Chronic kidney disease

Chronic kidney disease

This article discusses chronic kidney diseases. Here, learn about the causes, investigation, diagnosis symptoms, and more.

Keywords: chronic kidney diseases| glomerular filtration rate | albumin/creatinine ratio (ACR) |NDD-CKD|ESKD|dialysis|kidney transplant|summary |FAQ

Table of contents

1.	Introduction
2.	Causes
3.	Diagnosis
4.	Symptoms and Signs
5.	Stages of CKD
6.	Management outline

Chronic kidney disease, there is a gradual deterioration in kidney function over a prolonged period. The onset of the disease is insidious and progresses slowly to the ‘end-stage chronic kidney disease.’

At first, the person is unaware of the disease due to the absence of symptoms and signs. Therefore, the condition is diagnosed incidentally during blood and urine tests in the early stage.

At a later stage, signs and symptoms appear and deteriorate slowly.

A person with a glomerular filtration rate below 60 ml/minute /1.73meter square for at least three months is diagnosed as suffering from chronic kidney disease.

Kidney damage is defined as histopathological abnormalities of the kidney or markers of damage with blood and urine abnormalities. The albumin/creatinine ratio (ACR) equals or exceeds 30.

Incidence: It is prevalent globally and in India. Females are affected more than males. In 2016, 417 million females and 336 million males were globally affected.

Causes:

A significant risk factor is a family history of chronic kidney disease.

It may be idiopathic[i].

Important causes are :

• Diabetes mellitus
• Hypertension
• Glomerulonephritis
• Polycystic kidney disease

Symptoms and Signs:

At first, there are no symptoms or signs.

Later, symptoms and signs develop, although there is a slight individual variation in the appearance of these symptoms and signs.

1. Increase in blood pressure due to (i) fluid overload -mild edema to pulmonary edema.

(ii) Vasoactive hormones may cause heart failure.

2. Kidney fails to excrete urea, so urea accumulates and, finally, uremia.

3. High potassium -hyperkalemia occurs in stage four when the power of the kidney to excrete potassium decreases. It may cause severe cardiac arrhythmias.

5. High level of phosphate-hyperphosphatemia.

6. Anemia-less formation of erythropoietin.

7. Hypocalcemia

8. Sexual dysfunction.

9. Menstrual disorders in females.

10. Metabolic acidosis.

11. In the later stage, cachexia develops.

Diagnosis:

1. History -family history, occupational history, lethargy, weakness, loss of appetite.

2. Clinical examination of leg swelling, muscle weakness, anorexia, nausea, and vomiting.

3. Blood examination -raised serum creatinine level, low hemoglobin, electrolytes levels,

4. Urine examination-presence of protein.

5. Ultrasonography of the kidney is helpful for diagnostic and prognostic value. Ultrasonography shows pathological changes in interstitial fibrosis, glomerular sclerosis, tubular atrophy, and interstitial inflammation. In addition, the size of the kidney reduces.

6. Kidney function tests-to determine glomerular filtration rate. Normal value is 90-120 MLS/minute.The normal GFR does not indicate a healthy kidney. With other parameters, it is advantageous to diagnose chronic kidney disease.

7. Kidney biopsy to diagnose and confirm interstitial fibrosis, glomerular sclerosis, tubular atrophy, and interstitial inflammation.

Screening tests are recommended in

1. Family history

2. Age over 60 years.

3. Individuals suffering from

• Diabetes mellitus
• Hypertension
• Polycystic kidney disease
• Glomerulonephritis
• Previous kidney disease.

Stages of chronic kidney disease

Stage 1. GFR normal or slightly raised >90 ml/min/1.73-meter square.Albuminuria and evidence of kidney damage.

Stage 2. GFR mildly reduced 60-89 ml/min/1.73-meter square. Albuminuria and evidence of kidney damage.

Stage 3 A. GFR moderately reduced 45-59 ml/min/1.73-meter square—Albuminuria and evidence of kidney damage.

Stage 3B. GFR reduced 30-44 ml/min/1.73-meter square. Albuminuria and evidence of kidney damage.

Stage 4. Severe reduction in GFR 15-29ml/min/1.73-meter square.Dialysis and arrange for kidney replacement.

Stage 5. Established kidney failure GFR less than 15 ml/min/1.73-meter square. Stage 5 is end-stage kidney disease.

The term ‘Non-dialysis-dependent chronic kidney disease’ (NDD-CKD) is used for the condition of individuals with established CKD who do not require life-supporting treatments for kidney failure.

The term ‘End-stage kidney disease’ is used for the condition of individuals with established CKD who require life-supporting treatments for kidney failure is the term (ESKD). Life-supporting treatments for kidney failure are dialysis or kidney transplant.

Management :

1. The treatment aims to slow down or halt the progression of CKD.

2. Control the underlying disease-blood pressure, Diabetes mellitus.

Summary

Kidney damage is defined as histopathological abnormalities of the kidney or markers of damage with blood and urine abnormalities. The albumin/creatinine ratio (ACR) equals or exceeds 30.

A person with a glomerular filtration rate below 60 ml/minute /1.73meter square for at least three months is diagnosed as suffering from chronic kidney disease.

FAQ :

Q. What is glomerular filtration rate ?

A. The glomerular filtration rate is the volume of glomerular filtrate filtered in a minute by all the nephrons.

The average volume of GFR is 125 ml/minute.

Q. What is Hypertension

A. Hypertension is mild to severe systolic B.P. from 140mmHg to more than 180mmHg, and diastolic B.P. from 90 mmHg to 110 mmHg.

Learn More :

1. About us

2. Contact us

3. Disclaimer

4. Privacy Policy

5. About the author

Please submit your comments about the article chronic kidney disease. The team will work hard to evaluate the statement and make appropriate corrections.

Help to improve the article.

Have a comment about the Pancreatic function test

Name:

Email:

Phone No.

Comment/question

More Articles

1. https://blog.totalphysiology.com/2021/09/regulation-of-blood-pressure-part-2.html

2.https://blog.totalphysiology.com/2021/09/regulation-of-blood-pressure-part-1.html

3. https://blog.totalphysiology.com/2021/01/diabetes-mellitus-you-must-know.html

Hashtags: chronic kidney diseases # glomerular filtration rate # albumin/creatinine ratio (ACR) # NDD-CKD # ESKD # dialysis# kidney transplant # summary # FAQ

Thanks for reading.

Was this article helpful ?

Rate this article

[i] Of unknown origin