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Chronic Kidney Insufficiency

Chronic Kidney Failure

Chronic kidney insufficiency affects a significant number of individuals in the developed countries, particularly the United States. The progressive nature of the disease and a substantial reduction in the quality of life over the period of time are the primary reasons why an early diagnosis is crucial. Anemia, progressive bone loss, cardiovascular pathologies such as hypertension and heart failure, as well as dyslipidemia are the most important long-term complications of chronic kidney disease. A complete laboratory workup and determination of the stage of kidney insufficiency are crucial steps in order to optimize treatment and determine the prognosis.


Presentation

Individuals suffering from chronic kidney insufficiency are at risk of developing cardiovascular, skeletal, and metabolic complications, which is why their quality of life progressively declines over the course of years [1] [2] [3] [4]. One of the most prevalent signs of chronic kidney insufficiency is anemia, seen in up to 50% of cases [1] [4]. Anemia stems from the inability of the damaged kidneys to produce erythropoietin, thus promoting various cardiovascular disorders, such as left ventricular hypertrophy, hypertension, angina, and heart failure [1] [4]. In fact, drowsiness, fatigue, and an overall lack of energy are encountered in the majority of patients, along with pruritus and pain [5]. Dyslipidemia is a frequent finding and contributes to the appearance of cardiovascular diseases, which is the cause of death in up to 40% of cases [1] [6]. Renal osteodystrophy is a term denoting the pathological changes of the skeletal system that arise in the setting of chronic kidney disease and its four subtypes (osteitis fibrosa cystica, osteomalacia, adynamic bone disease, and mixed osteodystrophy) are responsible for abnormal rates of bone loss and bone growth in these patients, as well as persistent albuminuria and proteinuria [1]. Electrolyte and hormone abnormalities (particularly hyperphosphatemia and changes in the levels of parathyroid hormone, or PTH) arise at later stages and have a severe effect on morbidity [1] [6].

