Definition of Chronic Kidney Disease
Chronic kidney disease is a certain type of medicalcondition which is characterized by a rather slow but progressive loss in renalfunction. It is also sometimes referred to as chronic renal disease. Thesymptoms of such medical condition are not always easily discernible since theymay sometimes include only a reduced appetite while in some other cases thepatient may feel generally unwell. This medical condition can be identifiedonly by conducting a blood test for creatinine. Early stages of the disease maystill indicate normal levels of creatinine, but they gradually get increased asthe disease progresses. Kidney damage then needs to be investigated byconducting various other types of blood tests, imaging and sometimes even renalbiopsy. The chronic kidney disease is characterized by five different stages.As of now there is no specific type of treatment which can be used for theslowing down of the progress of the disease.
There are more than 16 percent of American citizens who areolder than 20 and are affected by the chronic kidney disease. There are alsoapproximately 2 million Canadian citizens affected by the chronic kidneydisease. The number of people in the United Kingdom affected by the chronickidney disease is more than 8 percent of its entire population.
Causes and Diagnosis
The most common causes of chronic kidney disease includeglomerulonephritis, hypertension, diabetes mellitus, bilateral kidney stones,reflux nephropathy, toxin induced tubulointerstitial nephritis, polycystickidney disease, lupus nephritis, diabetic nephropathy, focal segmentalglomerulosclerosis, vasculitis, hemolytic uremic syndrome, bilateral renalartery stenosis and ischemic nephropathy. First off, chronic kidney diseaseneeds to be differentiated from acute renal failure because it cannot bereversed. Abdominal ultrasound is usually one of the first steps in the properdiagnosis of chronic kidney disease. Kidneys affected by CKD commonly tend to be smaller than usual. As mentionedearlier, blood tests for creatinine are also excellent indicators, sincechronic kidney disease always involves heightened levels of the serum creatinine.Some cases may involve further tests such as nuclear medicine MAG3 scans andDMSA scans.
Signs and Symptoms
In most cases, chronic kidney disease cannot be characterizedby any symptoms in its initial stages. It is only when the amounts of serumcreatinine get increased that the function of the kidney gets decreased. One ofthe most common symptoms is metabolic acidosis which occurs due to theaccumulation of uric acid, phosphates and sulfates. It may also lead to severalother medical complications. Another common sign of chronic kidney disease is amedical condition called hyperphosphatemia in which the excretion of phosphategets significantly reduced. This medical condition usually progresses to othersevere medical conditions such as vascular calcification, renal osteodystrophyand hyperparathyroidism. These three medical conditions are known for leadingto extremely impaired cardiac function. Fluid volume overload is also commonfor those who suffer from chronic kidney disease and it is usuallycharacterized by various forms of edema, some of which may even be lifethreatening. Some other common signs and symptoms of chronic kidney diseaseinclude significantly decreased synthesis of erythropoietin and accumulationsof potassium and urea which ultimately lead to azotemia and uremia. It is awidely known fact that chronic kidney disease is also often associated withincreased blood pressure and therefore it may often lead to severe medicalconditions such as congestive heart failure and hypertension.
Stage 1 ofchronic kidney disease is characterized by only mildly diminished function ofthe kidneys. This stage also includes kidney damage characterized only bycertain abnormalities in imaging studies and urine or blood tests.
In stage 2 of chronic kidney disease, one cannotice kidney damage as described in the stage one, but this time alsoaccompanied by pathological abnormalities and mild reduction in GFR.
Stage 3 ofchronic kidney disease is clearly defined by moderate reduction in GFR.
Stage 4of chronic kidney disease involves severe reduction in GFR and according to thetreatment plan it usually involves the preparation for renal replacementtherapy.
Stage 5 of chronic kidney disease is commonly characterized by kidneyfailure and in some cases it may require permanent renal replacement therapy.
Prognosis and Management
The treatment method for all those who suffer from chronickidney disease aims to stop or slow down the progression and prevent theaforementioned stage 5 from occurring. The types of medications commonly usedfor the treatment include angiotensin II receptor antagonists and angiotensinconverting enzyme inhibitors. Most cases of chronic kidney disease may alsorequire a replacement of two hormones commonly processed by the kidneys, knownby the names of calcitrol and erythropoietin. Those who suffer from chronic kidney disease also suffer from elevatedserum phosphate levels so they also need to be treated with phosphate binders.The stage 5 requires dialysis or a kidney transplant.