Stuart M. Homer MD and Associates

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 Frequently Asked Questions

What is chronic kidney disease?

Healthy kidneys function to remove extra water and waste from the blood, help control blood pressure, keep body chemicals in balance, keep bones strong, tell your body to make red blood cells and help children grow normally. Chronic kidney disease (CKD) occurs when kidneys are no longer able to clean toxins and waste products from the blood and perform their functions to full capacity. This can happen suddenly or over time.

What is a nephrologist?

A nephrologist is a medical doctor who specializes in kidney care and treating diseases of the kidneys. The term “nephrologist” comes from the Greek word “nephros,” which means kidney or renal, and “ologist,” which refers to someone who studies. Nephrologists are also called kidney doctors. Nephrologists are educated in internal medicine and then undergo more training to specialize in treating patients with kidney diseases.

What are kidneys and what do they do?

The kidneys are essential organs that filter the blood in order to remove waste and regulate the various chemicals in the blood. In addition, the kidneys secrete hormones that regulate blood pressure, prevent anemia and promote bone strength.

What are the main causes of kidney disease?

Diabetes is the number one cause of kidney disease, responsible for about 40 percent of all kidney failure. High blood pressure is the second cause, responsible for about 25 percent. Another form of kidney disease is glomerulonephritis, a general term for many types of kidney inflammation. Genetic diseases, autoimmune diseases, birth defects and other problems can also cause kidney disease.

What are the symptoms of chronic kidney disease?

Knowing the symptoms of kidney disease can help people detect it early enough to get treatment. Symptoms can include:

  • Changes in urination—making more or less urine than usual, feeling pressure when urinating, changes in the color of urine, foamy or bubbly urine, or having to get up at night to urinate
  • Swelling of the feet, ankles, hands or face—caused by fluid the kidneys can’t remove that may stay in the tissues
  • Fatigue or weakness—caused by a build-up of waste or a shortage of red blood cells (anemia) when the kidneys begin to fail
  • Shortness of breath—caused by fluid building up in the lungs; for this reason, kidney failure is sometimes confused with asthma or heart failure
  • Ammonia breath or an ammonia or metal taste in the mouth—a result of waste build-up in the body that can cause bad breath, changes in taste or an aversion to protein foods like meat
  • Back or flank pain—affecting the area where the kidneys are located on either side of the spine in the back
  • Itching—may be severe, especially in the legs, as a result of waste build-up in the body
  • Loss of appetite
  • Nausea and vomiting
  • More hypoglycemic episodes (if diabetic)

If you believe you have any of these symptoms, talk to your doctor about your concerns. This is especially important if you have a close family member who has kidney disease, or if you have diabetes or high blood pressure, which are the main causes of kidney failure.

What are the five stages of kidney disease?

Kidneys are organs whose function is critical to the health of your body. Your kidneys filter your blood, removing waste and unneeded fluid. But that’s not all the kidneys do. They also produce certain hormones that help other organs function properly, and they maintain a complex balance of acid, potassium and salt in your body.

Chronic kidney disease occurs when kidneys lose their ability to work properly, sometimes due to chronic high blood pressure, uncontrolled diabetes, genetic disease or other reasons.

There are five stages of chronic kidney disease, as shown in the chart below.

GFR = Glomerular Filtration Rate
Stage 1
Stage 2
Stage 3 (moderate)
Stage 4 (severe)
Stage 5
Kidney damage with normal or elevated GFR. Kidneys are minimally damaged and still clean the blood normally.
Kidney damage with some decrease in GFR. Kidneys are not functioning normally.
Moderate decrease in GFR. Kidneys are damaged and are half way to failure.
Severe decrease in GFR. Kidneys are near failure.
Kidney failure – dialysis required.
GFRSymptomsTreatment/Next Steps
More than 90 mL/minUsually noneDiagnosis and treatment of CKD. Treatment of accompanying conditions. Reducing risk of CKD/slowing its progression.
60 to 89 mL/minUsually noneEstimating and slowing progression.
30 to 59 mL/minUsually noneEvaluating and treating complications and slowing progression.
15 to 29 mL/minThere may be swelling and nausea.Preparation for dialysis and/or transplant.
Less than 15 mL/minThere may be swelling, nausea or shortness of breath.Dialysis is necessary. Kidney transplant possible.
What is the kidney diet?

If you have chronic kidney disease (CKD), your kidneys are not able to remove waste products and excess fluid from your body in the way that healthy kidneys do. Your diet can have a significant impact on your body’s overall health and the progression of CKD, since certain foods can add to the accumulation of waste products and extra fluid in your blood. The kidney diet is a plan for eating that supports your kidney health.

If you have recently been diagnosed with CKD, a renal dietitian can help you determine which foods are best for you.

Typically, a kidney diet is:

  • Low in sodium
  • Low in protein
  • Low in phosphorus
What is dialysis and which dialysis treatment option is best for me?

Dialysis is a treatment that performs some of the functions diseased kidneys are not able to do, such as removing excess fluid from the body, filtering waste products from the blood and helping maintain fluid and chemical balances. In the early stages of chronic kidney disease (CKD), you do not need dialysis. But if your kidneys fail, you will need to undergo regular dialysis or a kidney transplant to keep you alive. Today, more than 380,000 people living in the United States are dialysis patients.

There are two main types of kidney dialysis:

  • Hemodialysis (HD), the most common procedure, uses a machine to route blood taken from a patient’s body through a filter. Patients can choose from several hemodialysis treatment options, including:
    • In-center hemodialysis: Patients come to a dialysis facility, usually three times a week for about four hours per treatment.
    • In-center nocturnal dialysis: Patients receive dialysis three or more nights a week for about eight hours while they sleep.
    • Home hemodialysis: Patients perform hemodialysis at home, with the help of a care partner, five to six times per week with treatment times averaging about four hours.
  • Peritoneal dialysis (PD) uses the lining of the patient’s abdomen, the peritoneal membrane, to filter the blood. PD is a home treatment option that is performed on a daily basis, either during the day or while a person sleeps at night.

Treatment options are constantly being developed to improve the quality of life for dialysis patients. The one that is right for you will depend on your needs and which option best fits your lifestyle. Your doctor will be able to tell you if you are medically better suited for one treatment or the other, but most often, the choice will be yours.

How can I schedule an appointment?

To schedule an appointment, please call us at the number found on the Contact Us page.

What should I bring to my first appointment?

To have a productive first appointment, please read the First Appointment page.

We are committed to providing you with the best care possible. If you have any questions, please do not hesitate to call our office.