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Chronic Kidney Disease : Causes

Chronic kidney disease (CKD) is a dreaded disease for which medical science has no remedy. CKD is increasing at an alarming rate all over the world. One in ten persons has some form of chronic kidney disease. Rising prevalence of diabetes, hypertension, obesity, smoking, and high cholesterol is major reason for increasing incidences of CKD.

What is chronic kidney disease?

CKD occurs when the kidneys become damaged and gradually unable to perform their functions. With treatment, the kidney function may remain stable, but if not, the damage becomes worse over months to years. The serum creatinine levels rise gradually and the level of kidney function (also called the glomerular filtration rate or GFR) can be calculated from this blood test. The stage CKD can thus be graded as mild, moderate or severe. The presence of albumin in the urine also indicates that kidney damage is present (see tables stage of chronic kidney disease). CKD was previously called Chronic Renal Failure (CRF) but the word failure gives a wrong impression. In early CKD, there is still some degree of renal function and only in the late stages where kidneyfailure truly occur.

What is end stage kidney disease?

End-stage kidney disease (ESKD) or end-stage renal disease (ESRD) refers to the time when CKD reaches an advanced stage (less than 10% of normal function). The kidneys may even fail completely and the condition is irreversible.

At this point, conservative management (i.e. medications, diet, lifestyle modifications) is not sufficient to maintain life and renal replacement therapy (dialysis or kidney transplantation) is required.

Chronic kidney disease is a gradual, progressive and permanent loss of kidney functions.
CHP. 10. Chronic Kidney Disease: Causes 43.

What causes chronic kidney disease?

A number of conditions can cause permanent damage to the kidneys. But the two main causes of chronic kidney disease are diabetes and high blood pressure. They account for about two third cases of CKD.

Important causes of CKD are:

  1. Diabetes. Accounting for nearly 35-40 % of all cases, Diabetes is the most common cause of CKD. Roughly every third person with diabetes is at the risk of developing CKD.
  2. High blood pressure. Untreated or poorly treated high blood pressure is another leading cause of CKD accounting for nearly 30 % of cases. Furthermore, whatever may be the cause of CKD, high blood pressure will definitely cause further damage to the kidneys.
  3. Glomerulonephritis. These disorders which cause inflammation and damage the kidneys are the third in line of ailments that cause CKD.
  4. Polycystic kidney disease. This is the most common hereditary cause of CKD characterized by multiple cysts in both kidneys.
  5. Other causes: ageing of the kidneys, renal artery stenosis (narrowing), blockage of urine flow by stones or an enlarged prostate, drug- induced and toxin-induced kidney damage, recurrent kidney infection in children and reflux nephropathy.
Two most common causes of chronic kidney disease are diabetes and high blood pressure.