Chronic kidney disease

chronic renal failurerenal insufficiencyend-stage renal diseasechronic kidney failureend-stage kidney diseaseend stage renal diseasekidney diseasekidney failurechronic renal diseasechronic renal insufficiency
Chronic kidney disease (CKD) is a type of kidney disease in which there is gradual loss of kidney function over a period of months or years.wikipedia
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Renal osteodystrophy

bone disease
Complications may include heart disease, high blood pressure, bone disease, or anemia. The concept of chronic kidney disease-mineral bone disorder (CKD-MBD) currently describes a broader clinical syndrome that develops as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of: 1) abnormalities of calcium, phosphorus (phosphate), parathyroid hormone, or vitamin D metabolism; 2) abnormalities in bone turnover, mineralization, volume, linear growth, or strength (renal osteodystrophy); and 3) vascular or other soft-tissue calcification. CKD-MBD has been associated to poor hard outcomes. Hypocalcemia, due to 1,25 dihydroxyvitamin D 3 deficiency (caused by stimulation of FGF-23 and reduction of renal mass), and resistance to the calcemic action of parathyroid hormone. Osteocytes are responsible for the increased production of FGF-23, which is a potent inhibitor of the enzyme 1-alpha-hydroxylase (responsible for the conversion of 25-hydroxycholecalciferol into 1,25 dihydroxyvitamin D 3 ). Later, this progresses to secondary hyperparathyroidism, renal osteodystrophy, and vascular calcification that further impairs cardiac function. An extreme consequence is the occurrence of the rare condition named calciphylaxis.
Renal osteodystrophy is currently defined as an alteration of bone morphology in patients with chronic kidney disease (CKD).

Kidney disease

renal diseasenephropathykidney damage
Chronic kidney disease (CKD) is a type of kidney disease in which there is gradual loss of kidney function over a period of months or years.
Chronic kidney disease causes the gradual loss of kidney function over time.

Diabetic nephropathy

diabetic kidney diseasenephropathydiabetic nephropathies
Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease.
Likewise, the estimated glomerular filtration rate (eGFR) may progressively fall from a normal of over 90 ml/min/1.73m 2 to less than 15, at which point the patient is said to have end-stage kidney disease (ESKD).

Glomerulonephritis

glomerular nephritisglomerulonephritis, membranoproliferativeglomerulus
Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. The most common cause of CKD as of 2015 is diabetes mellitus followed by high blood pressure and glomerulonephritis.
As it is not strictly a single disease, its presentation depends on the specific disease entity: it may present with isolated hematuria and/or proteinuria (blood or protein in the urine); or as a nephrotic syndrome, a nephritic syndrome, acute kidney injury, or chronic kidney disease.

Renal function

glomerular filtration ratekidney functioncreatinine clearance
Chronic kidney disease (CKD) is a type of kidney disease in which there is gradual loss of kidney function over a period of months or years. Potassium accumulates in the blood (hyperkalemia with a range of symptoms including malaise and potentially fatal cardiac arrhythmias). Hyperkalemia usually does not develop until the glomerular filtration rate falls to less than 20–25 ml/min/1.73 m 2, at which point the kidneys have decreased ability to excrete potassium. Hyperkalemia in CKD can be exacerbated by acidemia (which leads to extracellular shift of potassium) and from lack of insulin.
Staging of chronic kidney disease is based on categories of GFR as well as albuminuria and cause of kidney disease.

Hypertension

high blood pressurehypertensivearterial hypertension
Complications may include heart disease, high blood pressure, bone disease, or anemia. Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. Blood pressure is increased due to fluid overload and production of vasoactive hormones created by the kidney via the renin–angiotensin system, increasing one's risk of developing hypertension and/or suffering from congestive heart failure. The most common cause of CKD as of 2015 is diabetes mellitus followed by high blood pressure and glomerulonephritis.
Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease, and dementia.