Easy Bruising
  • bruising and bleeding blood in your stools hiccups excessive thirst decreased interest in sex impotence insomnia sleep apnea You may also have the symptoms of any diseases that are contributing to your kidney problems.[healthline.com]
  • bruising, or blood in the stool Excessive thirst Frequent hiccups Problems with sexual function Menstrual periods stop (amenorrhea) Shortness of breath Sleep problems Vomiting Exams and Tests Most people will have high blood pressure at all stages of[ufhealth.org]
  • […] especially at night (nocturia); swelling of the legs and puffiness around the eyes (fluid retention); high blood pressure; fatigue and weakness (from anemia or accumulation of waste products in the body); loss of appetite, nausea and vomiting; itching, easy[emedicinehealth.com]
Anemia
  • We call this interrelationship between congestive heart failure, chronic kidney insufficiency, and anemia the Cardio-Renal Anemia syndrome.[ncbi.nlm.nih.gov]
  • One of the most prevalent signs of chronic kidney insufficiency is anemia, seen in up to 50% of cases.[symptoma.com]
  • In addition, dietary changes and treatment to relieve specific symptoms such as anemia and high blood pressure are critical to the treatment process.[medical-dictionary.thefreedictionary.com]
  • Anemia of CKD: A common problem Anemia of CKD is one of the first signs of kidney dysfunction, yet it often goes undetected because of its insidious onset.[mdedge.com]
Fatigue
  • In fact, drowsiness, fatigue, and an overall lack of energy are encountered in the majority of patients, along with pruritus and pain.[symptoma.com]
  • End stage renal disease causes weight loss, nausea and vomiting, fatigue, difficulty breathing and seizures. If left untreated, end stage renal disease is a fatal condition. At this stage, dialysis or a kidney transplant is usually needed.[kidneyandhypertensioncare.com]
  • Increased fatigue. Toxic substances in the blood and the presence of anemia may cause feelings of exhaustion. Itching. Phosphorus, which is typically eliminated in the urine, accumulates in the blood of patients with kidney failure.[medical-dictionary.thefreedictionary.com]
  • The waste buildup can make you sick and you may have these symptoms: swelling of the ankles, face or belly, vomiting, loss of appetite, fatigue, weakness, confusion and headaches.[heart.org]
  • Lassitude, fatigue, anorexia, and decreased mental acuity often are the earliest manifestations of uremia.[merckmanuals.com]
Weight Loss
  • This can lead to malnutrition and weight loss. Diagnosis Kidney failure is typically diagnosed and treated by a nephrologist, a doctor that specializes in treating the kidneys.[medical-dictionary.thefreedictionary.com]
  • Treatment can also prevent and manage complications of CKD, such as: fluid overload congestive heart failure anemia brittle bones weight loss electrolyte imbalance Controlling underlying problems, such as hypertension and diabetes, can slow the progression[healthline.com]
  • Symptoms may include: Appetite loss General ill feeling and fatigue Headaches Itching ( pruritus) and dry skin Nausea Weight loss without trying to lose weight Symptoms that may occur when kidney function has gotten worse include: Abnormally dark or light[ufhealth.org]
  • Adults can have non-specific symptoms like nausea, vomiting, weight loss, and easy fatigability. Hypertension is common in adults with chronic kidney disease.[radiopaedia.org]
Weakness
  • The waste buildup can make you sick and you may have these symptoms: swelling of the ankles, face or belly, vomiting, loss of appetite, fatigue, weakness, confusion and headaches.[heart.org]
  • That can cause swelling in your ankles, nausea, weakness, poor sleep, and shortness of breath. Without treatment, the damage can get worse and your kidneys may eventually stop working. That’s serious, and it can be life-threatening.[webmd.com]
  • Lethargy Weakness Shortness of breath Generalized swelling ( edema ) Generalized weakness due to anemia Loss of appetite Lethargy Fatigue Congestive heart failure Metabolic acidosis High blood potassium ( hyperkalemia ) Fatal heart rhythm disturbances[medicinenet.com]
  • Patients will have to undergo dialysis treatments several times a week and may become very weak and fragile. Certain dietary changes may be necessary during dialysis treatment, including limiting fluids and salt and maintaining a low-protein diet.[kidneyandhypertensioncare.com]
  • […] and break easily pericarditis, when the sac-like membrane around the heart becomes inflamed stomach ulcers weak immune system Prevention Managing the chronic condition Some conditions increase the risk of chronic kidney disease (such as diabetes).[medicalnewstoday.com]
