Chronic kidney disease (CKD) is a widespread disorder that is linked to large preventable morbidity and mortality, primarily as a result of the population's markedly elevated risk of cardiovascular disease (CVD). Early detection of CKD is crucial for the initiation of treatment to stop or slow the evolution of the condition, stop the emergence of comorbidities, and lower the risk of cardiovascular disease. Those at the highest risk of unfavourable outcomes can be classified according to their estimated glomerular filtration rate and urine albumin to creatinine ratios.

A kidney function or structural problem that has been present for more than three months is referred to be CKD. This includes people who:

• Albuminuria, abnormal urine sediment, electrolyte and other abnormalities caused by tubular problems, abnormalities found by histology, structural abnormalities seen by imaging, and a history of kidney transplantation are all indications of kidney impairment.
• Glomerular Filtration Rate (GFR) 60 mL/min/1.73 m2 at least twice within a 90-day period of each other.

The CKD-EPI creatinine equation should be used by clinical laboratories to calculate GFRcreatinine. This should be taken cautiously in individuals with extremes of muscle mass since decreased muscle mass will result in an overestimation of the GFR and higher muscle mass will result in an underestimating.

20% of all emergency admissions result in acute renal damage, which is a common occurrence and a significant risk factor for the onset of CKD. Even if serum creatinine has returned to normal levels, individuals should continue to be watched for the onset or progression of CKD for at least two to three years after an episode of acute renal injury. In order to ensure that this follow-up can take place in the community, effective communication between primary care physicians and secondary care specialists is crucial. People who have experienced acute renal injury should be made aware of their elevated risk of developing or worsening CKD.

Over many years, kidney function is gradually lost as a result of chronic kidney disease (CKD). In the early stages, there are frequently no symptoms, but fluid retention can result in high blood pressure and swelling. It can eventually result in renal failure.

Symptoms of CKD can include:

decreased urine flow, bloody urine, occasionally black urine, decreased mental alertness, and, in more severe cases, appetite loss persistent itching, more frequent urination when the condition is severe, especially at night, in some circumstances.

Glomerular filtration rate:

The estimated glomerular filtration rate (eGFR), specifically the amount of blood filtered per minute, is a helpful metric for evaluating kidney function. Filtration rates below 60 millilitres (mL)/min normally signify severe abnormalities in kidney function because a healthy person typically filters at least 90 millilitres (mL)/min.

A method that considers the person's age, gender, and ethnicity can be used to compute the value of the creatinine concentration in the urine once it has been tested. Another method for calculating GFR is to use the albumin creatinine ratio.

Diagnostic staging

Based on the eGFR, there are six phases of CKD that serve as indicators of the condition's progression and as a reference for recommended treatments.

Stage 1 (G1) Normal eGFR (>90 mL/min) with other tests showing renal impairment.

Stage 2 (G2): eGFR slightly decreased.

Stage 3a (G3a): modest to moderate decline in renal function and mild to moderately reduced eGFR.

Stage 3b (G3b): renal function loss ranging from mild to severe with a moderately lowered eGFR.

Stage 4 (G4): Extremely low eGFR, substantial impairment of renal function, and potential symptoms are all present.

Stage 5 (G5): Renal failure is characterised by a significantly lower eGFR.

In order to diagnose CKD and find any structural deviations or obstructions in the urine flow, a number of diagnostic imaging techniques are available. Investigating whether a man has an enlarged prostate gland is especially crucial.

Ultrasound scans, CT scans, and magnetic resonance imaging (MRI) may all be helpful in the diagnosis in some circumstances.

In some circumstances, a kidney tissue biopsy may be necessary. This can be taken to a lab to be inspected under a microscope for damage that might be impairing kidney function.

Despite the fact that there is no treatment for chronic kidney disease (CKD), it is crucial to take action to stop or limit the illness's course, even in its early stages, since this can assist to avoid end-stage kidney failure.

Stages 1-3 of chronic kidney disease are typically managed without the need for specialised care by mainly monitoring the illness's progression. Referral to a specialist for assistance in making treatment decisions may be advantageous for people with more severe instances or those who have stage 4 or stage 5 CKD.

To minimise the strain on the kidneys and slow the spread of the disease, it is important to identify and treat any health issues that may be contributing to CKD. This might comprise:

Diabetes: Pharmaceutical blood sugar control measures

Diet, lifestyle changes, and medication can all help people with hypertension drop their blood pressure to less than 130/80 mmHg.

Prophylactic antibiotic use to treat recurrent UTI

Surgery to remove the blockage from the urinary tract