Chronic kidney disease (CKD) is a gradual disorder that causes kidneys to lose function. The slow deterioration over several years accumulates waste materials in the blood, rendering people sick. This page uses current research and statistics to explore CKD's stages, symptoms, causes, and prevention.

Epidemiology and Prevalence

Chronic Kidney Disease stages are prevalent worldwide, affecting millions of individuals across various age groups, genders, and ethnicities. Healthcare providers can develop targeted interventions and public health strategies by understanding its prevalence and distribution.

Global Spread

Chronic Kidney Disease stages are present across continents, impacting people from various socio-economic backgrounds. This universal prevalence has made CKD a significant public health concern. Worldwide, about 10% of the population has some form of CKD. This implies that approximately 700 million people suffer from this condition to varying degrees.

High-risk Groups

• Diabetes and Hypertension: These two conditions of chronic kidney disease self-care are the primary drivers behind CKD. They contribute to the majority of CKD cases globally. Proper management and control of these conditions can help prevent the onset or progression of kidney disease.
• Elderly Population: Age is a significant factor when it comes to CKD. With age, kidney function naturally decreases, making older adults more susceptible.
• Lack of healthcare attention: Lack of healthcare, diagnostic facilities, and preventative treatment may make low- and middle-income countries more prone to CKD, according to studies.
• Ethnicity: African, Hispanic, and Indigenous people are at higher risk due to genetics and healthcare availability.

Kidney Anatomy & Physiology

The kidneys, two bean-shaped organs below the rib cage on either side of the spine, are essential to health. Their primary functions are crucial for sustaining life.

Primary Role

• Blood Filtration: chronic kidney disease self-care Kidneys filter out toxins, excess salts, and urea – a waste product. Daily, kidneys filter about 120-150 quarts of blood to produce 1-2 quarts of urine.
• Fluid Balance: They help regulate the body’s fluid levels, maintaining the balance between water and salts.

Secondary Functions

• Blood Pressure Regulation: Kidneys regulate blood pressure by altering blood volume or sodium removal.
• Red Blood Cell Regulation: Erythropoietin, produced by the kidneys, regulates red blood cell formation.
• Acid Regulation: They maintain a stable pH level by regulating bicarbonate levels.

Nephron – The Vital Unit

Every kidney contains about a million nephrons, tiny structures that filter blood, remove waste, and produce urine. Each nephron comprises a glomerulus – a ball of small blood vessels, and a tubule.

Stages of CKD

The progression of CKD is typically gradual, with five defined causes chronic kidney disease stages. The stages are based on the Glomerular Filtration Rate (GFR), which measures kidney function.

Stage 1 (Normal kidney function but evidence of kidney damage)

GFR >' 90 mL/min

• The presence of protein in the urine or structural abnormalities of the kidney might be indicative at this stage.
• Management primarily involves monitoring and addressing potential risk factors to prevent progression.

Stage 2 (Mild reduction in kidney function)

GFR between 60-89 mL/min

• Kidney damage signs continue to persist or intensify. Regular monitoring and healthy lifestyle practices are essential at this stage.

Stage 3 (Moderate reduction)

GFR between 30-59 mL/min

• Symptoms such as fatigue, fluid retention, and changes in urine might become more noticeable.
• Treatment strategies might include medications to control associated symptoms.

Stage 4 (Severe reduction)

GFR between 15-29 mL/min

• By this stage, kidney function has declined significantly. The risk of complications like anemia or bone disease increases. Medical intervention is more aggressive, with a focus on slowing further damage.

Stage 5 (Kidney failure)

GFR < 15 mL/min

• At this terminal stage, the kidneys have almost or entirely stopped functioning. Treatment options include dialysis or a kidney transplant.

In all stages, regular check-ups, adhering to prescribed medications, dietary changes, and lifestyle modifications play pivotal roles in management and outcome improvement.

Signs & Symptoms

Chronic Kidney Disease is often termed a "silent" disease primarily because its symptoms are non-specific and can be easily confused with other conditions. As the causes chronic kidney disease advance, symptoms become more pronounced, impacting multiple body systems.

General Well-being

• Fatigue and a decrease in overall energy.
• Trouble concentrating, leading to challenges in daily activities.
• Appetite disturbances and subsequent weight changes.

Musculoskeletal Changes

• Muscle cramping, particularly noticeable at night.
• Bone pain or fragility, hinting at mineral imbalances managed by the kidney.

Skin Alterations

• Dryness and itchiness due to waste accumulation.
• Pale skin is indicative of anemia commonly seen in CKD patients.

Urinary Changes

• Increased frequency of urination, especially during night-time.
• Presence of blood or foam in the urine.
• A marked decrease in urine output in advanced stages.

Causes and Risk Factors

The etiology of CKD is multifactorial, with some causes being primary insults to the kidneys, while others are secondary, stemming from systemic diseases.

Primary Causes

• Diabetes: Uncontrolled high blood sugar can harm renal nephrons, reducing filtering capacity.
• Hypertension: High blood pressure damages renal blood vessels, reducing kidney function.
• Chronic Glomerulonephritis: Kidney filtering unit inflammation and damage.

Secondary Causes

• Polycystic Kidney Disease: A genetic condition where fluid-filled cysts develop in the kidneys, impairing their function over time.
• Urinary Tract Obstructions: Conditions like enlarged prostate, kidney stones, or tumors can obstruct urine flow, causing pressure and kidney damage.
• Repeated Kidney Infections: If untreated, can lead to scarring and reduced kidney function.

Risk Factors

• Age: As age advances, the risk of CKD increases.
• Family History: A hereditary component has been identified, making those with family members suffering from CKD more vulnerable.
• Ethnicity: Certain groups, such as African, Hispanic, and Indigenous populations, face elevated risks.
• Smoking: It accelerates kidney damage, especially in those with renal problems.
• Obesity: Excess weight strains the kidneys, worsening CKD and other renal diseases.

Diagnosis

Chronic Kidney Disease often goes undetected until it has advanced to later stages, as early-stage symptoms can be non-specific or absent. Precise diagnostic processes are paramount to discern its presence and measure its progression.

Blood Tests

• Purpose: Blood tests are often the initial step in diagnosing CKD. They measure the amount of waste products in your blood, such as creatinine and urea.
• Findings: Elevated levels can indicate that the kidneys aren't functioning optimally.
• Creatinine Clearance Test: This test measures how effectively kidneys remove creatinine from the blood. Lower clearance rates can signal impaired kidney function.

Urine Tests

• Microalbuminuria Test: Detects minute levels of protein in the urine.
• Significance: Early detection of kidney damage often reflects elevated proteins in the urine.
• Urine Protein to Creatinine Ratio: Gauges the quantity of protein excreted in urine. Elevated levels indicate kidney malfunction.
• Urine Sediment Examination: Evaluates the presence of red and white blood cells, high levels of bacteria, or cellular casts, indicating kidney disease.

GFR Estimation

• Significance: The Glomerular Filtration Rate (GFR) is the primary metric to define and stage CKD.
• Calculation: Often derived from serum creatinine levels, age, body size, and gender.
• Interpretation: A declining GFR is a hallmark of diminishing kidney function.