Chronic kidney disease

Chronic kidney disease (CKD) is a common condition that is often unrecognised until the most advanced stages.

Diagnosis is determined only by laboratory studies: proteinuria or haematuria, and/or a reduction in the glomerular filtration rate, for more than 3 months' duration.

The most common causes are diabetes mellitus and hypertension.

Glycaemic control for diabetic kidney disease and optimisation of blood pressures are key in slowing the progression of the disease. Use of agents that block the renin-angiotensin system and sodium-glucose co-transporter-2 (SGLT2) inhibitors have kidney function preserving benefits that are independent of blood pressure and glucose control.

CKD is a risk factor for cardiovascular disease, independent of comorbidities such as diabetes, hypertension, and dyslipidaemia.

Chronic kidney disease (CKD), also known as chronic renal failure, is defined as abnormalities of kidney structure or function, present for ≥3 months, with implications for health.[1]Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013 Jan;3(1):1-150. https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf This means a glomerular filtration rate less than 60 mL/minute/1.73 m², or the presence of one or more of the following markers of kidney damage: albuminuria/proteinuria, urine sediment abnormalities (e.g., haematuria), electrolyte abnormalities due to tubular disorders, abnormalities detected by histology, structural abnormalities detected by imaging, or history of kidney transplantation.[1]Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013 Jan;3(1):1-150. https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf

BMJ talk medicine: chronic kidney disease Opens in new window