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Evaluation of laboratory measurements for the clinical assessment of chronic kidney disease
Received: 08-Nov-2017 Accepted Date: Nov 13, 2017; Published: 29-Nov-2017
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Chronic kidney disease (CKD) earlier used to called as chronic renal failure (CRF). Chronic kidney disease (CKD) is having higher rate of morbidity and mortality. CKD is a globally recognized public health problem.
It involves all degrees of decreased renal function, progressively leads from damaged–at risk through mild, moderate, and ultimately end-stage kidney failure. Most patients are asymptomatic until the disease has significantly progressed, they remain unaware of the condition. Thus, it is essential to have clinical guidelines, aimed at early detection, evaluation, diagnosis, and treatment for slowing down the progression of this condition.
CKD is more common in the elderly population. Whereas in younger patients with CKD typically experience progressive loss of renal function, about 30% of patients over the age of 65 years with CKD have stable disease [1]. CKD is recognized for its association with an increased risk of cardiovascular disease and end-stage renal disease (ESRD). Major cause for chronic kidney disease may be by diabetes, high blood pressure and other disorders. Early detection and treatment can often useful to keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to end-stage renal disease (ESRD), which requires dialysis or a kidney transplant to sustain life (Table 1).
| Stage | eGFR value | Clinical symptoms associated with CKD |
|---|---|---|
| Stage 1 – Structural or functional abnormalities of Kidney with normal kidney function | From 90-120 | Hypertension, urinary tract infections, abnormal findings in Urine |
| Stage 2 – Structural or functional abnormalities of Kidney with mild loss of kidney function | From 60–89 | Hypertension, urinary tract infections, abnormal findings in Urine |
| Stage 3a – Mild to moderate loss of kidney function | From 45–59 | Hypertension, urinary tract infections, abnormal findings in Urine |
| Stage 3b – Moderate to severe loss of kidney function | From 30–44 | Anemia, malnutrition, bone problems, abnormal nerve sensations, reduced mental functioning |
| Stage 4 – Severe loss of kidney function | From 15–29 | Swelling and puffiness, anemia, decreased appetite and blood and urine abnormalities |
| Stage 5 – Kidney failure, also known as end stage renal disease (ESRD) | Less than 15 | difficulty breathing , decreased appetite, fatigue, mental symptoms and blood and urine abnormalities |
Table 1: Stages of Chronic Kidney Disease.
Based on GFR estimation, the National Kidney Foundation has classified CKD into five stages.
Chronic kidney disease (CKD) is classified according to the degree of kidney damage – measured by the level of proteinuria – and the decline in glomerular filtration rate. The most severe form is end-stage renal disease. CKD define as either presence of kidney damage or a decreased glomerular filtration rate (GFR) which is less than 60 mL/min/1.73 m2 for at least 3 months. Whatever the underlying cause, once the loss of nephrons occurs and reduction of functional renal mass reaches to a certain point, the remaining nephrons begin a process of irreversible sclerosis which leads to a progressive decline in the GFR [2].
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