Chronic kidney disease (CKD) is a dreaded disease for which medical
science has no remedy. CKD is increasing at an alarming rate all over
the world. One in ten persons has some form of chronic kidney disease.
Rising prevalence of diabetes, hypertension, obesity, smoking, and high
cholesterol is major reason for increasing incidences of CKD.
What is chronic kidney disease?
CKD occurs when the kidneys become damaged and gradually unable
to perform their functions. With treatment, the kidney function may
remain stable, but if not, the damage becomes worse over months to
years. The serum creatinine levels rise gradually and the level of kidney
function (also called the glomerular filtration rate or GFR) can be
calculated from this blood test. The stage CKD can thus be graded as
mild, moderate or severe. The presence of albumin in the urine also
indicates that kidney damage is present (see tables stage of chronic
kidney disease). CKD was previously called Chronic Renal Failure
(CRF) but the word failure gives a wrong impression. In early CKD,
there is still some degree of renal function and only in the late stages
where kidneyfailure truly occur.
What is end stage kidney disease?
End-stage kidney disease (ESKD) or end-stage renal disease (ESRD)
refers to the time when CKD reaches an advanced stage (less than 10% of normal function). The kidneys may even fail completely and the condition is irreversible.
At this point, conservative management (i.e. medications, diet, lifestyle
modifications) is not sufficient to maintain life and renal replacement
therapy (dialysis or kidney transplantation) is required.
Chronic kidney disease is a gradual, progressive
and permanent loss of kidney functions.
CHP. 10. Chronic Kidney Disease: Causes 43.
What causes chronic kidney disease?
A number of conditions can cause permanent damage to the kidneys.
But the two main causes of chronic kidney disease are diabetes and
high blood pressure. They account for about two third cases of CKD.
Important causes of CKD are:
- 1. Diabetes. Accounting for nearly 35-40 % of all cases, Diabetes is
the most common cause of CKD. Roughly every third person with
diabetes is at the risk of developing CKD.
- 2. High blood pressure. Untreated or poorly treated high blood pressure
is another leading cause of CKD accounting for nearly 30 % of
cases. Furthermore, whatever may be the cause of CKD, high blood
pressure will definitely cause further damage to the kidneys.
- 3. Glomerulonephritis. These disorders which cause inflammation and
damage the kidneys are the third in line of ailments that cause CKD.
- 4. Polycystic kidney disease. This is the most common hereditary cause
of CKD characterized by multiple cysts in both kidneys.
- 5. Other causes: ageing of the kidneys, renal artery stenosis (narrowing),
blockage of urine flow by stones or an enlarged prostate, drug-
induced and toxin-induced kidney damage, recurrent kidney infection
in children and reflux nephropathy.
Two most common causes of chronic kidney disease
are diabetes and high blood pressure.