What is Chronic Kidney Disease (CKD)?
Chronic Kidney Disease (CKD) is a progressive and irreversible decline in kidney function lasting more than three months, characterized by structural or functional abnormalities of the kidney. CKD is often measured by a reduction in the glomerular filtration rate (GFR) or the presence of markers like proteinuria.
The 5 Stages of CKD
CKD is classified into five stages based on the GFR:
- Stage 1: Kidney damage with normal or increased GFR (≥90 mL/min/1.73m²).
- Stage 2: Kidney damage with mild GFR reduction (60–89 mL/min/1.73m²).
- Stage 3a and 3b: Moderate reduction in GFR (30–59 mL/min/1.73m²).
- Stage 4: Severe reduction in GFR (15–29 mL/min/1.73m²).
- Stage 5: Kidney failure (GFR <15 mL/min/1.73m²) or end-stage renal disease (ESRD).
Clinical Manifestations of CKD
Patients with CKD often present with a variety of systemic symptoms, including:
- Fluid and electrolyte imbalances: Edema, hypertension, and metabolic acidosis.
- Uremic symptoms: Fatigue, anorexia, nausea, vomiting, and pruritus.
- Cardiovascular complications: Left ventricular hypertrophy, heart failure, and atherosclerosis.
- Hematologic issues: Anemia due to erythropoietin deficiency.
- Bone and mineral disorders: Osteodystrophy, hyperphosphatemia, and secondary hyperparathyroidism.
Treatment Approaches for CKD
Management focuses on slowing disease progression, treating complications, and preparing for renal replacement therapy if needed.
1. General Measures
- Lifestyle Modifications: Low-sodium diet, cessation of smoking, and regular physical activity.
- Blood Pressure Control: Use of ACE inhibitors or ARBs.
2. Treatment of Complications
- Anemia: Erythropoiesis-stimulating agents and iron supplementation.
- Bone Disease: Phosphate binders, vitamin D analogs, and calcium supplements.
- Fluid Overload: Loop diuretics.
3. Dialysis or Transplantation
- Dialysis: Hemodialysis or peritoneal dialysis for end-stage disease.
- Kidney Transplantation: Definitive treatment offering improved quality of life.
