Chronic Kidney Disease I: Introduction

Chronic Kidney Disease, or CKD, involves a progressive and gradual loss of kidney function leading to End-stage kidney disease, which necessitates dialysis or a kidney transplant for survival.

In early-stage CKD, symptoms are often absent as functional nephrons compensate for damaged ones, maintaining kidney function until significant nephron loss occurs, making early detection challenging.

Major risk factors for CKD include diabetes, which damages kidney blood vessels, and hypertension, which increases pressure within the kidney's filtering units. Additional risk factors include obesity, smoking, aging, and genetic predisposition.

The pathophysiology of CKD begins with damage to nephrons, triggering compensatory mechanisms in the remaining nephrons.

As more nephrons are lost, the kidneys' filtering ability declines, leading to a build-up of waste substances like urea and creatinine in the blood—a condition called uremia that can impair multiple organ systems.

Additionally, proteinuria often signals further glomerular injury. Uncontrolled high blood pressure worsens this damage, accelerating CKD progression.