Chronic Kidney Disease

Disease State Hub

MULTIDISCIPLINARY ROUNDTABLE

Key Approaches to Managing Patients With CKD

In this Multidisciplinary Roundtable discussion, James Matera, DO, speaks with nephrologist Wayne Kotzker, MD, primary care physician Maria Ciminelli, MD, cardiologist Lance Berger, MD, and nutritionist Jamie Miller, RD, about the role of the multidisciplinary approach in the management of patients with chronic kidney disease (CKD), including referring a patient to a specialist, ensuring risk reduction and slowing the progression of end-stage renal disease, and cardiovascular risk factors in patients with CKD.

Featured

Podcast

Podcast

Tools For a Successful Urgent-Start Peritoneal Dialysis Program

05/14/2023

Expert Q&A

Chronic Kidney Disease and Aging

05/10/2023

In this Q&A, Ping Liu, PhD, and Pietro Ravani, MD, PhD, answer our questions about the diagnosis and management of chronic kidney disease (CKD) and discuss how the current definition of CKD does not...

05/10/2023

Video

Video

Estimated GFR With Cystatin C and Creatinine in Clinical Practice

05/02/2023

In this video, Eric Gottlieb, MD, MS, discusses the use of cystatin C vs creatinine to estimate glomerular filtration rate in diverse patient populations and how the use of cystatin C to estimate GFR can...

05/02/2023

Interactive Features

Pop Quiz

Nutritional Status as a Predictor of CKD Adverse Events

03/26/2023

Poll

Transparent blue Xray of a person. The person's kidneys stand out in the image. They are highlighted as red.

Poll

Controversies in CKD Management

01/07/2023

Controversies exist in the management of chronic kidney disease and comorbidities. Do you think the currently available clinical practice guidelines sufficiently address these controversies?

01/07/2023

Pop Quiz

Pop Quiz

Calcium Intake and Chronic Kidney Disease

08/30/2022

Patients with chronic kidney disease (CKD) are encouraged to maintain a diet that helps manage the disease. Do you know the recommended amount of calcium a person with CKD should ingest every day?

08/30/2022

Pop Quiz

Defining CKD

04/25/2021

Do you know how long abnormal kidney structure or function should be present before a patient is diagnosed with chronic kidney disease? Test your knowledge with our latest pop quiz!

04/25/2021

Poll

ESRD, Amputations, and Death

09/17/2018

Nearly half of patients with ESRD who undergo a lower extremity amputation die within how many years of amputation?

09/17/2018

Clinical Insights

Podcast

Tools For a Successful Urgent-Start Peritoneal Dialysis Program

05/14/2023

Expert Q&A

Chronic Kidney Disease and Aging

05/10/2023

Video

Estimated GFR With Cystatin C and Creatinine in Clinical Practice

05/02/2023

Expert Q&A

Will New ADA Guidelines Impact GLP-1 RA, SGLT-2 Inhibitor Usage?

05/01/2023

Expert Q&A

Expert Q&A

Effects of Empagliflozin in Patients With Chronic Kidney Disease

04/10/2023

In this Q and A, Chief Investigator of the EMPA-KIDNEY trial, William Herrington, MA, MBBS, MD, answers questions about the results of the trial, including the effects of the SGLT2 inhibitor, empagliflozin,...

04/10/2023

Chronic Kidney Disease Snapshot

Reviewed by: James J. Matera, DO

Overview

Chronic kidney disease (CKD) is the progressive loss of kidney function. The kidneys filter waste products from the blood and maintain fluid balance with the production of urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electolytes, and nitrogenous waste to build up in the body and may lead to high blood pressure, heart disease, stroke, and early death.

CKD can also be called chronic kidney failure or chronic renal insufficiency. CKD is classified into 5 levels, based on the estimated glomerular filtration rate (eGFR).

Specialty Impact

Nephrologist, Nutritionist, Primary Care Physician, Transplant Surgeon

Presentation

Kidney function loss can cause fluid buildup or body waste or electrolyte problems. CKD symptoms generally include:

Nausea
Vomiting
Loss of appetite
Fatigue and weakness
Sleep problems
Urinating more or less
Decreased mental sharpness
Muscle cramps
Swelling of feet and ankles
Dry, itchy skin
Hypertension
Shortness of breath if fluid builds up in the lungs
Chest pain if fluid builds up around the lining of the heart

Diagnostic Testing

Serum creatinine
- A serum creatinine blood test measures the amount of creatinine in the blood. Creatinine is a waste product that comes from the normal use of muscles in the body. The kidneys remove waste from the blood. If the kidneys are not functioning properly, the level of serum creatinine increases. Generally, a creatinine level more than 1.2 for women and more than 1.4 for men is considered elevated.
Estimated glomerular filtration rate (eGFR)
- eGFR measures kidney function. A patient's creatinine level, age, and sex are used to calculate eGFR. As kidney disease progresses, eGFR decreases. An eGFR less than 60 ml/min is generally below normal limits, and a eGFR of less than 15 ml/min is generally considered advanced kidney failure.
Blood urea nitrogen (BUN)
- Urea nitrogen is a waste product that the body creates from the breakdown of protein in food. BUN is a blood test that measures the amount of urea nitrogen in the blood. Healthy kidneys filter urea nitrogen out of the blood, and it exits the body through urine. Normal levels of urea nitrogen depend on age and other factors and generally range from 7 to 20. As kidney disease progresses, the BUN level increases.
Dipstick urine test
- A dipstick urine test can test for albumin in the urine. Albumin in the protein produced by the liver. The test does not provide an exact measurement of albunin but can indicate if levels are within normal range. A piece of chemically treated paper is placed in a urine sample and will change color if albumin levels are elevated above normal range.
Urine albumin-to-creatinine ratio (UACR)
- UACR measures the amount of albumin in the urine and compares it with the amont of creatinine. The test measures the albumin that passes into the urine over the course of 24-hours. A UACR test result of 30 or higher may be the result of kidney disease.
Blood pressure
- High blood pressure is a leading cause of kidney disease and failure.
Imaging
- Images of the kidney can help locate problems, damage, blockage, or narrowing of blood vessels.
Kidney biopsy
- A small piece of the kidney tissue can be removed by inserting a thin needle through the skin to examine for signs of damage or disease.