Pallor
  • […] ankles Frequent urination or, in children 5 years or older, prolonged bedwetting Stunted or poor growth, as compared to similar age group peers Loss of appetite and chronic nausea Fatigue Frequent severe headaches from high blood pressure Anemia and pallor[healthychildren.org]
Nausea
  • Nausea, loss of appetite, and vomiting. Urea in the gastric juices may cause upset stomach. This can lead to malnutrition and weight loss.[medical-dictionary.thefreedictionary.com]
  • The symptoms of hypercalcemia include: Feeling tired Difficulty thinking clearly Loss of appetite Nausea Vomiting Constipation Increased thirst Increased urination Weight loss Other side effects of Vitamin D include: Diarrhea Nausea Swelling Allergic[emedicinehealth.com]
  • Feeling of nausea or vomiting. Muscle cramps. Darkness of skin. Cleveland Clinic News & More Cleveland Clinic News & More[my.clevelandclinic.org]
  • Diet may also help alleviate symptoms of nausea. Salt intake must be carefully regulated to control hypertension. Potassium and phosphorus consumption, over time, may also need to be restricted.[medicalnewstoday.com]
  • Adults can have non-specific symptoms like nausea, vomiting, weight loss, and easy fatigability. Hypertension is common in adults with chronic kidney disease.[radiopaedia.org]
Vomiting
  • Nausea, loss of appetite, and vomiting. Urea in the gastric juices may cause upset stomach. This can lead to malnutrition and weight loss.[medical-dictionary.thefreedictionary.com]
  • Feeling of nausea or vomiting. Muscle cramps. Darkness of skin. Cleveland Clinic News & More Cleveland Clinic News & More[my.clevelandclinic.org]
  • Call your doctor immediately if you: Have symptoms of uremic syndrome, such as increasing fatigue, nausea and vomiting, loss of appetite, or inability to sleep. Vomit blood or have blood in your stools.[uwhealth.org]
  • The waste buildup can make you sick and you may have these symptoms: swelling of the ankles, face or belly, vomiting, loss of appetite, fatigue, weakness, confusion and headaches.[heart.org]
  • Adults can have non-specific symptoms like nausea, vomiting, weight loss, and easy fatigability. Hypertension is common in adults with chronic kidney disease.[radiopaedia.org]
Loss of Appetite
  • Nausea, loss of appetite, and vomiting. Urea in the gastric juices may cause upset stomach. This can lead to malnutrition and weight loss.[medical-dictionary.thefreedictionary.com]
  • Loss of appetite. Swelling of hands and feet. A feeling of itchiness. Numbness. Feeling of nausea or vomiting. Muscle cramps. Darkness of skin. Cleveland Clinic News & More Cleveland Clinic News & More[my.clevelandclinic.org]
  • The waste buildup can make you sick and you may have these symptoms: swelling of the ankles, face or belly, vomiting, loss of appetite, fatigue, weakness, confusion and headaches.[heart.org]
  • Uremic gastroenteropathy leads to a loss of appetite and nausea. Pruritus occurs and muscle fibrillations become apparent.[lecturio.com]
Hiccup
  • […] skin, called uremic frost drowsiness mental cloudiness numbness in your hands and feet restless leg syndrome brittle hair and nails itching weight loss a loss of muscle mass muscle twitching and cramps easy bruising and bleeding blood in your stools hiccups[healthline.com]
  • […] worse include: Abnormally dark or light skin Bone pain Drowsiness or problems concentrating or thinking Numbness or swelling in the hands and feet Muscle twitching or cramps Breath odor Easy bruising, or blood in the stool Excessive thirst Frequent hiccups[ufhealth.org]
  • Other signs and symptoms include: Unintentional weight loss or weight gain Headache, trouble concentrating Pruritus, dry itchy skin, uremic frost Frequent hiccups, poor appetite, excessive thirst Nighttime muscle cramps, swollen ankles Oliguria, or increased[library.ahima.org]
Constipation
  • Supplements and medication Your treatment may involve: iron and vitamin supplements to manage anemia calcium and vitamin D supplements erythropoietin injections to stimulate the production of red blood cells phosphate binders stool softeners for constipation[healthline.com]
  • All phosphate binders may cause constipation , nausea, vomiting , bowel obstruction, and fecal impaction. Phosphate binders may interfere with the absorption of other medications if these are taken together.[emedicinehealth.com]
Metallic Taste
  • Common signs and symptoms of CKD include difficulty urinating ( dysuria ), dizziness, foamy urine, frequent urination at night ( nocturia ), metallic taste (dysgeusia), swelling of the feet, ankles, feet, hands, or face ( edema ), and others.[verywell.com]
