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VNA of Care New England
VNA of Care New England

Chronic Kidney Disease

(Chronic Renal Failure; Chronic Renal Disease; Chronic Renal Insufficiency)

Chronic kidney disease is a condition in which the kidneys are not working correctly. It is caused by damage to tiny structures within the kidneys called nephrons. In the early stages, chronic kidney disease does not cause symptoms; therefore, most people don’t know they have the condition.
The kidneys are bean-shaped organs located in the lower back just below the rib cage. Each kidney is about the size of a fist. The two kidneys filter blood, catch needed substances, return them to the circulation, and dispose of wastes in the urine. If the kidneys don’t filter properly, wastes build up in the blood. The kidneys also maintain the balance of water in the body and release hormones. These hormones keep the bones strong, control blood pressure, and help the body make red blood cells. If your kidneys stop working, your bones may become weak, your blood pressure may increase, and your red blood cell count may decrease.
Anatomy of the Kidneys
Anatomy of the Kidney
Copyright © Nucleus Medical Media, Inc.

Stages

Chronic kidney disease is a progressive condition. Doctors use stages to describe how serious it is. The stage is based on the glomerular filtration rate (GFR).
Stage Glomerular Filtration Rate (GFR)
1 Over 90 mL/min (normal)
2 60 to 89 mL/min (mild decrease)
3 30 to 59 mL/min (moderate decrease)
4 15 to 29 mL/min (severe decrease)
5 under 15 mL/min (kidney failure or end-stage renal disease)

Causes

The two most common causes of chronic kidney disease are diabetes and hypertension.
  • Diabetes type 1 and type 2 occur when the body doesn’t process the sugar in the blood well. The amount of sugar in the blood increases. High blood glucose damages the kidneys, the heart, blood vessels, and eyes.
  • Hypertension , also known as high blood pressure, occurs when there is high pressure within the arteries of the body. Hypertension damages the kidneys. Chronic kidney disease can also cause hypertension.
Other conditions that can cause chronic kidney disease include:

References

About chronic kidney disease (CKD): a guide for patients and their families. National Kidney Foundation website. Available at: http://www.kidney.org/kidneydisease/aboutckd.cfm . Accessed July 2, 2013.

Are you at increased risk for chronic kidney disease? National Kidney Foundation website. Available at: http://www.kidney.org/atoz/pdf/11-10-1814.pdf . Published 2010. Accessed July 2, 2013.

Chronic kidney disease. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated April 22, 2013. Accessed July 2, 2013.

Chronic kidney disease: patient information handout. American Academy of Family Physicians website. Available at: http://familydoctor.org/online/famdocen/home/common/kidney/832.html . Updated November 2010. Accessed July 2, 2013.

Kidney disease basics. National Kidney Disease Education Program website. Available at: http://www.nkdep.nih.gov/patients/kidney%5Fdisease%5Finformation.htm . March 1, 2012. Accessed July 2, 2013.

National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003; 42:S1-201.

National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:S1-266.

National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004; 43:S1-S29.

Snyder S, Pendergraph B. Detection and evaluation of chronic kidney disease. Am Fam Physicians. 2005;72:723-732.

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