Chronic kidney disease.
Chronic kidney disease is a common, progressive condition defined by reduced glomerular filtration rate or markers of kidney damage persisting beyond three months, and it markedly raises the risk of cardiovascular disease and premature death.
Background
Chronic kidney disease (CKD) is defined by decreased kidney function (glomerular filtration rate below 60 ml/min/1.73 m2) or markers of kidney damage, or both, of at least 3 months duration, regardless of underlying cause. It affects a large share of the population worldwide, is more prevalent with older age, diabetes, and hypertension, and is frequently asymptomatic until later stages, so diagnosis is often made through screening or once symptoms become severe.
Key recommendations
Diabetes and hypertension are the leading causes of CKD in most countries. Classification and risk stratification use glomerular filtration rate and albuminuria together with the underlying cause. Management centers on treating the underlying cause where possible, blood pressure control, renin-angiotensin system inhibition, reduction of proteinuria, cardiovascular risk reduction, avoidance of nephrotoxins, and monitoring for complications such as anemia and mineral and bone disorder.
Clinical implications
People with CKD are far more likely to die prematurely, largely from cardiovascular disease, than to progress to end-stage kidney disease, and the risk rises as kidney function declines. Early detection, risk-based personalized care, and timely nephrology referral for advanced or rapidly progressive disease are emphasized to reduce the substantial individual and public health burden of CKD.
Category
Research
Source
Nat Rev Dis Primers
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