  • Common adverse drug reactions of these drugs include: Hypotension ( low blood pressure ) Cough Hyperkalemia (high potassium) Headache Dizziness Fatigue Nausea Skin rash A metallic taste in the mouth Diarrhea Indigestion Abnormal liver function Muscle[emedicinehealth.com]
  • Have a metallic taste in your mouth. Have severe itching. What Happens At first with chronic kidney disease, your kidneys are still able to regulate the balance of fluids, salts, and waste products in your body.[uwhealth.org]
Dysgeusia
  • Common signs and symptoms of CKD include difficulty urinating ( dysuria ), dizziness, foamy urine, frequent urination at night ( nocturia ), metallic taste (dysgeusia), swelling of the feet, ankles, feet, hands, or face ( edema ), and others.[verywell.com]
  • 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[merckmanuals.com]
Diastolic Hypertension
  • […] period are: Above 4 mg per deciliter OR At a clearance level of 20 ml or lower per minute AND You experience at least one of the following complications: Renal osteodystropy Motor or sensory nephropathy Chronic fluid overload syndrome, accompanied by diastolic[disability-benefits-help.org]
Pruritus
  • In fact, drowsiness, fatigue, and an overall lack of energy are encountered in the majority of patients, along with pruritus and pain.[symptoma.com]
  • Pruritus Common, Bothersome in Non-Dialysis CKD In a study of patients with non-dialysis CKD, pruritus was associated with poor health-related quality-of-life.[renalandurologynews.com]
  • They often complain of pruritus. Internal membranes are also affected – leading to pericarditis, peritonitis and pleurisy. Uremia can also lead to hemolysis with anemia.[lecturio.com]
  • Pruritus may respond to dietary phosphate restriction and phosphate binders if serum phosphate is elevated. Severe protein restriction in renal disease is controversial.[merckmanuals.com]
  • Symptoms may include: Appetite loss General ill feeling and fatigue Headaches Itching ( pruritus) and dry skin Nausea Weight loss without trying to lose weight Symptoms that may occur when kidney function has gotten worse include: Abnormally dark or light[ufhealth.org]
Petechiae
  • […] gastrointestinal bleeding, bleeding from cannulation sites, retinal haemorrhage, subdural haematoma, epistaxis, haematuria, ecchymosis, purpura, bleeding from the gums, gingival bleeding, genital bleeding, haemoptysis, telangiectasia, haemarthrosis and petechiae[academic.oup.com]
Purpura
  • Clinically, an increased bleeding tendency in patients with renal failure may present as gastrointestinal bleeding, bleeding from cannulation sites, retinal haemorrhage, subdural haematoma, epistaxis, haematuria, ecchymosis, purpura, bleeding from the[academic.oup.com]
Muscle Cramp
  • Muscle cramps. Darkness of skin. Cleveland Clinic News & More Cleveland Clinic News & More[my.clevelandclinic.org]
  • Patients with CKD may not notice any symptoms during the early stages of this condition, although those in more advanced stages may experience: Fatigue Difficulty concentrating Lack of appetite Muscle cramping Dry, itchy skin Frequent urination Once CKD[kidneyandhypertensioncare.com]
  • Muscle cramps. Fluid retention which causes swollen feet and ankles. Puffiness around the eyes. A need to pass urine more often than usual. Being pale due to anaemia. Feeling sick.[patient.info]
  • However, you may notice that you: feel more tired and have less energy have trouble concentrating have a poor appetite have trouble sleeping have muscle cramping at night have swollen feet and ankles have puffiness around your eyes, especially in the[kidney.org]
  • Other signs and symptoms include: Unintentional weight loss or weight gain Headache, trouble concentrating Pruritus, dry itchy skin, uremic frost Frequent hiccups, poor appetite, excessive thirst Nighttime muscle cramps, swollen ankles Oliguria, or increased[library.ahima.org]
Muscle Twitch
  • twitching and cramps easy bruising and bleeding blood in your stools hiccups excessive thirst decreased interest in sex impotence insomnia sleep apnea You may also have the symptoms of any diseases that are contributing to your kidney problems.[healthline.com]
  • twitching or cramps Breath odor Easy bruising, or blood in the stool Excessive thirst Frequent hiccups Problems with sexual function Menstrual periods stop (amenorrhea) Shortness of breath Sleep problems Vomiting Exams and Tests Most people will have[ufhealth.org]
  • twitches nausea pain on the side or mid to lower back panting (shortness of breath) protein in urine sudden change in bodyweight unexplained headaches Stages Changes in the GFR rate can assess how advanced the kidney disease is.[medicalnewstoday.com]
