Chronic Kidney Disease

The primary role of the kidneys is to filter blood to remove waste and excess water from the body. Half a cup of blood is filtered every minute to make urine.

In chronic kidney disease (CKD), the kidney function declines over time.

It is a progressive disease with 5 stages of severity:

1. normal function
2. mildly decreased function
3. mild-moderate to moderate-severe loss of function
4. severe loss of function
5. kidney failure

Early stages usually show no symptoms and patients may not realise they have the disease until it’s advanced.

Up to 2 of 3 CKD cases are caused by diabetes and high blood pressure.

Associated complications

CKD is known as a “disease multiplier” as it often occurs in the context of multiple comorbidities.

As kidney function continues to decline, patients face an increased risk of developing other complications, including anaemia and hyperkalaemia.

Progression of the disease might be slowed but no cure exists.

Hyperkalaemia:
Hyperkalaemia is characterised by too much potassium in the blood.8 As kidney function declines, the kidneys are less able to remove excess potassium.

Elevated potassium (especially at higher levels) is associated with increased risk of cardiovascular (CV) events and death.

Anaemia:
Anaemia happens when there aren’t enough red blood cells. As kidney function declines, anaemia develops because the body does not properly signal that it should produce enough red blood cells.

Anaemia in CKD can be associated with hospitalisation and higher risk of death.

Bone disease:
Bone disease happens when there is too much phosphorus in the blood. When kidney function declines, phosphorus is less able to be removed properly, causing the body to pull calcium from your bones.

Elevated phosphorus has been associated with an increased risk of death in CKD patients undergoing dialysis.

Heart disease:
Heart disease (heart attack, heart failure, stroke, arrhythmias, peripheral vascular disease) can develop when damaged kidneys fail to help the body regulate blood pressure.

Patients with stage 5 CKD have been estimated to have 3.4x higher risk of CV events than patients with stage 1 or 2.

Some CKD statistics

• Global deaths caused by CKD nearly doubled Global deaths caused by CKD from 0.6 million in 1990 to 1.2 million in 2016.
• In 2017, approximately 35.8 million healthy years of life were lost globally due to disability caused by CKD.