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Chronic Kidney Disease
Chronic Renal Disease

Images

WIKIDATA, CC BY-SA 3.0
WIKIDATA, CC BY 4.0
WIKIDATA, CC BY 4.0
WIKIDATA, CC BY 4.0
WIKIDATA, CC BY 4.0
WIKIDATA, CC BY-SA 3.0

Presentation

A 34-year-old man with severe kidney function loss secondary to renal TB initially presented with urinary symptoms, including dysuria and polacyuria. [ncbi.nlm.nih.gov]

Fever may be present without local signs. Clotting of the vascular access presents as loss of normal bruit or palpable thrill. There may be signs or symptoms of distal limb ischemia. [emedicine.com]

Entire Body System

  • Anemia

    The thyroid gland function should be assessed both in differential diagnostics of anemia and in case of unsatisfactory treatment with ESA. [ncbi.nlm.nih.gov]

    It also suggests that factors causing the anemia, not the anemia itself, have adverse consequences. [content.nejm.org]

    The high rates of heart disease and anemia in the patients who died are consistent with the hypothesis that anemia accelerates the progression of heart disease and increases the risk of death. [archinte.ama-assn.org]

  • Fatigue

    The Vitality and Physical functioning domains of the SF-36 and the FACT-An Total, Fatigue and Anemia subscales were identified as domains relevant to CKD-associated anemia. [ncbi.nlm.nih.gov]

    Symptoms develop slowly and in advanced stages include anorexia, nausea, vomiting, stomatitis, dysgeusia, nocturia, lassitude, fatigue, pruritus, decreased mental acuity, muscle twitches and cramps, water retention, undernutrition, peripheral neuropathies [msdmanuals.com]

    We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]

    General symptoms of CKD include: Fatigue, weakness, lack of energy and pale skin due to anemia Loss of appetite, nausea, and vomiting Frequent urination, especially at night Fluid retention, swelling around legs and eyes Itching Headaches Numbness in [kibowbiotech.com]

  • Weight Gain

    Dialysis started one year later, and was followed by weight gain of about 5 kg. [ncbi.nlm.nih.gov]

    "Exercise may have an array of health benefits to these patients ranging from keeping their diabetes under control, maintaining healthy muscles and blood vessels to controlling weight gains after a transplant that are associated with prescribed medications [sciencedaily.com]

    Physical activity can help lower blood pressure, control diabetes, and prevent weight gain. Ask your health care provider about physical activities that would be right for you. Avoid certain drugs and supplements. [choosingwiselycanada.org]

    For those taking prednisone for long periods of time, these effects can be significant, including weight gain (especially around the face and trunk), moodiness, sleep disturbances, cataracts, and osteoporosis (weakening of the bones). [kidshealth.org]

  • Leg Edema

    Symptoms can include: Dry, itchy skin Nausea and vomiting Loss of appetite Fatigue Weight loss or weight gain Headaches Swelling in the legs (edema) Trouble sleeping Changes in urination Metallic taste in the mouth Joint problems Muscle cramps Shortness [health.ucsd.edu]

  • Laboratory Technician

    Patricia Orellana de Figueroa, laboratory technician. Coordinator of national clinical laboratory network, National Health Institute, MINSAL, San Salvador, El Salvador. [medicc.org]

Gastrointestinal

  • Nausea

    A 69-year-old male was admitted to the hospital with a chief complaint of abdominal pain, nausea, and vomiting. He had an extensive past medical history, including diabetes mellitus type 2 and chronic kidney disease stage III. [ncbi.nlm.nih.gov]

    Symptoms develop slowly and in advanced stages include anorexia, nausea, vomiting, stomatitis, dysgeusia, nocturia, lassitude, fatigue, pruritus, decreased mental acuity, muscle twitches and cramps, water retention, undernutrition, peripheral neuropathies [msdmanuals.com]

    General symptoms of CKD include: Fatigue, weakness, lack of energy and pale skin due to anemia Loss of appetite, nausea, and vomiting Frequent urination, especially at night Fluid retention, swelling around legs and eyes Itching Headaches Numbness in [kibowbiotech.com]

    These include fatigue, drowsiness, decrease in urination or inability to urinate, dry skin, itchy skin, headache, weight loss, nausea, bone pain, skin and nail changes and easy bruising. [hopkinsmedicine.org]

  • Polydipsia

    […] intake to prevent disease such as nephrolithiasis; ( 2 ) those who need a high fluid intake to compensate for a underlying disease, such as renal or central diabetes insipidus or salt-wasting nephropathy; and ( 3 ) those who have conditions such as polydipsia [cjasn.asnjournals.org]

Cardiovascular

  • Hypertension

    AND chronic kidney disease Hypertensive heart AND chronic kidney disease with congestive heart failure Hypertensive heart and CKD Hypertensive heart and CKD, w CHF Hypertensive heart and kidney disease Hypertensive heart and kidney disease with chf Hypertensive [icd9data.com]

    Most common was chronic kidney disease of unknown cause, associated with neither diabetes nor hypertension. [ncbi.nlm.nih.gov]

    McClellan WTuttle EIssa A Racial differences in the incidence of hypertensive end-stage renal disease (ESRD) are not entirely explained by differences in the prevalence of hypertension. [doi.org]

