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Chronic Kidney Disease (CKD)

Chronic Kidney Disease (CKD) is gradual, irreversible decline in kidney function, characterised by a decreased GFR (< 60) or markers of kidney damage (albuminuria, electrolyte abnormalities, structural or histological renal abnormalities) present for 3 + months.

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“A graphic representation of a chronically affected kidney” © https://www.scientificanimations.com (Licensed under CC-BY 4.0) https://creativecommons.org/licenses/by/4.0/


Causes

  • Diabetes

  • Hypertension

  • Chronic glomerulonephritis

  • Polycystic kidney disease

  • Renal artery stenosis

  • Amyloidosis, myeloma


Staging

  • Stage 1 - eGFR is > 90 with demonstrable kidney damage

  • Stage 2 - eGFR is 60-89 with demonstrable kidney damage

  • Stage 3 - eGFR is 30-60 - CKD diagnosis is made from here

  • Stage 4 - eGFR is 15-30

  • Stage 5 - eGFR is < 15 - End-stage renal failure


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Complications

  • Cardiovascular disease (CVD)

  • HTN

  • Anaemia (low EPO)

  • Electrolyte imbalance (metabolic acidosis, hyperkalaemia)

  • Renal bone disease

  • Peripheral/pulmonary oedema

  • Peripheral neuropathy


N.B. CVD is the most common cause of death in those with CKD.


Management

  • Control DM

  • Control HTN - ACEi 1st line

  • Iron supplementation and EPO for anaemia

  • Salt restriction and diuretics for oedema

  • Vit D for renal bone disease

  • Sodium Bicarbonate for metabolic acidosis



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