  • twitching or cramping a yellowish-brown tint to the skin As the kidney failure gets worse and the toxins continue to build up in the body, seizures and mental confusion can result.[medbroadcast.com]
Restless Legs Syndrome
  • leg syndrome brittle hair and nails itching weight loss a loss of muscle mass muscle twitching and cramps easy bruising and bleeding blood in your stools hiccups excessive thirst decreased interest in sex impotence insomnia sleep apnea You may also have[healthline.com]
  • Walking and strength training make bones stronger and stimulate muscles and nerves that can help ease "restless leg syndrome" and other nervous system problems sometimes associated with kidney disease.[kidshealth.org]
  • legs syndrome, and seizures (usually the result of hypertensive or metabolic encephalopathy).[merckmanuals.com]
  • legs syndrome; chest pain due to pericarditis (inflammation around the heart); bleeding (due to poor blood clotting); bone pain and fractures; and decreased sexual interest and erectile dysfunction.[emedicinehealth.com]
Bone Pain
  • pain abnormally dark or light skin an ashen cast to your skin, called uremic frost drowsiness mental cloudiness numbness in your hands and feet restless leg syndrome brittle hair and nails itching weight loss a loss of muscle mass muscle twitching and[healthline.com]
  • pain Drowsiness or problems concentrating or thinking Numbness or swelling in the hands and feet Muscle twitching or cramps Breath odor Easy bruising, or blood in the stool Excessive thirst Frequent hiccups Problems with sexual function Menstrual periods[ufhealth.org]
  • pain and fractures; and decreased sexual interest and erectile dysfunction.[emedicinehealth.com]
Muscle Weakness
  • Severe muscle weakness. To check your heart rate, see the instructions for taking a pulse.[uwhealth.org]
Epistaxis
  • Clinically, an increased bleeding tendency in patients with renal failure may present as gastrointestinal bleeding, bleeding from cannulation sites, retinal haemorrhage, subdural haematoma, epistaxis, haematuria, ecchymosis, purpura, bleeding from the[academic.oup.com]
Uremic Frost
  • frost drowsiness mental cloudiness numbness in your hands and feet restless leg syndrome brittle hair and nails itching weight loss a loss of muscle mass muscle twitching and cramps easy bruising and bleeding blood in your stools hiccups excessive thirst[healthline.com]
  • Other signs and symptoms include: Unintentional weight loss or weight gain Headache, trouble concentrating Pruritus, dry itchy skin, uremic frost Frequent hiccups, poor appetite, excessive thirst Nighttime muscle cramps, swollen ankles Oliguria, or increased[library.ahima.org]
  • Image : “Uremic frost on forehead and scalp of young Afro-Caribbean male” by Fythrion.[lecturio.com]
  • Occasionally, urea from sweat crystallizes on the skin (uremic frost). Pruritus may be especially uncomfortable. Undernutrition leading to generalized tissue wasting is a prominent feature of chronic uremia.[merckmanuals.com]
Nocturia
  • Nocturia is often noted, principally due to failure to concentrate the urine. Lassitude, fatigue, anorexia, and decreased mental acuity often are the earliest manifestations of uremia.[merckmanuals.com]
  • Common signs and symptoms of CKD include difficulty urinating ( dysuria ), dizziness, foamy urine, frequent urination at night ( nocturia ), metallic taste (dysgeusia), swelling of the feet, ankles, feet, hands, or face ( edema ), and others.[verywell.com]
  • Signs and symptoms of chronic kidney disease include: need to urinate frequently, especially at night (nocturia); swelling of the legs and puffiness around the eyes (fluid retention); high blood pressure; fatigue and weakness (from anemia or accumulation[emedicinehealth.com]
Polyuria
  • Further early indicators are polyuria, newly emerging or worsening hypertension or peripheral edemas. Depending on the etiology, there can also be flank pains or fever.[lecturio.com]
  • Thus, despite moderate or severe reductions in GFR, tubulointerstitial renal diseases may manifest first as polyuria and volume depletion, with inability to concentrate the urine.[emedicine.medscape.com]
Anuria
  • In the final stages, it leads to oliguria or anuria, dyspnea, vomiting, uremic encephalopathy with a severe reduction in vigilance, as well as the patient being more susceptible to bleeding.[lecturio.com]
Seizure
  • […] pounds in 7 days Little or no urine output Trouble breathing Muscle aches Fever of 100.4 F (38 C) or higher, or as advised by your healthcare provider Blood in your urine or stool Bloody discharge from your nose, mouth, or ears Severe headache or a seizure[fairview.org]
