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Posted: January 28th, 2022

Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney

Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over time. It is the progressive loss of renal function associated with systemic diseases such as hypertension, diabetes mellitus (most significant risk factor), hypertension, systemic lupus erythematosus, or intrinsic kidney disease, including acute kidney injury, chronic glomerulonephritis, chronic pyelonephritis, obstructive uropathies, or vascular disorders (McCance et al., 2018, p. 1267). It is referenced to a declining Glomerular filtration rate (GFR), which shows the kidneys filtration rate and tells how the kidneys are functioning and filter blood. CKD decreases filtration and tubular functions that is shown throughout all organs in the body. Decreased renal function interferes with the kidneys’ ability to maintain fluid and electrolyte homeostasis. The ability to concentrate urine declines early and is followed by decreases in ability to excrete excess phosphate, acid, and potassium which is reflected in the GFR. Obtaining a complete medical history of the patient and family history is crucial when identifying risks for decreased kidney function. Doctors determine the stage of kidney disease using the glomerular filtration rate (GFR), a math formula using a person’s age, gender, and their serum creatinine level (identified through a blood test). Creatinine, a waste product that comes from muscle activity, is a key indicator of kidney function. When kidneys are working well they remove creatinine from the blood; but as kidney function slows, blood levels of creatinine rise. Lab tests such as complete urinalysis (U/A), urine albumin-to-creatinine ratio (UACR), creatinine with estimated GFR, blood urea nitrogen (BUN), electrolytes, glucose, calcium, phosphorus, albumin, and a complete blood count (CBC) are used in diagnosing CKD and determining the level of kidney disease in an individual. CKD is divided into five different levels and depending on the level of the GFR will assist in determining what additional diagnostic work ups are needed (Chen et al., 2019, p. 1295).

Reference

Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic Kidney Disease Diagnosis and Management: A Review. JAMA, 322(13), 1294–1304. https://doi.org/10.1001/jama.2019.14745

McCance K., L., & Huether, S., E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.) St Louis, MO: Mosby Inc; ISBN-13: 978-0323583473

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