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Chronic Kidney Disease


Chronic Kidney Disease includes a number of conditions that damage the kidneys:

  • Azotemia: A higher than normal level of urea or other nitrogen containing compounds in the blood [medical Medline enyclopedia]
  • Glomerulopathy: General disease of the renal glomeruli (filtration structure in the kidney) [28]
  • Glomerulosclerosis: Hyaline deposits or scarring within the renal glomeruli, a degenerative process occurring in association with renal arteriosclerosis or diabetes [medical medline encyclodpedia]
  • Nephrosis: Lesions of the epithelial lining of the renal tubules, resulting in marked disturbance in the filtration function [medical medline encyclopedia
  • Nephrosclerosis: Hardening (sclerosis) of the kidney usually due to disease of the blood vessels [25, 45, 48]

 

 

diseased kidney

 

 

 

 

 

 

 

 

 

Diagnosis


The kidneys are the body's filtration system. This system allows doctors to use biomarkers in the urine to determine the presence of dysfunction or disease. Some of the biomarkers include proteinuria and albuminuria (substances in the urine) [27, 37, 53].
Urine tests are most commonly used to assess kidney function, these include:
Dipstick tests: a chemically treated strip, dipped into the urine in order to assess the presence of excess proteins and abnormalites.
Creatinine clearance: asseses the glomerular filtration rate (GFR) of the kidneys by comparing creatinine levels in the urine over a 24 hour period to the level in the blood. This represents how much blood the kidneys are able to filter out per minute [19, 20].  


The GFR score is used to describe the stages of kidney function:

:

 

Stage GFR Description 
1 90 + Normal Kidney Function
2 60-89 Mildy Reduced Kidney Function
3A 45-59 Moderately Reduced Kidney Function
3B 30-44 Moderately Reduced Kidney Function
4 15-29 Severely Reduced Kidney Function
5 < 15  Very Severe or Endstage Kidney Failure 

 

Progression to End Stage Renal Disease


End-Stage Renal Disease (ESRD) occurs when the kidneys have lost complete or almost complete ability to work and can no longer provide day to day filtration for the blood. This is a severe condition as toxins begin to build up in the blood stream and in the urine that result in symptoms like [30, 58]:

  • headaches
  • nausea
  • weight loss
  • pain in the bones
  • severe thirst
  • swelling of hands and feet
  • vomiting

Those who progress into ESRD are moved to a waiting list for kidney transplants, or they are placed on dialysis for treatment [61].

 

 

Prevalence

The prevalence of CKD has continually grown in the last two decades. CKD is growing most rapidly in people over 60 years of age. 1 in 10 Americans (20 million people) have some level of CKD [7].  

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CKD Prevalence Chart

 

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Page Updated 03.20.2014