Chronic Kidney Disease (CKD)

What it is

CKD is defined by reduced eGFR or kidney damage markers (e.g. persistent albuminuria) for >3 months. Staging is by eGFR (G1–G5) and albuminuria category (A1–A3), combined into a risk-stratified grid.

Why it matters

• Affects ~10% of adults globally.
• Powerful independent cardiovascular risk factor (CKD patients are far more likely to die of CVD than to reach end-stage renal disease).
• Requires dose adjustment for many drugs.
• End-stage CKD (G5) requires renal replacement (dialysis, transplant) with major quality-of-life and mortality implications.

Major causes

• Diabetes (#1 cause globally).
• Hypertension.
• Glomerulonephritis.
• Polycystic kidney disease (genetic).
• Repeated AKI episodes.
• NSAID overuse.

What slows progression

• Tight blood-pressure control (target ~<130/80).
• SGLT2 inhibitors (now also approved in non-diabetic CKD).
• ACE inhibitors / ARBs when proteinuric.
• Treating diabetes intensively.
• Avoiding nephrotoxins (NSAIDs, contrast when avoidable).
• Treatment of metabolic acidosis, hyperphosphataemia, anaemia.

Monitoring

eGFR + urine albumin:creatinine ratio annually in at-risk adults. Cystatin-C based eGFR more accurate in low-muscle adults.

Related entries

eGFR, SGLT2 inhibitors, Type 2 diabetes, Klotho.