Musculoskeletal

  • Increased Muscle Mass

    Increased muscle mass or increased protein intake could also have increased the mean serum creatinine concentration. [jama.ama-assn.org]

Neurologic

  • Lethargy

    Symptoms of anaemia include: tiredness lethargy shortness of breath (dyspnoea) palpitations (awareness of heartbeat) Anaemia can occur because of many other conditions and your doctor will investigate to rule out any other possible causes. [hse.ie]

    Case study 2 June, 83 years of age, is a female nursing home resident with a 3 month history of lethargy, anorexia and itch. [racgp.org.au]

    Encephalopathy, a condition in which the brain malfunctions, may ensue and lead to confusion, lethargy, and seizures. Heart failure may cause shortness of breath. Body swelling may develop, particularly in the legs. [merckmanuals.com]

    Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). [en.wikipedia.org]

Workup

Acute Kidney Injury Workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/243492-workup#c13. Accessed May 2016. (April 2014) Seaborg E. New Biomarkers Offer Hope for Identifying Acute Kidney Injury Risk. [labtestsonline.it]

Other benefits of early nephrology referral include proper patient education regarding options for renal replacement therapy as well as pre-emptive transplantation, and timely workup and placement of an arteriovenous fistula in those patients opting for [en.wikipedia.org]

[…] stenosis, renal atheroembolic disease, atherosclerosis with aortorenal occlusion, and certain cases of necrotizing vasculitis (eg, polyarteritis nodosa) Renal biopsy: Can be useful in identifying intrarenal causes of AKI and directing targeted therapy See Workup [emedicine.com]

The increasing sensitivity of cTn assays has had a dramatic impact on the use of cTn testing, which is now an essential component of the diagnostic workup and management of acute coronary syndromes (ACS). [journal.frontiersin.org]

Serum

  • Glomerular Filtration Rate Decreased

    Her estimated glomerular filtration rate decreased from an admission value of 34 mL/min/1.73 m2 to 13 mL/min/1.73 m2. CT scan showed retroperitoneal haematoma. [ncbi.nlm.nih.gov]

Other Pathologies

  • Lymphocytic Infiltrate

    infiltration associated with glomerular atrophy and glomerular loss.[19] CKD in Sri Lanka is characterized by tubular proteinuria—usually alpha 1 and beta 2 microglobulin and elevated tubular proteinuria due to NGAL (>300 ng/mg creatinine/dL)—without [medicc.org]

Treatment

Since there are limited treatments for CKD, others with CKD may benefit from acupuncture and herbal treatments. [ncbi.nlm.nih.gov]

Few studies have examined the safety and efficacy of pharmacotherapy for treatment of dyslipidemia in the CKD population, and ongoing studies such as the Study of Heart and Renal Protection (SHARP) should help clarify the current treatment guidelines. [doi.org]

Prognosis

The Kaplan-Meier survival curves demonstrated that patients with a higher TFF1 and TFF3 alone, or in combination with macroalbuminuria, had a significantly worse renal prognosis. [ncbi.nlm.nih.gov]

Chronic Kidney Disease Prognosis Consortium (CKD-PC) is a research group composed of investigators representing cohorts from around the world. Investigators share data for the purpose of collaborative meta-analyses to study prognosis in CKD. [jhsph.edu]

Etiology

Especially in children, early diagnosis and detection of the etiologic factors are important to improve their health outcomes. [ncbi.nlm.nih.gov]

Clinical presentation depends a lot on etiology. Children with chronic kidney disease can have growth disorder, edema and cola colored urine (due to RBC casts). [radiopaedia.org]

Epidemiology

Long Beach, the Department of Epidemiology, University of California, Los Angeles (UCLA), and the Los Angeles Biomedical Research Institute at Harbor–UCLA, Torrance — all in California (K.K. [doi.org]

Several recent epidemiologic studies have shown that obesity and the metabolic syndrome are independent predictors of CKD. [cjasn.asnjournals.org]

A cross-sectional analytical epidemiological study was conducted based on active screening for chronic kidney disease and risk factors in persons aged ≥18 years during 2009-2011. [ncbi.nlm.nih.gov]

Pathophysiology

This pathophysiological cascade is still incompletely understood. Patients with advanced CKD and dialysis patients are especially at risk to develop CUA. [ncbi.nlm.nih.gov]

Aging and the Kidney: Clinical and Pathophysiological Issues Introduction Pathophysiology Pathogenesis Diagnosis Treatment Summary References Chapter 12. [elsevier.com]

Prevention

Prevention It is not too ambitious to consider CKD prevention. Hypertension and diabetes are the major causes of CKD in developed nations. [jasn.asnjournals.org]

Treating the condition that is causing the problem may help prevent or delay CKD. People who have diabetes should control their blood sugar and blood pressure levels and should not smoke. [nlm.nih.gov]

Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. JAMA. 1998 ; 279 : 1615–1622. [circ.ahajournals.org]

The results of the Diabetes Prevention Program (DPP) funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) show that moderate exercise, a healthier diet, and weight reduction can prevent the development of type 2 diabetes [healthypeople.gov]

Kidney Diseases Precautions for Healthy Person Precautions for Kidney Patients Prevention of Acute Kidney Failure Prevention of Polycystic Kidney Disease Precautions for Single Kidney Patients Prevention of Kidney Stone Disease Prevention of Urinary [kidneyeducation.com]

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