Back مرض الكلى المزمن Arabic Xroniki böyrək çatışmazlığı Azerbaijani Хронична бъбречна недостатъчност Bulgarian দীর্ঘস্থায়ী বৃক্কীয় রোগ Bengali/Bangla Malaltia renal crònica Catalan Chronické renální selhání Czech Clefyd cronig yr arennau Welsh Chronisches Nierenversagen German Χρόνια νεφρική ανεπάρκεια Greek Enfermedad renal crónica Spanish

Chronic kidney disease

This article is about CKD in general. For the end-stage of the disease, see kidney failure.
Chronic kidney disease
Other namesChronic renal disease, kidney failure, impaired kidney function[1]
Illustration of a kidney from a person with chronic renal failure
SpecialtyNephrology
SymptomsEarly: None[2]
Later: Leg swelling, feeling tired, vomiting, loss of appetite, confusion[2]
ComplicationsHeart disease, high blood pressure, anemia[3][4]
DurationLong-term[5]
CausesDiabetes, high blood pressure, glomerulonephritis, polycystic kidney disease[5][6]
Risk factorsGenetic predisposition,
low socioeconomic status[7]
Diagnostic methodBlood tests, urine tests[8]
TreatmentMedications to manage blood pressure, blood sugar, and lower cholesterol, renal replacement therapy, kidney transplant[9][10]
Frequency753 million (2016)[1]
Deaths1.2 million (2015)[6]

Chronic kidney disease (CKD) is a type of long-term kidney disease, in which either there is a gradual loss of kidney function which occurs over a period of months to years, or an abnormal kidney structure (with normal function).[2][5] Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion.[2] Complications can relate to hormonal dysfunction of the kidneys and include (in chronological order) high blood pressure (often related to activation of the renin–angiotensin system), bone disease, and anemia.[3][4][11] Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization.[12] CKD can lead to kidney failure requiring kidney dialysis or kidney transplantation.[9]

Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease.[5][6] Risk factors include a family history of chronic kidney disease.[2] Diagnosis is by blood tests to measure the estimated glomerular filtration rate (eGFR), and a urine test to measure albumin.[8] Ultrasound or kidney biopsy may be performed to determine the underlying cause.[5] Several severity-based staging systems are in use.[13][14]

Screening at-risk people is recommended.[8] Initial treatments may include medications to lower blood pressure, blood sugar, and cholesterol.[10] Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs) are generally first-line agents for blood pressure control, as they slow progression of the kidney disease and the risk of heart disease.[15] Loop diuretics may be used to control edema and, if needed, to further lower blood pressure.[16][10][17] NSAIDs should be avoided.[10] Other recommended measures include staying active, and certain dietary changes such as a low-salt diet and the right amount of protein.[vague][10][18] Treatments for anemia and bone disease may also be required.[19][20] Severe disease requires hemodialysis, peritoneal dialysis, or a kidney transplant for survival.[9]

Chronic kidney disease affected 753 million people globally in 2016 (417 million females and 336 million males.)[1][21] In 2015, it caused 1.2 million deaths, up from 409,000 in 1990.[6][22] The causes that contribute to the greatest number of deaths are high blood pressure at 550,000, followed by diabetes at 418,000, and glomerulonephritis at 238,000.[6]

  1. ^ a b c Bikbov B, Perico N, Remuzzi G (23 May 2018). "Disparities in Chronic Kidney Disease Prevalence among Males and Females in 195 Countries: Analysis of the Global Burden of Disease 2016 Study". Nephron. 139 (4): 313–318. doi:10.1159/000489897. PMID 29791905.
  2. ^ a b c d e "What Is Chronic Kidney Disease?". National Institute of Diabetes and Digestive and Kidney Diseases. June 2017. Retrieved 19 December 2017.
  3. ^ a b Liao MT, Sung CC, Hung KC, Wu CC, Lo L, Lu KC (2012). "Insulin resistance in patients with chronic kidney disease". Journal of Biomedicine & Biotechnology. 2012: 691369. doi:10.1155/2012/691369. PMC 3420350. PMID 22919275.
  4. ^ a b "Kidney Failure". MedlinePlus. Retrieved 11 November 2017.
  5. ^ a b c d e "What is renal failure?". Johns Hopkins Medicine. Retrieved 18 December 2017.
  6. ^ a b c d e Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  7. ^ Cite error: The named reference Appel was invoked but never defined (see the help page).
  8. ^ a b c "Chronic Kidney Disease Tests & Diagnosis". National Institute of Diabetes and Digestive and Kidney Diseases. October 2016. Retrieved 19 December 2017.
  9. ^ a b c "Kidney Failure". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 11 November 2017.
  10. ^ a b c d e "Managing Chronic Kidney Disease". National Institute of Diabetes and Digestive and Kidney Diseases. October 2016.
  11. ^ KDIGO: Kidney Disease Improving Global Outcomes (August 2009). "KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)" (PDF). Kidney Int. 76 (Suppl 113). Archived from the original (PDF) on 2016-12-13.
  12. ^ Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY (September 2004). "Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization". The New England Journal of Medicine. 351 (13): 1296–1305. doi:10.1056/NEJMoa041031. PMID 15385656.
  13. ^ "Summary of Recommendation Statements". Kidney International Supplements. 3 (1): 5–14. January 2013. doi:10.1038/kisup.2012.77. PMC 4284512. PMID 25598998.
  14. ^ Ferri FF (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. pp. 294–295. ISBN 9780323529570.
  15. ^ Xie X, Liu Y, Perkovic V, Li X, Ninomiya T, Hou W, et al. (May 2016). "Renin-Angiotensin System Inhibitors and Kidney and Cardiovascular Outcomes in Patients With CKD: A Bayesian Network Meta-analysis of Randomized Clinical Trials". American Journal of Kidney Diseases (Systematic Review & Meta-Analysis). 67 (5): 728–41. doi:10.1053/j.ajkd.2015.10.011. PMID 26597926.
  16. ^ Wile D (September 2012). "Diuretics: a review". Annals of Clinical Biochemistry. 49 (Pt 5): 419–31. doi:10.1258/acb.2011.011281. PMID 22783025.
  17. ^ James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. (February 2014). "2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–20. doi:10.1002/14651858.CD011339.pub2. PMC 6485696. PMID 24352797.
  18. ^ "Eating Right for Chronic Kidney Disease | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 5 September 2019.
  19. ^ "Anemia in Chronic Kidney Disease". National Institute of Diabetes and Digestive and Kidney Diseases. July 2016. Retrieved 19 December 2017.
  20. ^ "Mineral & Bone Disorder in Chronic Kidney Disease". National Institute of Diabetes and Digestive and Kidney Diseases. November 2015. Retrieved 19 December 2017.
  21. ^ Tjempakasari A, Suroto H, Santoso D (December 2022). "Osteoblastogenesis of adipose-derived mesenchymal stem cells in chronic kidney disease patient with regular hemodialysis". Annals of Medicine and Surgery. 84: 104796. doi:10.1016/j.amsu.2022.104796. PMC 9758290. PMID 36536732.
  22. ^ Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. (GBD 2013 Mortality and Causes of Death Collaborators) (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442. Table 2, p. 137 Open access icon

Developed by StudentB