Chronic Kidney Disease (CKD) is defined as a progressive loss of kidney function over months or years. Patients with early stage CKD are generally asymptomatic, while later stages can cause nausea, vomiting, fatigue, and other symptoms. CKD is staged based on glomerular filtration rate, with stage 5 being severe kidney failure requiring dialysis or transplant. Risk factors include diabetes, high blood pressure, smoking, and family history. Screening helps detect CKD in at-risk groups. Treatment focuses on lifestyle changes, medications, and dialysis or transplant for kidney failure.

1. Chronic Kidney Disease
(CKD)

2. Definition
Also known as chronic renal disease, it is
a progressive loss in kidney function over
a period of months of years

3. Signs + Symptoms
Patients with CKD stages 1-3 are generally
asymptomatic. Typically, it is not until stages 4-5 that
endocrine/metabolic derangements or disturbances in
water or electrolyte balance become clinically
manifest.

4. Signs + Symptoms•Nausea
•Vomiting
•Loss of appetite and weight loss
•Fatigue and weakness
•Insomnia
•Changes in urine output
(polyuria  oliguria)
•Decreased mental sharpness
•Muscle twitches and cramps
•Hiccups
•Peripheral oedema
•Persistent itching
•Chest pain
•Shortness of breath
•High blood pressure
•Increased blood urea nitrogen (BUN)
and creatinine
•Mild anaemia
•GFR progressively decreases from 90
to 30 ml/min
•Erectile dysfunction (in men)

5. StagingStage GFR* Description
1 90+ Normal kidney function but urine findings or
structural abnormalities or genetic trait point to
kidney disease
2 60-89 Mildly reduced kidney function, and other findings
(as for stage 1) point to kidney disease
3A
3B
45-59
30-44
Moderately reduced kidney function
4 15-29 Severely reduced kidney function
5 <15 or on
dialysis
Very severe, or endstage kidney failure (sometimes
call established renal failure)
* All GFR values are normalized to an average surface area (size) of 1.73m2

6. Stage 5
Stage 5 CKD is often called end-stage kidney disease, end-
stage renal disease, or end-stage kidney failure, and is largely
synonymous with the now outdated terms chronic renal
failure or chronic kidney failure; and usually means the
patient requires renal replacement therapy, which may
involve a form of dialysis, but ideally constitutes a kidney
transplant.

7. Risk Factors
• Diabetes
• High blood pressure
• Heart disease
• Smoking
• Obesity
• High cholesterol
• Being African-American, Native American or Asian-American
• Family history of kidney disease
• Age 65 or older

8. Screening
Often, chronic kidney disease is diagnosed as a result of screening of
people known to be at risk of kidney problems, such as those with high
blood pressure or diabetes and those with a blood relative with CKD.
This disease may also be identified when it leads to one of its
recognized complications, such as cardiovascular disease, anaemia,
or pericarditis.

9. Assessing Patients
• Blood Tests: Creatinine, Urea Nitrogen, waste products and
electrolytes (Renal Function test)
• Urine test
• Imaging test
• Renal biopsy

10. Differential Diagnosis
• Systemic lupus erythematosus, an autoimmune disease
• Renal artery stenosis
• Urinary obstruction
• Wegener granulomatosis (inflammation of blood vessels)

11. Management
Although there is no cure for kidney disease, treatment can
help relieve symptoms, slow or prevent progression of the
condition, and reduce the risk of developing related problems.

12. • Stop smoking
• Healthy, balanced diet – high phosphate, low salt
• Reducing salt intake
• Reducing NSAIDs usage
• Moderate alcohol usage
• Regular exercise
• Lose weight if obese or overweight
1.Lifestyle Changes

13. • Medication to reduce BP
• Medication to reduce cholesterol
• If anaemic, give iron supplements
• Vitamin D supplements
For kidney failure,
• Kidney transplant or dialysis
2. Medications
and supplements

14. Long-term disease, so expect regular
follow-ups
Follow-up