Renal biopsy

kidney biopsyComplications
Further tests such as an ultrasound or kidney biopsy may be done to determine the underlying cause.
Kidney failure (or impaired kidney function due to kidney injury) can occur abruptly (acute kidney failure) or progress over a period of time (chronic kidney disease). The cause of acute kidney failure can usually be determined without kidney biopsy. Biopsy is performed in those instances where the cause is uncertain.

Nonsteroidal anti-inflammatory drug

non-steroidal anti-inflammatory drugNSAIDsnonsteroidal anti-inflammatory drugs
NSAIDs should be avoided.
NSAIDs are also associated with a fairly high incidence of adverse drug reactions (ADRs) on the kidney and over time can lead to chronic kidney disease.

Hyperkalemia

high blood potassiumhyperkalaemiahigh blood potassium levels
Potassium accumulates in the blood (hyperkalemia with a range of symptoms including malaise and potentially fatal cardiac arrhythmias). Hyperkalemia usually does not develop until the glomerular filtration rate falls to less than 20–25 ml/min/1.73 m 2, at which point the kidneys have decreased ability to excrete potassium. Hyperkalemia in CKD can be exacerbated by acidemia (which leads to extracellular shift of potassium) and from lack of insulin.
Decreased kidney function is a major cause of hyperkalemia.

Polycystic kidney disease

polycystic kidneyAutosomal dominant polycystic kidney diseasepolycystic kidney diseases
Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease.
Studies show that 10% of end-stage kidney disease (ESKD) patients being treated with dialysis in Europe and the U.S. were initially diagnosed and treated for ADPKD.

Peritoneal dialysis

continuous ambulatory peritoneal dialysisCAPD systemsAmbulatory Peritoneal Dialysis
Severe disease may require hemodialysis, peritoneal dialysis, or a kidney transplant.
There is insufficient research to adequately compare the risks and benefits between CAPD and APD; a Cochrane Review of three small clinical trials found no difference in clinically important outcomes (i.e. morbidity or mortality) for patients with end stage renal disease, nor was there any advantage in preserving the functionality of the kidneys.

Chronic kidney disease-mineral and bone disorder

chronic kidney disease-mineral bone disorder (CKD-MBD)chronic kidney disease–mineral and bone disorder
The concept of chronic kidney disease-mineral bone disorder (CKD-MBD) currently describes a broader clinical syndrome that develops as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of: 1) abnormalities of calcium, phosphorus (phosphate), parathyroid hormone, or vitamin D metabolism; 2) abnormalities in bone turnover, mineralization, volume, linear growth, or strength (renal osteodystrophy); and 3) vascular or other soft-tissue calcification. CKD-MBD has been associated to poor hard outcomes.
Chronic kidney disease–mineral and bone disorder (CKD-MBD) is one of the many complications associated with chronic kidney disease.

Blood pressure

systolic blood pressurediastolic blood pressurearterial blood pressure
Blood pressure is increased due to fluid overload and production of vasoactive hormones created by the kidney via the renin–angiotensin system, increasing one's risk of developing hypertension and/or suffering from congestive heart failure.
Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysms, and is the leading cause of chronic kidney failure.

Erythropoietin

EPOrecombinant EPOerythropoetin
Erythropoietin synthesis is decreased causing anemia.
ESAs are used in the treatment of anemia in chronic kidney disease, anemia in myelodysplasia, and in anemia from cancer chemotherapy.

Diabetes mellitus

diabetesdiabeticdiabetics
The most common cause of CKD as of 2015 is diabetes mellitus followed by high blood pressure and glomerulonephritis.
Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.

Calciphylaxis

vascular calcification
Hypocalcemia, due to 1,25 dihydroxyvitamin D 3 deficiency (caused by stimulation of FGF-23 and reduction of renal mass), and resistance to the calcemic action of parathyroid hormone. Osteocytes are responsible for the increased production of FGF-23, which is a potent inhibitor of the enzyme 1-alpha-hydroxylase (responsible for the conversion of 25-hydroxycholecalciferol into 1,25 dihydroxyvitamin D 3 ). Later, this progresses to secondary hyperparathyroidism, renal osteodystrophy, and vascular calcification that further impairs cardiac function. An extreme consequence is the occurrence of the rare condition named calciphylaxis.
It is seen mostly in people with end-stage kidney disease but can occur in the earlier stages of chronic kidney disease and rarely in people with normally functioning kidneys.

