Chronic Kidney Disease
(Chronic Renal Failure; Chronic Renal Disease; Chronic Renal Insufficiency)
Chronic kidney disease is a condition in which the kidneys are not working correctly. It is caused by damage to tiny structures within the kidneys called nephrons. In the early stages, chronic kidney disease does not cause symptoms; therefore, most people don’t know they have the condition.The kidneys are bean-shaped organs located in the lower back just below the rib cage. Each kidney is about the size of a fist. The two kidneys filter blood, catch needed substances, return them to the circulation, and dispose of wastes in the urine. If the kidneys don’t filter properly, wastes build up in the blood. The kidneys also maintain the balance of water in the body and release hormones. These hormones keep the bones strong, control blood pressure, and help the body make red blood cells. If your kidneys stop working, your bones may become weak, your blood pressure may increase, and your red blood cell count may decrease.
|Anatomy of the Kidneys|
|Copyright © Nucleus Medical Media, Inc.|
StagesChronic kidney disease is a progressive condition. Doctors use stages to describe how serious it is. The stage is based on the glomerular filtration rate (GFR).
|Stage||Glomerular Filtration Rate (GFR)|
|1||Over 90 mL/min (normal)|
|2||60 to 89 mL/min (mild decrease)|
|3||30 to 59 mL/min (moderate decrease)|
|4||15 to 29 mL/min (severe decrease)|
|5||under 15 mL/min (kidney failure or end-stage renal disease)|
CausesThe two most common causes of chronic kidney disease are diabetes and hypertension.
- Diabetes type 1 and type 2 occur when the body doesn’t process the sugar in the blood well. The amount of sugar in the blood increases. High blood glucose damages the kidneys, the heart, blood vessels, and eyes.
- Hypertension , also known as high blood pressure, occurs when there is high pressure within the arteries of the body. Hypertension damages the kidneys. Chronic kidney disease can also cause hypertension.
- Intrinsic renal disease such as polycystic kidney disease or glomerulonephritis
- Glomerular disease leading to renal damage
- Renal tubular disorders
- Diseases of the immune system such as lupus
- Kidney stones , tumors, or in men, an enlarged prostate , causing obstructive kidney diseases
- Recurrent urinary tract infections
- Toxic exposures
- Prolonged use of medications, such as ibuprofen, aspirin, or phenacetin
- Bilateral renal artery stenosis
- Viruses: hepatitis B , hepatitis C , or HIV
- Obstructive sleep apnea
- Tubular interstitial nephritis
ComplicationsChronic renal failure can cause many complications, including:
- High blood pressure
- Coronary heart disease and heart attacks
- High lipid levels in the blood
- Weak bones
- Anemia—low red blood cell count
- Weak immune system
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