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Chronic kidney disease: Difference between revisions
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(Created page with "'''Chronic kidney disease''' (CKD), previously called '''chronic renal failure''' is defined as the presence of either kidney damage or decreased kidney function for more than 3 months. Decreased kidney function is measured by decreased <abbr>GFR</abbr>. In practice, the presence of any of the following criteria for more than 3 months establishes CKD: * Abnormal GFR * Abnormal albuminuria * Abnormal urinary sediment * Abnormal electrolyte...") |
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'''Chronic kidney disease''' (CKD), previously called '''chronic renal failure''' is defined as the presence of either kidney damage or decreased kidney function for more than 3 months. Decreased kidney function is measured by decreased <abbr>[[Glomerular filtration rate|GFR]]</abbr>. In practice, the presence of any of the following criteria for more than 3 months establishes CKD: | <section begin="radiology" />'''Chronic kidney disease''' (CKD), previously called '''chronic renal failure''' is defined as the presence of either kidney damage or decreased kidney function for more than 3 months. Decreased kidney function is measured by decreased <abbr>[[Glomerular filtration rate|GFR]]</abbr>. <section end="radiology" />In practice, the presence of any of the following criteria for more than 3 months establishes CKD: | ||
* Abnormal GFR | * Abnormal GFR | ||
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It’s a very common condition. In Hungary alone, 1,3 million people are affected. The prevalence in Western countries is around 10%. | It’s a very common condition. In Hungary alone, 1,3 million people are affected. The prevalence in Western countries is around 10%. | ||
The disease is nowadays called chronic kidney disease, not chronic renal failure, because the definition has been expanded to not only include those conditions where the kidney function | The disease is nowadays called chronic kidney disease, not chronic renal failure, because the definition has been expanded to not only include those conditions where the glomerular filtration is decreased, but also those cases where other kidney function functions are pathological. | ||
== Etiology == | == Etiology == | ||
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* Uraemic pericarditis | * Uraemic pericarditis | ||
* Uraemic encephalopathy | * Uraemic encephalopathy | ||
<section begin="radiology" /> | |||
== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
The diagnosis of CKD is based on alterations in laboratory parameters, imaging, biopsy, etc., as already explained, as soon as it is established that these alterations have lasted 3 months or more. | <section end="radiology" />The diagnosis of CKD is based on alterations in laboratory parameters, imaging, biopsy, etc., as already explained, as soon as it is established that these alterations have lasted 3 months or more. | ||
For the evaluation of kidney function in CKD, estimated GFR (eGFR) must be used rather than serum creatinine. | For the evaluation of kidney function in CKD, estimated GFR (eGFR) must be used rather than serum creatinine. | ||
All patients with recently discovered decreased kidney function should undergo evaluation to determine the cause and to determine if this is acute kidney injury or CKD. If previous kidney function tests are available it may be trivial to determine whether this is acute or chronic, but these are not available in all cases. Tests for diabetes, hypertension, [[Urine dipstick test|urine analysis]] and kidney ultrasound are obligatory. | All patients with recently discovered decreased kidney function should undergo evaluation to determine the cause and to determine if this is acute kidney injury or CKD. If previous kidney function tests are available it may be trivial to determine whether this is acute or chronic, but these are not available in all cases. Tests for diabetes, hypertension, [[Urine dipstick test|urine analysis]] and kidney ultrasound are obligatory. | ||
<section begin="radiology" /> | |||
Kidneys with CKD have abnormal morphology. On ultrasound the following features are seen: | Kidneys with CKD have abnormal morphology. On ultrasound the following features are seen: | ||
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* Thinning of cortex (< 10 mm) | * Thinning of cortex (< 10 mm) | ||
* Irregular surface | * Irregular surface | ||
<section end="radiology" /> | |||
The following laboratory alterations may be present: | The following laboratory alterations may be present: | ||