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Chronic Kidney Disease

Chronic Kidney Disease

Introduction

Disease of the kidney of long standing, ie > 3 months are called chronic disease. These can be diagnosed
If the kidney function is lower. This is measured indirectly by Serum Creatinine. If the measured GFR is > 90 ml / min, it is normal. CKD is diagnosed if GFR is < 60 ml/min persistently for > 3 months.
If the urine albumin is > 30 mg/day, red or white blood cells are present in urine
If on ultrasound, X Rays or kidney biopsy, the kidneys are found to have abnormalities.
CKD in early cases is without symptoms. Symptoms gradually increase as the kidney function decreases with time.
Nearly all kidney diseases are progressive in nature and keep worsening with time. These will result in End-Stage renal disease in most cases. End-Stage is diagnosed when the kidney function is so low that life without external support is difficult and RRT or Renal Replacement Therapy in the form of Dialysis (either Hemo or peritoneal dialysis) or Renal transplant is required.
In some case, the function deteriorates suddenly and rapidly. This then is called Acute superimposed on CKD (Ac on CKD). This sometimes is reversible and the patient may require dialysis till this improvement is achieved.
The aim of the treatment is to alter the course of the disease (slow its progression or halt the progression).
In some cases the progression is very rapid (over months) while in others it may take decades.

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