Chronic Kidney Disease

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Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton, Bruno Serra, Vidya Acharya and Kim Jackson  

Introduction

Chronic kidney disease (CKD):

• A progressive loss of glomerular function caused by a long-standing renal parenchymal disease. It is present when the glomerular filtration rate (GFR) is less than 60 ml/min/1.73 m2 for three consecutive months or greater than or equal to this value in patients with a kidney damage that is present for three or more months.
• A non-communicable disease usually caused by diabetes and hypertension
• Often involves a progressive loss of kidney function necessitating renal replacement therapy (dialysis or transplantation). When a patient needs renal replacement therapy, the condition is called end-stage renal disease (ESRD).

Function

Filter the blood to remove excess water, minerals, and waste products of protein metabolism, producing urine in the process

Kidneys are involved in

• Blood pressure regulation
• Regulation of body fluid volume, osmolality and pH
• Vitamin D and red blood cell (RBC) production

Renal function tests

• Estimated glomerular filtration rate (eGFR)
• Electrolytes
• Blood urea nitrogen (BUN) (urea in the UK)
• Creatinine levels

Epidemiology

CKD is a prevalent disease, affecting between 10-15% of the adult population globally

• The true incidence and prevalence of CKD are difficult to determine because of the asymptomatic nature of early to moderate CKD.
• The prevalence of CKD is around 10% to 14% in the general population.
• Worldwide, CKD accounted for 2,968,600 (1%) of disability-adjusted life-years and 2,546,700 (1% to 3%) of life-years lost in 2012.
• In 2017, the global prevalence of CKD was 9·1%, roughly 700 million cases.
• Since 1990, the prevalence of CKD has increased by 29·3%.
• A substantial increase was noted in age-standardised incidence of end-stage kidney disease (ESKD) treated by renal replacement therapy, with dialysis and kidney transplantation increasing by 43·1% and 34·4%, respectively.
• The global age-standardised mortality rate for CKD is not declining, unlike those for other important non-communicable diseases.

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