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chronic kidney disease (CKD)

Genetics: - FAT10 may mediate NF-kappa-B activation & may promote tubulointerstitial inflammation in chronic kidney diseases Diagnostic criteria: - abnormal kidney struture or function for > 3 months - a marker of kidney damage - albuminuria - abnormal urine sediment - electrolyte disorder due to renal tubular dysfunction - abnormal renal histology - abnormal renal imaging (structure abnormalities) - renal transplantation OR - GFR < 60 mL/min/1.73 m2 [3] Laboratory: - see chronic renal failure Radiology: - renal ultrasonography is often the 1st imaging modality [3] Complications: - see chronic renal failure Staging: 1) GFR or G staging a) stage 1: GFR > 90 mL/min/1.73 m2 b) stage 2: GFR = 60-89 mL/min/1.73 m2 c) stage 3: GFR = 30-59 mL/min/1.73 m2 - stage 3a: GFR = 45-59 mL/min/1.73 m2 - stage 3b: GFR = 30-44 mL/min/1.73 m2 d) stage 4: GFR = 15-29 mL/min/1.73 m2 e) stage 5: GFR < 15 mL/min/1.73 m2 2) albuminuria or A classification a) stage A1: urine albumin/creatinine ratio: < 30 mg/gram b) stage A2: urine albumin/creatinine ratio: 30-300 mg/gram c) stage A3: urine albumin/creatinine ratio: > 300 mg/gram Management: - see chronic renal failure Notes: - USPSTF & American College of Physicians recommend against screening asymptomatic adults due to insufficient evidence [2] - American Society of Nephrology recommends screening all adults [3] - persons with a family history of chronic kidney disease should be screened [3]

Interactions

disease interactions

Related

age-associated changes in renal function hospice guidelines for determining prognosis, renal disease kidney

Specific

chronic glomerulonephritis chronic interstitial nephritis (analgesic nephropathy, drug-induced chronic interstitial nephritis) chronic pyelonephritis (xanthogranulomatous pyelonephritis) chronic renal failure (CRF) genetic disease of the kidney polycystic kidney disease

General

chronic disease kidney disease; renal disease

References

  1. UniProt :accession O15205
  2. Moyer VA et al Screening for Chronic Kidney Disease: U.S. Preventive Services Task Force Recommendation Statement Annals of Internal Medicine, Aug 28, 2012 PMID: 22928171 http://annals.org/article.aspx?articleid=1355168 (corresponding NGC guideline withdrawn Feb 2018) - Qaseem A et al Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease: A Clinical Practice Guideline From the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. Published online 22 October 2013 PMID: 24145991 http://annals.org/article.aspx?articleid=1757302
  3. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 19. American College of Physicians, Philadelphia 2012, 2015, 2021
  4. Drawz P, Rahman M. In the clinic. Chronic kidney disease. Ann Intern Med. 2009 Feb 3;150(3 PMID: 19189903
  5. Hage FG, Venkataraman R, Zoghbi GJ et al The scope of coronary heart disease in patients with chronic kidney disease. J Am Coll Cardiol. 2009 Jun 9;53(23):2129-40. PMID: 19497438
  6. Navaneethan SD, Pansini F, Perkovic V et al HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis. Cochrane Database Syst Rev. 2009 Apr 15;(2) PMID: 19370693
  7. Sprague SM, Coyne D. Control of secondary hyperparathyroidism by vitamin D receptor agonists in chronic kidney disease. Clin J Am Soc Nephrol. 2010 Mar;5(3):512-8. PMID: 20133492
  8. Glassock RJ, Winearls C. Screening for CKD with eGFR: doubts and dangers. Clin J Am Soc Nephrol. 2008 Sep;3(5):1563-8 PMID: 18667744
  9. Levey AS, de Jong PE, Coresh J et al The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011 Jul;80(1):17-28. PMID: 21150873
  10. Kalamas AG, Niemann CU. Patients with chronic kidney disease. Med Clin North Am. 2013 Nov;97(6):1109-22. Review. PMID: 24182722
  11. Yeung WG, Palmer SC, Strippoli GFM et al Vitamin D Therapy in Adults With CKD: A Systematic Review and Meta-analysis. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5. PMID: 37356648
  12. Owsiany MT, Hawley CE, Triantafylidis LK, Paik JM. Opioid Management in Older Adults with Chronic Kidney Disease: A Review. Am J Med. 2019 Dec;132(12):1386-1393. PMID: 31295441 PMCID: PMC6917891 Free PMC article. Review.
  13. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. PMID: 11904577 - Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. KDIGO Kidney International Supplements 2012; 2:288. http://www.kdigo.org/clinical_practice_guidelines/anemia.php