  • End stage renal disease causes weight loss, nausea and vomiting, fatigue, difficulty breathing and seizures. If left untreated, end stage renal disease is a fatal condition. At this stage, dialysis or a kidney transplant is usually needed.[kidneyandhypertensioncare.com]
  • […] common symptom) thirst bad taste in the mouth or bad breath weight loss generalized, persistent itchy skin muscle twitching or cramping a yellowish-brown tint to the skin As the kidney failure gets worse and the toxins continue to build up in the body, seizures[medbroadcast.com]
  • Fluid buildup around the lungs ( pleural effusion ) Heart and blood vessel complications High phosphorous levels High potassium levels Hyperparathyroidism Increased risk of infections Liver damage or failure Malnutrition Miscarriages and infertility Seizures[ufhealth.org]
Headache
  • Headaches. High blood pressure may trigger headaches. Hypertension, or high blood pressure. The retention of fluids and wastes causes blood volume to increase, which in turn, causes blood pressure to rise. Increased fatigue.[medical-dictionary.thefreedictionary.com]
  • The waste buildup can make you sick and you may have these symptoms: swelling of the ankles, face or belly, vomiting, loss of appetite, fatigue, weakness, confusion and headaches.[heart.org]
  • Swelling and/or puffiness around the eyes, feet, and ankles Frequent urination or, in children 5 years or older, prolonged bedwetting Stunted or poor growth, as compared to similar age group peers Loss of appetite and chronic nausea Fatigue Frequent severe headaches[healthychildren.org]
  • Symptoms of Chronic Kidney Disease Clinical Presentation of Chronic Kidney Disease Chronic renal failure often begins with generalized symptoms such as tiredness, loss of appetite and headaches.[lecturio.com]
  • […] or more than 5 pounds in 7 days Little or no urine output Trouble breathing Muscle aches Fever of 100.4 F (38 C) or higher, or as advised by your healthcare provider Blood in your urine or stool Bloody discharge from your nose, mouth, or ears Severe headache[fairview.org]
Confusion
  • Before then, conflicting classifications had created a state of confusion as to how many Americans were afflicted with this progressive, life-threatening condition.[lifeextension.com]
  • The waste buildup can make you sick and you may have these symptoms: swelling of the ankles, face or belly, vomiting, loss of appetite, fatigue, weakness, confusion and headaches.[heart.org]
  • Then, they may feel tired, have nausea or vomiting, have difficulty concentrating, or feel confused. Fluid build-up appears as swelling in the skin, fluid congestion in the lungs, and high blood pressure.[kidshealth.org]
  • […] bad taste in the mouth or bad breath weight loss generalized, persistent itchy skin muscle twitching or cramping a yellowish-brown tint to the skin As the kidney failure gets worse and the toxins continue to build up in the body, seizures and mental confusion[medbroadcast.com]
  • Symptoms of kidney failure are due to the build-up of waste products and excess fluid in the body that may cause weakness, shortness of breath, lethargy, swelling, and confusion.[medicinenet.com]
Insomnia
  • […] and symptoms of chronic kidney disease include: anemia blood in urine dark urine decreased mental alertness decreased urine output edema - swollen feet, hands, and ankles (face if edema is severe) fatigue (tiredness) hypertension (high blood pressure) insomnia[medicalnewstoday.com]
  • […] numbness in your hands and feet restless leg syndrome brittle hair and nails itching weight loss a loss of muscle mass muscle twitching and cramps easy bruising and bleeding blood in your stools hiccups excessive thirst decreased interest in sex impotence insomnia[healthline.com]
  • Clinical Outcomes Management More Research Summaries Clinical Edge Acute Illness and Cannabis Use in Adults Pregnancy History and Risk of Miscarriage Firearms Mortality Among US Schoolchildren Rapid Point of Care Test for Influenza More FDA/CDC May 8, 2019 Insomnia[jcomjournal.com]
  • […] include: Hypotension ( low blood pressure ) Cough Hyperkalemia (high potassium) Headache Dizziness Fatigue Nausea Skin rash A metallic taste in the mouth Diarrhea Indigestion Abnormal liver function Muscle cramps Aches and pains (myalgia) Back pain Insomnia[emedicinehealth.com]
Altered Mental Status
  • mental status (encephalopathy from the accumulation of waste products or uremic poisons), and restless legs syndrome; chest pain due to pericarditis (inflammation around the heart); bleeding (due to poor blood clotting); bone pain and fractures; and[emedicinehealth.com]

