Chronic kidney disease (CKD) is a worldwide public health problem.
lthough the exact reasons for the growth of CKD are unknown, changes in the demographics of the population, differences in disease burden among racial groups, and under-recognition of earlier stages of CKD and of risk factors for CKD may partially explain this growth
It is also known as Chronic Renal Disease.
Different stages of Chronic Kidney Disease(CKD)
Stage 1: The eGFR (estimated GFR) shows normal kidney function but you have some pre-existing kidney damage or disease. eGFR is 90 or more ml/min/1.73m2. This is the first stage of CKD.
Stage 2: Mildly reduced kidney function and you are already known to have some kidney damage or disease.
Stage 3: Moderately reduced kidney function (with or without a known kidney disease. For example, an elderly person with ageing kidneys may have reduced kidney function without a specific known kidney disease.)
Stage 3A: eGFR- 45 to 59 ml/min/1.73m2
Stage 3B: eGFR 30 -44 ml/min/1.73m2
Stage 4: Severely reduced kidney function (with or without known kidney disease). eGFR is15 to 29 ml/min/1.73m2
Stage 5: Very severely reduced kidney function. This is sometimes called end-stage kidney failure or established renal failure. eGFR ≤ 15 ml/min/1.73m2
Complications of Chronic Kidney Disease include:
Cancer: Patients with end-stage renal disease are at increased overall risk for cancer. This risk is particularly high in younger patients and gradually diminishes with age.
Fluid and electrolyte imbalance:
- Dehydration (excessive loss of body waterwith an accompaning disruption of metabolic processes)
- Edema (abnormal accumulation of fluid in the interstitium)
- Hyperkalemia (increase in potassium levels in blood)
- Metabolic acidosis (body producing too much acid when kidneys are unable to remove enough acid from the body)
Calcium, phosphate and bone complications:
- Hyperphosphatemia (abnormal elevated level of phosphate in blood)
- Hypocalcemia (low serum levels of calcium)
- Secondary hyperparathyroidism (excessive secretion of parathyroid hormone causing imbalance in calcium and phosphorus metabolism leading to multiple fractures in the body)
- Renal osteodystrophy (bone mineralisation deficiency due to electrolyte and endocrine derangements, i.e. hormonal disturbances)
Haematologic complications:
- Anaemia (decrease in hemoglobin content)
- Bleeding diathesis (an unusual susceptibility to bleeding due to hypocoagulation (decreased blood clotting)
Cardiopulmonary complications:
- Hypertension
- Congestive heart failure (inability to maintain sufficient pump action for blood flow)
- Cardiomyopathy (measurable detoriation of the function of the myocardium, heart muscle tissue)
- Pulmonary edema (abnormal accumulation of fluid in the lung area)
- Uremic pericarditis (a form of pericarditis i.e. inflammation of pericardium, the sac containing the heart)
Gastrointestinal complications:
- Nausea and vomiting
- Bleeding
- Esophagitis (inflammation of esophagus)
- Gastritis (inflammation of lining of stomach)
- Colitis (inflammation of colon)
Neuromuscular complications:
- Myopathy (muscular weakness that occurs due to combination of poor nutrition, hyperparathyroidism, vitamin D deficiency and disorders of electrolyte metabolism, mainly seen in association with CKD)
- Peripheral neuropathy (damage or disease affecting peripheral nerves)
- Encephalopathy (disease of the brain)
Dermatologic complications:
- Sallow colour due to urochrome (end product of haemoglobin breakdown) deposition under skin as impaired kidneys fail to remove excess urochromes from the body
- Pruritis (itching of the skin)
- Dermatitis (inflammation of skin)
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