Chronic kidney disease

March 2017


Definition


Chronic kidney disease (CKD) is a progressive and irreversible reduction in capabilities of the kidneys. Gradually, the latter become incapable of eliminating wastes and excess water in the body. Chronic kidney disease is assessed by measuring the glomerular filtration rate that reflects the capacity of the kidneys. Chronic renal failure is calculated with several factors including age, sex, and mainly creatinine levels in the blood, a protein found in the blood and excreted in the urine. In the case of CKD, the latter is less than 60 milliliters per minute over the course of 3 months or more. Based on this rate, kidney failure is categorized as moderate, severe or terminal. Generally speaking, chronic renal failure is due to a chronic renal disease evolution (nephropathy), diabetes or hypertension. Acute renal failure, appears abruptly and must be differentiated (treated separately).

Symptoms


Chronic kidney disease itself is not directly responsible for any clinical signs. The onset of symptoms is often concomitant with the appearance of complications. Symptoms of the disease in question can be found. The evolution of chronic renal failure may cause a heart murmur, increased arterial deposits responsible for diseases of the blood vessels (atherosclerosis), bone demineralization, but also many other diseases secondary to metabolic disorders.

Diagnosis


The diagnosis of CKD is done with a blood sample and the calculation by the laboratory of the glomerular filtration rate. Below 30 m/minute, it is considered to be a severe renal insufficiency, and below 15ml/min it is called terminal. The laboratory diagnosis is often supplemented with an ultrasound of the urinary tract which may show a decrease in kidney size. In this context, further tests must be performed such as a quantification of the amount of protein in the blood and a 24-hour collection of urine to look for any possible diseases.

Treatment


The management of chronic renal failure is based on a treatment of all the symptoms and the prevention of the appearance of others. Additionally, blood pressure should be closely monitored. At an advanced stage, kidney failure is called terminal, and replacement therapy of renal function is necessary. Pending kidney transplant, dialysis is a technique for replacing the functions performed by the kidneys that are no longer functional. Two methods are practiced: hemodialysis, performed several times a week in the hospital with the use of a machine that circulates purified blood and that ensures are proper evacuation of water retained in the body. The other technique can be done at home and makes use of the peritoneal membrane as a "filter".

Prevention


The occurrence of chronic renal failure is prevented by regular monitoring of glomerular filtration. Research and management of the disease in question permit the prevention of a progression of CKD.

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Published by Jeff.
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