medicine has the potential to completely heal damaged tissues and organs, offering solutions and hope for people who have conditions that are currently untreatable.
Regenerative medicine approaches include:
Enhance the body's natural ability to heal itself
Using healthy cells, tissues, or organs from a living or deceased donor to replace damaged ones
Transfer of specific types of cells or cell products into diseased tissues or organs to restore tissue and organ function
For people with kidney disease, regenerative medicine approaches may be developed in the future to help slow the progression of the disease.
Lifestyle and Home Remedies
As part of your kidney disease treatment, your doctor may recommend a special diet to help support your kidneys and limit their functioning. Ask your doctor for a referral to a dietitian who can analyze your current diet and suggest ways to diet without stressing your kidneys.
Depending on your situation, your kidney function and your overall health, your dietitian may recommend:
Avoid products that contain salt. Reduce the amount of sodium you eat each day by avoiding products that contain salt, including many easy-to-prepare foods, such as frozen dinners, canned soups and fast foods. Other foods that contain salt include salty snack foods, canned vegetables, and processed meats and cheeses.
Choose foods that contain less potassium. Your dietitian may recommend that you choose foods with less potassium at each meal. Foods high in potassium include bananas, oranges, potatoes, spinach and tomatoes. Examples of foods low in potassium include apples, cabbage, carrots, green beans, grapes, and strawberries. You should be aware that many salt substitutes contain potassium, so you should generally avoid them if you have kidney failure.
Limit the amount of protein you eat. Your dietitian will estimate how many grams of protein you need each day and make recommendations based on that amount. Foods rich in protein include lean meats, eggs, milk, cheese and beans. Low-protein foods include vegetables, fruits, bread and cereals.
Bioartificial kidney assist device (RAD)
Accurate that there is a series of progenitor cells that regenerate the tubular epithelium after tubular necrosis or acute renal failure of a given etiology, Humes et al. 10 were able to select this type of cell population and manufacture tubular-like elements in collagen gels with programmed growth factors. They introduced a binding matrix inside the polysulfone capillary, filling it with progenitor cells. Culture medium with growth factors was added to the extracapillary space to facilitate cell expansion and differentiation until a layer formed to fill the inner surface of the capillary, thus making a bioartificial tubule. .
Up to then, the replacement of renal function in acute renal failure succeeded only in replacing the elimination of solutes of light molecular weight and bulk, but without restoring the metabolic properties and endocrine renal functions, which reside in its cellular elements. This group has developed an extracorporeal circulation device with a hemofiltration filter that contains millions of human kidney tubular cells inside the hair fibers. Preclinical studies have shown that these cells retained metabolic and endocrine transport properties in uremic animals11 and, in addition, improved multiorgan dysfunction in gram-negative septic shock in a large series of animals.12,13
Tumlin et al.14 studied, over a period of up to 72 hours, whether treatment with RAD (renal assistive device) improves survival in patients with acute renal failure by comparing it to continuous replacement therapy. in a multicenter randomized controlled study involving 58 patients. suffering from acute renal failure and requiring dialysis.
Forty patients underwent venovenous hemofiltration associated with ARD and only 18 continuous renal prostheses. The primary objective was 28-day mortality, and the other objectives were 90-day and 180-day mortality, duration of renal recovery, length of ICU hospital stay, total hospital stay, and Security. On day 28, mortality was 33% in the RAD group and 61% in the group that received continuous renal replacement. Improved survival was also found at day 180 in the RAD group with a 50% risk of mortality compared to the continuous replacement group. In addition, under RAD treatment, rapid recovery of renal function was observed and tolerance improved. Nowadays, this technological breakthrough is in preparation for stage 3 multicenter randomized to assess its therapeutic effect more consistently, and several publications are available to the interested reader.
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