Chronic kidney disease
Medical condition / From Wikipedia, the free encyclopedia
Chronic kidney disease (CKD) is a type of long-term kidney disease, in which either there is a gradual loss of kidney function occurs over a period of months to years, or 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]
Chronic kidney disease | |
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Other names | Chronic renal disease, kidney failure, impaired kidney function[1] |
Illustration of a kidney from a person with chronic renal failure | |
Specialty | Nephrology |
Symptoms | Early: None[2] Later: Leg swelling, feeling tired, vomiting, loss of appetite, confusion[2] |
Complications | Heart disease, high blood pressure, anemia[3][4] |
Duration | Long-term[5] |
Causes | Diabetes, high blood pressure, glomerulonephritis, polycystic kidney disease[5][6] |
Risk factors | Genetic predisposition, low socioeconomic status[7] |
Diagnostic method | Blood tests, urine tests[8] |
Treatment | Medications to manage blood pressure, blood sugar, and lower cholesterol, renal replacement therapy, kidney transplant[9][10] |
Frequency | 753 million (2016)[1] |
Deaths | 1.2 million (2015)[6] |
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]