Chronic kidney disease

Chronic kidney disease (CKD), also known as chronic renal failure, is a progressive loss in glomerular function caused by a long standing renal parenchymal disease. It is present when the glomerular filtration rate (GFR) is less than 60 ml/min/1.73 m² for 3 consecutive months or greater than or equal to this value in patients with a kidney damage that is present for 3 or more months ¹.

Epidemiology

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Clinical presentation

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ClassificationPathology

A variety of different diseases can affect and cause damage to the renal parenchyma, the most common are ²:

• diabetes
• hypertension
• glomerulonephritis 
• polycystic kidney disease

Classification

CKD is divided in five stages based on the GFR (ml/min/1.73 m²) ¹:

• >90 - Stage 1: kidney damage with normal or elevated GFR
• 60-89 - Stage 2: kidney damage with mild reduction in GFR
• 30-59 - Stage 3: moderate reduction in GFR
• 15-29 - Stage 4: severe reduction in GFR
• < 15 (or dialysis) - Stage 5: kidney failure 

The same conference ¹ suggests that CKD could also be classified by treatment type:

• kidney transplant recipient 
• CKD independent of dialysis
• CKD on dialysis

Radiographic features

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Treatment and prognosis 

Stage 3 CKD's patients patients are reported to be 20 times more likely to die of a cardiovascular event than to reach end-stage renal disease ³. Chronic vascular disease is a common CKD associated complication and deserves a special attention ¹. A large study evidenced that treatment and prevention of coronary artery disease, congestive heart failure, diabetes mellitus, and anemia should be the target treatment to reduce the mortality of patients with CKD ³.