Chronic kidney disease
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
Chronic Kidney Disease: An Overview
Definition and Classification of Chronic Kidney Disease (CKD)
Chronic kidney disease (CKD) is characterized by a persistent reduction in kidney function, typically defined by a glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m², or markers of kidney damage, for at least three months . The disease is progressive and can lead to end-stage renal disease (ESRD) if not managed effectively . CKD is classified into stages based on GFR and albuminuria levels, which help in assessing the severity and guiding treatment strategies .
Causes and Risk Factors
The primary causes of CKD are diabetes and hypertension, which account for a significant proportion of cases globally . Other risk factors include age, ethnicity, obesity, and exposure to nephrotoxic substances . Genetic predispositions and low nephron number at birth also contribute to the development and progression of CKD.
Symptoms and Diagnosis
CKD often remains asymptomatic until it reaches advanced stages. Common symptoms include lethargy, swelling in the ankles, feet, or hands, shortness of breath, and blood in the urine. Diagnosis is typically made through routine blood and urine tests, which can detect abnormalities in kidney function and proteinuria .
Complications
CKD is associated with numerous complications, including cardiovascular disease, anemia, metabolic acidosis, secondary hyperparathyroidism, and mineral bone disorders . These complications significantly impact the quality of life and increase the risk of mortality in CKD patients .
Management and Treatment
Non-Pharmacological Interventions
Dietary and lifestyle modifications play a crucial role in managing CKD. A plant-dominant, low-protein, and low-salt diet can help mitigate glomerular hyperfiltration and preserve renal function. Regular physical activity and weight management are also recommended to improve overall health outcomes.
Pharmacological Interventions
Pharmacotherapies targeting intrarenal hemodynamics, such as renin-angiotensin-aldosterone system (RAAS) inhibitors and SGLT2 inhibitors, are effective in reducing intraglomerular pressure and preserving kidney function . Novel agents like non-steroidal mineralocorticoid receptor antagonists offer additional protection through anti-inflammatory and antifibrotic mechanisms.
Managing Complications
Addressing CKD-associated cardiovascular risk, preventing acute kidney injury, and minimizing infection risk are critical components of CKD management . Treatment of complications such as anemia and metabolic acidosis is essential to improve patient outcomes and quality of life .
Screening and Early Detection
Early detection through routine screening in high-risk populations, such as those with diabetes and hypertension, is vital for preventing the progression of CKD . Screening typically involves measuring serum creatinine to estimate GFR and testing for proteinuria.
Global Perspective and Public Health
CKD is a significant public health issue worldwide, with an estimated prevalence of 8-16%. The burden of CKD is disproportionately higher in disadvantaged populations, highlighting the need for equitable access to healthcare services and early intervention strategies. National programs for non-communicable diseases should incorporate CKD management to reduce its global impact.
Conclusion
Chronic kidney disease is a complex and progressive condition with significant health implications. Effective management requires a combination of dietary, lifestyle, and pharmacological interventions, along with early detection and treatment of complications. Addressing the global burden of CKD necessitates comprehensive public health strategies and equitable healthcare access to improve outcomes for all affected individuals.
Sources and full results
Most relevant research papers on this topic