Workup

The diagnosis of chronic kidney disease may not be easy to attain early on, which is why a thorough laboratory assessment is necessary. Some definitions interpret chronic kidney insufficiency as kidney damage in the presence of reduced albumin levels due to reduced kidney function (estimated by calculating the glomerular filtration rate, or GFR, based on creatinine levels) that persists for at least three months [1] [3]. For this reason, a complete biochemical workup consisting of serum electrolytes, urea, albumin, and most importantly creatinine, together with urinalysis to evaluate protein loss, is crucial to make the diagnosis [1]. Hyperphosphatemia and hyperparathyroidism are common findings, whereas a complete blood count (CBC) reveals anemia with normochromic and normocytic characteristics, thus excluding causes such as iron or vitamin B12 deficiency [1]. The key step of the workup is to determine the GFR and patients are classified based on the results [1] [3]:

  • Stage 1 - GFR is ≥ 90 mL/min/1.73 m2 with loss of albumin through urine
  • Stage 2 - GFR values between 60-89 mL/min/1.73 m2
  • Stage 3 - GFR values between 30-59 mL/min/1.73 m2
  • Stage 4 - GFR values between 15-29 mL/min/1.73 m2
  • Stage 5 (also known as end-stage renal disease) - GFR is < 15 mL/min/1.73 m2

To make an exact value of the GFR, a 24-hour urine collection of creatinine is used over serum values [1].

Pericardial Effusion
  • Clinical findings, internal Hypertension, heart failure, pulmonary oedema, pleural effusions, pericardial effusion, GI bleeding due to peptic ulceration, gastritis/oesophagitis/colitis, acute pancreatitis.[medical-dictionary.thefreedictionary.com]
Hypertriglyceridemia
  • This is not only to help guide initiation of statin treatment in CKD patients under the age of 50 years, but also to provide information on secondary causes of dyslipidemia such as nephrotic syndrome and to identify hypertriglyceridemia, a common lipid[acc.org]
  • Dietary modification may be helpful for hypertriglyceridemia. Statins are effective for hypercholesterolemia.[merckmanuals.com]
Creatinine Increased
  • Creatinine test As kidney function declines, your creatinine increases. This protein is also related to muscle mass. Parathyroid hormone (PTH) test The kidney and the parathyroid glands interact through the regulation of calcium and phosphorus.[healthline.com]
Hyponatremia
  • Hypocalcemia (see chapter) Hyponatremia (see chapter) Uremia: The three most severe forms of uremia are encephalopathy, bleeding diathesis, and pericarditis.[clinicaladvisor.com]

Treatment
  • In addition, dietary changes and treatment to relieve specific symptoms such as anemia and high blood pressure are critical to the treatment process.[medical-dictionary.thefreedictionary.com]
  • What is the treatment for chronic kidney disease? Treatment for most cases of CKD is usually done by GPs. This is because most cases are mild-to-moderate (stages 1-3) and do not require any specialist treatment.[patient.info]
  • Treatment of the anemia in congestive heart failure may prove vital in preventing progression of both the heart failure and the associated renal disease.[ncbi.nlm.nih.gov]
  • A complete laboratory workup and determination of the stage of kidney insufficiency are crucial steps in order to optimize treatment and determine the prognosis.[symptoma.com]
  • Specific Treatment The treatment of AKI and consequently ACRF is predicated on treating the underlying cause. There are no validated specific therapies for the treatment of ACRF. 5.[clinicaladvisor.com]

