CKD

Chronic kidney disease (CKD) is a long-term condition characterized by decreased kidney function or evidence of kidney damage persisting for three months or more. Kidney function is commonly assessed by the estimated glomerular filtration rate (eGFR). CKD is staged from G1 to G5 based on eGFR, with higher stages indicating greater loss of function, and A1–A3 for albuminuria levels to reflect kidney damage.

Common causes include diabetes mellitus and hypertension, which account for most cases, as well as glomerulonephritis, polycystic kidney disease, and nephrotoxic exposures. Risk factors include age, obesity, smoking, and a family history of CKD. The condition often presents with no symptoms in early stages; later symptoms may include fatigue, edema, reduced appetite, nausea, anemia, or electrolyte disturbances.

Diagnosis relies on sustained reductions in eGFR, albuminuria or abnormal kidney imaging, and sometimes kidney biopsy. Regular monitoring includes serum creatinine to estimate GFR and urine albumin-to-creatinine ratio.

Management focuses on slowing progression and managing complications. Core strategies include control of diabetes and blood pressure (often with renin-angiotensin system blockers), protein intake adjustment, salt and fluid management, and treatment of dyslipidemia.

Addressing anemia, bone-mineral disorder, electrolyte abnormalities, and cardiovascular risk is important. In advanced disease, renal replacement therapy with dialysis or kidney transplantation may be required.

Prognosis varies; CKD progression is associated with increased cardiovascular risk and can lead to end-stage renal disease. Early detection and risk-factor modification can slow progression in many patients.