From the Guidelines
Chronic kidney disease (CKD) is defined as an abnormality of kidney structure or function, present for more than 3 months, with health consequences, as stated in the most recent study 1.
Definition and Classification
CKD is a progressive condition where the kidneys gradually lose their ability to filter waste and excess fluids from the blood. It develops when kidney damage occurs over months or years, causing a decline in kidney function. The disease is characterized by a decreased glomerular filtration rate (GFR) and/or the presence of kidney damage markers like protein in the urine (proteinuria) for at least three months.
Causes and Risk Factors
Common causes include diabetes, high blood pressure, glomerulonephritis, polycystic kidney disease, and recurrent kidney infections. Hypertension and diabetes are the predominant risk factors for CKD, as mentioned in the study 1.
Stages of CKD
CKD is typically classified into five stages based on GFR levels, with stage 1 being mild damage with normal function and stage 5 representing kidney failure requiring dialysis or transplantation.
Symptoms and Management
Symptoms often don't appear until advanced stages and may include fatigue, swelling in legs and ankles, changes in urination, and high blood pressure. Management focuses on treating underlying causes, controlling blood pressure (often with ACE inhibitors or ARBs), managing blood sugar in diabetics, following a kidney-friendly diet low in sodium, potassium and phosphorus, and regular monitoring of kidney function through blood and urine tests to slow progression and prevent complications, as recommended in the study 1. Some key points to consider in the management of CKD include:
- Early detection and treatment to prevent or delay adverse outcomes
- Routine laboratory measurements to detect earlier stages of CKD
- Persistent proteinuria as the principal marker of kidney damage
- Abnormalities in urine sediment, blood and urine chemistry measurements, and abnormal findings on imaging studies as other markers of damage
- Consideration of patients with CKD as being in the highest risk group for subsequent cardiovascular disease (CVD) events, as stated in the study 1.
From the Research
Definition of Chronic Kidney Disease
Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over time. It is defined as two consecutive estimated glomerular filtration rate (eGFR) measurements below 15 ml/min/1.73 m2 2.
Stages of Chronic Kidney Disease
CKD is classified into five stages based on the level of kidney function, with stage 1 being the least severe and stage 5 being the most severe. Stage 5 CKD is also known as end-stage renal disease (ESRD) and requires dialysis or a kidney transplant 3, 4.
Symptoms and Risk Factors
The symptoms of CKD may not appear until the disease is advanced. Risk factors for CKD include diabetes, high blood pressure, family history, and age. CKD can lead to complications such as cardiovascular disease, anemia, and bone disease 5, 6.
Treatment and Management
Treatment for CKD depends on the stage and severity of the disease. It may include lifestyle changes, medications, and dialysis or a kidney transplant. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are commonly used to slow the progression of CKD and reduce the risk of cardiovascular events 2, 3, 4.
Key Points
- CKD is a gradual loss of kidney function over time
- It is classified into five stages based on the level of kidney function
- Risk factors include diabetes, high blood pressure, family history, and age
- Treatment depends on the stage and severity of the disease
- ACEIs and ARBs are commonly used to slow the progression of CKD and reduce the risk of cardiovascular events
- Discontinuation of ACEIs and ARBs is common in patients with advanced CKD, particularly in those with lower eGFR 5.