Prognosis
  • A complete laboratory workup and determination of the stage of kidney insufficiency are crucial steps in order to optimize treatment and determine the prognosis.[symptoma.com]
  • However, the available population studies suggest that the prognosis for ACRF is poor. In one study, only 35% of patients regained renal function back to baseline.[clinicaladvisor.com]
  • Prognosis Early diagnosis and treatment of kidney failure is critical to improving length and quality of life in chronic kidney failure patients. Patient outcome varies by the cause of chronic kidney failure and the method chosen to treat it.[medical-dictionary.thefreedictionary.com]
  • Renal biopsy results and any surgical notes Neurological exam results, if you experience nephropathy Other diagnostic test results documenting any complications of your kidney disease A statement from your doctor, outlining the diagnosis, treatment, and prognosis[disability-benefits-help.org]
  • […] irregularities papillary calcifications cysts (see also: acquired cystic kidney disease ) Abnormal Doppler findings in these patients are 2 : reduced renal vascularity increased resistance index (RI) values (segmental and interlobular arteries) Treatment and prognosis[radiopaedia.org]

Etiology
  • 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]
  • Abstract In the last four decades, increasing numbers of young people, in clusters of vulnerable farming communities in several Central American countries, have developed a severe form of kidney failure of uncertain etiology (thus termed chronic kidney[iris.paho.org]
  • CKD is a major international public health concern that is increasing worldwide, and while the most common causes in developed countries are diabetes and hypertension, the etiology of CKD in Nicaragua is unknown.[bu.edu]
  • Epidemiology and Etiology of Chronic Kidney Disease Causes and Distribution of Chronic Kidney Disease The incidence of chronic renal failure is in the region of 10 cases per 100.000 people.[lecturio.com]
  • Proteinuria can provide a clue to the underlying etiology of CKD, such as diabetes or glomerular diseases. The higher the proteinuria, the faster the progression of CKD.[library.ahima.org]

Epidemiology
  • Anemic patients double their relative risk of death when CKD is present and triple their risk if they have anemia, CKD, and cardiovascular disease. 6 Epidemiologic studies suggest an association among anemia, left ventricular hypertrophy (LVH), mortality[mdedge.com]
  • […] characterized by progressive renal insufficiency, often diagnosed at a very late stage, in the absence of early symptoms, necessitating renal replacement therapy if the patient is to survive...This document presents a background to this epidemic, including its epidemiology[iris.paho.org]
  • Epidemiology The best estimates of the incidence of AKI and ACRF combined range from 500 to 2,000 pmp, depending on the definition. A study conducted in Scotland using the consensus RIFLE criteria placed the incidence at 2,147 pmp.[clinicaladvisor.com]
  • Insights into the cause of kidney failure have emerged from research, but less is known about the epidemiology of less severe forms of kidney disease known both as chronic kidney disease (CKD) or chronic renal insufficiency (CRI).[clinicaltrials.gov]
  • This Review focuses on the epidemiology, prevention and treatment of infections with ARB. Tina Z. Wang, Rosy Priya L. Kodiyanplakkal & David P. Calfee Research 09 May 2019 open Mostafa E.[nature.com]
Sex distribution
Age distribution

Pathophysiology
  • Pathophysiology The pathophysiology of ACRF is congruent with the pathophysiology of AKI. However, within each stratum of pathologic mechanism of injury of AKI special considerations exist for those patients with pre-existing CKD.[clinicaladvisor.com]
  • License: CC BY-SA 3.0 Pathophysiology of Chronic Kidney Disease The Pathophysiological Processes of Chronic Kidney Disease Chronic renal failure is caused by a progressive decline of all kidney functions which end with terminal kidney damage.[lecturio.com]
  • This review comprises the findings on the complex pathophysiology of coagulation disorders including new factors such as MPs and microRNAs in patients with renal insufficiency.[academic.oup.com]

Prevention
  • Treatment of the anemia in congestive heart failure may prove vital in preventing progression of both the heart failure and the associated renal disease.[ncbi.nlm.nih.gov]
  • They will also give you treatment and advice on how to prevent or slow down the progression of CKD. This usually includes: Blood pressure control.[patient.info]
  • 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]
  • 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.[medlineplus.gov]
  • Treating the condition that is causing the problem may help prevent or delay CKD.[ufhealth.org]

References

Article

  1. Thomas R, Kanso A, Sedor JR. Chronic Kidney Disease and Its Complications. Prim Care. 2008;35(2):329-vii.
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Last updated: 2019-07-11 20:18