Chronic Kidney Disease (CKD) in Critical Care: everything you need to know about ICU care

Chronic Kidney Disease (CKD) in Critical Care: everything you need to know about ICU care, including dialysis.

Chronic Kidney Disease, well, this is still not a very known term for many of us. However, we all should know this term to protect us from kidney diseases. According to the reports around 10% population in India is suffering from Chronic Kidney Disease (CKD) and every year over one lakh cases of renal failure are reported. Doctors are stating that the lack of awareness is the main reason behind it. Doctors are tackling CKD with ICU (Intensive Care Unit) support including dialysis consideration. In this blog, we will help you to know everything about CKD and how it is managed in the ICU including dialysis considerations. Neotia Getwel Multispecialty Hospital has a well-equipped nephrology department. Neotia Getwel Multispecialty Hospital has expertise in dealing with acute & chronic kidney diseases, haemodialysis, glomerulonephritis, renal biopsy, glomerular disease & hemodiafiltration.


1. What is Chronic Kidney Disease (CKD)?

Chronic Kidney Disease is kidney failure. When kidneys start losing their capability of filtering wastes and excess fluids from blood, they start building up in the body instead of getting out of the body with urine. In advanced CKD the fluid electrolytes and wastes start building up in the body and increase the health risks.

2. How does it impact on the patient’s health?

CKD impacts every part of the patient body. The impacts are-
a. Fluid retention: CKD happens because the kidney fails to filter wastes and excess fluids from blood and the fluids start depositing in the body. This leads to swelling arms and legs or fluid in your lungs which is called pulmonary edema.

b. Hyperkalemia: CKD increases the potassium level suddenly. This higher level of potassium increases the heart rate abnormally and increases the life risk.

c. Anaemia: Due to CKD the number of blood cells starts to reduce in the patient’s body and leads to anaemia.

d. Orthopaedic impact: CKD leads to weak bones and an increased risk of bone fractures.

e. Heart issues: When a patient has CKD, their heart needs to pump harder to get the blood to the kidneys and this increases the pressure on the heart and increases the chances of heart issues. At the same time, CKD increases the potassium level which increases the heart beat & increases heart risks. CKD also makes a huge change in blood pressure and leads to heart troubles.

Apart from the above-mentioned, CKD is also an important reason for pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium).

CKD also reduces the fertility rate and sex drive. Not only that CKD can be an important reason for loss of appetite or eating less, depression or lower quality of life etc.

2.1. The symptoms of CKD:

It is important to recognise the issue in the earlier. As we have mentioned in the beginning ignorance is the main reason for the increasing number of CKD patients. The symptoms are-
● Nausea
● Vomiting
● Loss of appetite
● Fatigue and weakness
● Sleep problems
● Urinating more or less
● Decreased mental sharpness
● Muscle cramps
● Swelling of feet and ankles
● Dry, itchy skin
● Extreme high blood pressure (hypertension)
● Shortness of breath, Chest pain

3. How CKD patients are managed in the ICU?

A-RRT is frequently necessary for volume management in CKD/ESKD patients who have sepsis, acute respiratory distress syndrome, or who have undergone surgery. Patients with CKD/ESKD who are brought to the ICU may have hemodynamic instability and a low effective arterial blood volume, necessitating the administration of intravenous fluids. When using isotonic fluids, it is recommended to maintain a normal serum sodium concentration and tonicity. Additionally, one should anticipate the administration of some antibiotics diluted in 5% dextrose and hypotonic infusions (such as vasopressors). Daily evaluations of weight, fluid intake and output, central venous pressure, and central venous oxygen saturation are crucial. If at all possible, invasive hemodynamic monitoring should also be carried out. Bioimpedance and ultrasonography techniques are noninvasive procedures that have proven useful for diagnosing both critically unwell and CKD/ESKD patients.

4. How does dialysis help in CKD?

CKD or Chronic Kidney Disease is kidney failure and often it gets treated through dialysis. Do you know why? It’s because the dialysis process helps in removing the waste products from the body. A study has shown that almost 25% of patients require dialysis in intensive care to remove waste products and fluid that build up due to kidney failure.
Dialysis helps the doctor to provide the necessary fluids, nutrition, antibiotics and other medications to the patient without making worry about the accumulation of waste products and fluid from the failing kidneys. This led to effective treatment as well. In Neotia Getwel Multispecialty you will be able to get the best experts to get the dialysis done. Neotia Getwel Multispecialty Hospital has expertise in dealing with acute & chronic kidney diseases, haemodialysis, glomerulonephritis, renal biopsy, glomerular disease & hemodiafiltration.

5. How to keep your kidney healthy & fit?

There is an age-old idiom, prevention is better than cure. It is always best to have precautions rather than treatment. So, here are some tips for keeping your kidney healthy & fit.
● Stay hydrated. Doctors say that staying dehydrated always increases the risk factor for your kidneys.
● If you have heart issues or high blood pressure, then keep a check on your kidney too. It is better to have a regular medical test to avoid further complications.
● If you have diabetes, you should be double careful about your kidney health. Diabetes increases kidney-related risks. In that case, you can consult with a doctor for the necessary precautions.

Final words: CKD is a fatal disease. Although it takes a quite long time to develop. So, it is important to pay a significant amount of attention to your health and it is also important to have a medical check-up at a regular interval. If you have diseases such as heart issues, diabetes or high blood pressure, maintaining a good lifestyle is crucial for you. Remember, a healthy lifestyle & regular exercise can save you from 100 diseases. For further information, you can visit Neotia Getwel Multispecialty Hospital at any time.



Though all attempts are made to provide correct information on the subject, inadvertent & typographical errors arising out of manual intervention cannot be ruled out. It is requested to bring any such discrepancies to the notice of the blogger for correction.