Secondary hyperparathyroidism

hyperparathyroidism, secondary
Hypocalcemia, due to 1,25 dihydroxyvitamin D 3 deficiency (caused by stimulation of FGF-23 and reduction of renal mass), and resistance to the calcemic action of parathyroid hormone. Osteocytes are responsible for the increased production of FGF-23, which is a potent inhibitor of the enzyme 1-alpha-hydroxylase (responsible for the conversion of 25-hydroxycholecalciferol into 1,25 dihydroxyvitamin D 3 ). Later, this progresses to secondary hyperparathyroidism, renal osteodystrophy, and vascular calcification that further impairs cardiac function. An extreme consequence is the occurrence of the rare condition named calciphylaxis.
Chronic kidney failure is the most common cause of secondary hyperparathyroidism.

Uremic frost

Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). Due to its high systemic circulation, urea is excreted in eccrine sweat at high concentrations and crystallizes on skin as the sweat evaporates ("uremic frost").
Uremic frost is a colloquial description for crystallized urea deposits that can be found on the skin of those affected by chronic kidney disease.

Uremia

uraemiauremicuremic toxin
Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). Due to its high systemic circulation, urea is excreted in eccrine sweat at high concentrations and crystallizes on skin as the sweat evaporates ("uremic frost").
These include acute and chronic kidney failure, acute and chronic glomerular nephritis, tubular necrosis and other kidney diseases.

Mesoamerican nephropathy

Mesoamerican nephropathy, a form of CKDu, is "a new form of kidney disease that could be called agricultural nephropathy".
Mesoamerican nephropathy (MeN) is a currently unexplained epidemic of chronic kidney disease of unknown origin (CKDu), prevalent in the Pacific Ocean coastal low lands of the Mesoamerican region, including southern Mexico, Guatemala, El Salvador, Nicaragua, Honduras and Costa Rica.

Anemia

anaemiaanemicanaemic
Complications may include heart disease, high blood pressure, bone disease, or anemia. Erythropoietin synthesis is decreased causing anemia.
They are not recommended in people with chronic kidney disease unless hemoglobin levels are less than 10 g/dL or they have symptoms of anemia.

Focal segmental glomerulosclerosis

focal segmental glomerular sclerosisfocal and segmental glomerulosclerosisfocally
Primary glomerular disease such as focal segmental glomerulosclerosis and IgA nephropathy (or nephritis)
The collapsing variant is associated with higher rate of progression to end-stage renal disease, whereas glomerular tip lesion variant has a low rate of progression to end-stage renal disease in most patients.

Reflux nephropathy

renal scar
Tubulointerstitial disease includes drug- and toxin-induced chronic tubulointerstitial nephritis, and reflux nephropathy.
The end results of reflux nephropathy can include high blood pressure, excessive protein loss in the urine, and eventually kidney failure.

Kidney failure

renal failurekidney problemsrenal impairment
Established kidney failure (GFR
It is divided into acute kidney failure (cases that develop rapidly) and chronic kidney failure (those that are long term).

Calcifediol

calcidiol25-hydroxyvitamin D25-hydroxycholecalciferol
Hypocalcemia, due to 1,25 dihydroxyvitamin D 3 deficiency (caused by stimulation of FGF-23 and reduction of renal mass), and resistance to the calcemic action of parathyroid hormone. Osteocytes are responsible for the increased production of FGF-23, which is a potent inhibitor of the enzyme 1-alpha-hydroxylase (responsible for the conversion of 25-hydroxycholecalciferol into 1,25 dihydroxyvitamin D 3 ). Later, this progresses to secondary hyperparathyroidism, renal osteodystrophy, and vascular calcification that further impairs cardiac function. An extreme consequence is the occurrence of the rare condition named calciphylaxis.
#* Patients with osteoporosis, chronic kidney disease, malabsorption, obesity, and some other infections may be high risk and thus have greater indication for this test.