For organs so small, your kidneys works hard and have a number of vital roles to play in the daily functions of our body to keep us healthy. But did you know that 1 in 3 Australians is at increased risk of developing kidney disease! 

Are you at increased risk of kidney disease? 
Anyone can get kidney disease, but especially those at 'increased risk'. Research shows that early detection of kidney disease can improve long term outcomes and reduce the progression of CKD and cardiovascular risk by 50%! Read more on KEY kidney health prevention messages which also focus on the importance of maintaining a balanced lifestyle.

You are at 'increased risk' if you:

• are 60 years or older
• aged 30 years if of Aboriginal or Torres Strait Islander descent or are between 18-29 with any one of these CKD risk factors
• have diabetes
• have a family history of kidney disease
• have established heart problems (heart failure or past heart attack) and/or have had a stroke
• have high blood pressure
• are obese (BMI>=30)
• are a smoker

If you have one of more of the above risk factors, you should ask your GP for a>Kidney Health Check which includes: BMI (Body Mass Index) including height, weight and waist circumference. (See more below)

Signs and symptoms of kidney disease 

• high blood pressure
• changes in the amount and number of times urine is passed for example at night
• changes in the appearance of urine (it is normally pale yellow or straw colour)
• blood in the urine
• puffiness in the legs and ankles
• pain in the kidney area
• tiredness and difficulty sleeping
• loss of appetite
• headaches
• lack of concentration
• itching
• shortness of breath
• nausea and vomiting 

What is eGFR? 
eGFR stands for ‘estimated Glomerular Filtration Rate’ 
It is difficult to calculate the exact rate at which your kidneys are working so a formula has been developed to estimate your GFR. This formula uses your age, gender and the level of *creatinine in your blood to estimate your glomerular filtration rate or rate of kidney function.

The glomerular filtration rate measures how well your kidneys filter wastes from your blood and is the best measure of kidney function. It helps to determine if there is any kidney damage. The higher the filtration rate, the better the kidneys are working. If your doctor orders a blood test to learn more about your kidney function, an eGFR result is usually provided automatically by the pathology laboratory along with your blood concentration and creatinine results.

What do the stages of CKD mean?
The following is the different stages used by doctors to determine the severity of chronic kidney disease:

Early stages of kidney failure - small amount of kidney damage, although GFR may be normal

• Often there are no symptoms in the early stages of kidney disease, blood tests can be normal.
• There may be scarring and blockages that change blood flow to parts of the kidney so they don't work as well as they should.
• There is an increased risk of heart disease. You doctor can help you reduce your risk of heart disease.

Middle stages of kidney failure - sometimes discovered because the level of waste product in the blood rises

• Some people begin to feel unwell and notice an increase in urine frequency.
• Blood pressure can rise as the kidneys slow down. High blood pressure further increases the risk of heart disease, heart attack and stroke.
• Early signs of bone disease may be present.
• Anaemia may appear, caused when there are not enough red blood cells in the blood to carry oxygen around the body. Symptoms include weakness, fatigue and a shortness of breath.

Later stages of kidney failure

• High blood pressure almost always occurs.
• You may start to notice changes in the amount of urine you pass.
• Lack of energy, increased tiredness and reduced appetite are common symptoms.
• You may need to make dietary changes, including limiting the use of salt or reducing the amount of potassium or phosphorus in your diet. 

End-Stage Kidney Disease  (ESKD)

• The kidneys are only functioning at 10-15 per cent of their capacity and are unable to properly filter waste products, remove extra water from the body and help maintain the blood's chemical balance.
• This is the time to consider commencing dialysis or having a kidney transplant.

Adjusting to kidney failure is more difficult for some people than others, even with time to prepare for it. When there is no time to prepare, the sudden impact makes dealing with kidney failure much harder. If recently diagnosed with kidney problems, we highly recommend our booklet Living with Kidney Failure. 

The KEY to Good Health Program is a local community and workplace initiative provided by Kidney Health Australia. This program has been successful in a variety of settings. It provides an innovative comprehensive health check which embraces our National Chronic Kidney Disease Strategy to prevent the onset of kidney disease through community awareness, health promotion and early detection.

The KEY to Good Health Program is important for the early detection and prevention of chronic kidney disease (CKD) and is aimed only at those with increased risk of developing kidney disease, diabetes and cardiovascular disease (see information above).

All participants are given information relating to their risk assessment for cardiovascular disease and diabetes along with test results. This initiative has positive consequences for any community and local area in raising awareness of the success of early detection for chronic kidney disease. Our objective in working together is to save lives and reduce the need for dialysis. 

Kidney Health Australia is the national peak body funding research and promoting public awareness, prevention and management of kidney disease. For more information contact: The KEY Program Manager on 03 9674 4306, or via email to Theresa Whalen. 

Kidney Evaluation for You (KEY) Program - our pilot Early Detection Program
The KEY Program is Kidney Health Australia’s chronic kidney disease early detection and prevention program - the first primary heath care program to be established in Australia using point-of-care machines to screen for kidney function. The use of point-of-care technology enabled participants to receive all their pathology results before the end of their visit. This unique aspect sets KEY apart from other screening programs. Read full publications via links below or at our Publications - Key database

Screening for chronic kidney disease in Australia: a pilot study in the community and workplace
Kidney International (2010) 77 (Suppl 116), S9–S16; doi:10.1038/ki.2009.538 - Timothy H Mathew, Olivia Corso, Marie Ludlow, Adam Boyle, Alan Cass, Steven Chadban, Beres Joyner, Mark Shephard and Tim Usherwood
Correspondence:TH Mathew, 25 North Tce, Hackney Sth Australia 5069 tim.mathew@kidney.org.au. 

Review article: Early detection of chronic kidney disease in Australia: Which way to go?
NEPHROLOGY Kidney Health Australia, Medical, Hackney Sth Australia 2009; 14, 367–373 doi:10.1111/j.1440-1797.2009.01113.x Dr Timothy Mathew and Miss Olivia Corso

UPDATED 2 FEBRUARY 2012
Disclaimer: This information is intended as a general introduction to this topic and is not meant to substitute for your doctor's or health professional's advice. All care is taken to ensure the information is relevant and applicable to each Australian state. It should be noted Kidney Health Australia recognises each person's experience is individual and variations do occur in treatment and management due to personal circumstances. Should you require further info always consult your doctor or health professional.