Chronic Kidney Disease

Chronic kidney disease (CKD) is an abnormality of kidney structure or function that persists for at least 3 months and has implications for health. One abnormal creatinine or urine result during an acute illness does not establish chronicity. Acute kidney injury can occur on top of CKD, so a new change must be assessed against the person's baseline rather than attributed automatically to the chronic diagnosis. Common causes include diabetes, hypertension, glomerular disease, inherited disease, obstruction, vascular disease, and prior kidney injury. Progressive nephron loss reduces filtration and disrupts fluid, electrolyte, and acid-base regulation. The kidneys also participate in erythropoiesis and mineral metabolism. CKD can therefore lead to fluid overload, potassium and acid-base disturbances, anemia, and CKD-mineral and bone disorder. Cardiovascular disease, medication accumulation, acute kidney injury, malnutrition, and kidney failure are major complications. Classify CKD by cause, glomerular filtration rate (GFR) category, and albuminuria category. The GFR categories are G1 at least 90 mL/min/1.73 m², G2 60–89 mL/min/1.73 m², G3a 45–59 mL/min/1.73 m², G3b 30–44 mL/min/1.73 m², G4 15–29 mL/min/1.73 m², and G5 less than 15 mL/min/1.73 m². G1...