Chronic kidney disease: pathophysiology and complications

Clinical Case: Chronic Kidney Disease

Chronic kidney disease (CKD) is a syndrome defined as persistent alterations in kidney structure, function or both with implications for the health of the individual.

MECHANISMS/ PATHOPHYSIOLOGY

nephrons can contend with transient increases in filtration load by transiently increasing GFR without structural changes, longer or persistent increases in body mass (for example, during pregnancy or obesity) promote nephron hypertrophy as the compensatory mechanism.

Nephron hypertrophy Remnant nephron hypertrophy is triggered by persistent elevations of GFRand filtration pressure across the glomerular filtration barrier, which implies glomerular hyperfiltration.

Fibrosis Nephron loss involves nonspecific wound-healing responses that include interstitial fibrosis.

Prematurity and low birth weight Newborns with low birth weight frequently display incomplete kidney development ; poor nephron endowment can cause CKD at any age.

Contributing factors

Prematurity and low birth weight

Genetic factors

Obesity

Pregnancy

Diabetes

Aging

SYSTEMIC COMPLICATIONS OF CKD

Metabolic acidosis ● anaemia ● mineral bone disorder ● arterial hypertension ● Hyperuricemia.