CKD
https://cks.nice.org.uk/topics/chronic-kidney-disease/ [NICE guideline ref]
Definition: Chronic kidney disease is impaired kidney function for more than 3 months. It is
irreversible and tends to progress over time. It can be caused by physical damage even if the
eGFR remains normal
Causes:
Conditions associated with intrinsic kidney damage, such as:
o Hypertension
o Diabetes mellitus.
o Glomerular disease, such as acute glomerulonephritis (typically if CKD follows
a Streptococcal upper respiratory tract infection; may also follow hepatitis B,
hepatitis C, or HIV infection). See the CKS topics on Sore throat - acute,
Hepatitis B, Hepatitis C, and HIV infection and AIDS for more information.
Current or previous history of acute kidney injury (AKI).
o This may be triggered by severe intercurrent illness or dehydration.
Potentially nephrotoxic drugs, such as:
o Aminoglycosides,
o angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor
antagonists (AIIRAs),
o bisphosphonates,
o calcineurin inhibitors (such as ciclosporin or tacrolimus),
o diuretics, lithium,
o mesalazine, and
o nonsteroidal anti-inflammatory drugs (NSAIDs).
Conditions associated with obstructive uropathy, such as:
o Structural renal tract disease.
Bladder voiding problems such as neurogenic bladder, benign prostatic hypertrophy.
Urinary diversion surgery.
Recurrent urinary tract calculi.
o Multisystem diseases with potential renal involvement, such as:
o Systemic lupus erythematosus (SLE) which may cause lupus nephritis.
o Vasculitis.
o Myeloma.
A family history of CKD stage 5, or hereditary kidney disease such as autosomal
dominant polycystic kidney disease, Alport's syndrome (a sex-linked recessive
disease which typically causes haematuria), and familial glomerulonephritis.
Cardiovascular disease.
Diagnosis:
1. Serum creatinine:
https://cks.nice.org.uk/topics/chronic-kidney-disease/ [NICE guideline ref]
Definition: Chronic kidney disease is impaired kidney function for more than 3 months. It is
irreversible and tends to progress over time. It can be caused by physical damage even if the
eGFR remains normal
Causes:
Conditions associated with intrinsic kidney damage, such as:
o Hypertension
o Diabetes mellitus.
o Glomerular disease, such as acute glomerulonephritis (typically if CKD follows
a Streptococcal upper respiratory tract infection; may also follow hepatitis B,
hepatitis C, or HIV infection). See the CKS topics on Sore throat - acute,
Hepatitis B, Hepatitis C, and HIV infection and AIDS for more information.
Current or previous history of acute kidney injury (AKI).
o This may be triggered by severe intercurrent illness or dehydration.
Potentially nephrotoxic drugs, such as:
o Aminoglycosides,
o angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor
antagonists (AIIRAs),
o bisphosphonates,
o calcineurin inhibitors (such as ciclosporin or tacrolimus),
o diuretics, lithium,
o mesalazine, and
o nonsteroidal anti-inflammatory drugs (NSAIDs).
Conditions associated with obstructive uropathy, such as:
o Structural renal tract disease.
Bladder voiding problems such as neurogenic bladder, benign prostatic hypertrophy.
Urinary diversion surgery.
Recurrent urinary tract calculi.
o Multisystem diseases with potential renal involvement, such as:
o Systemic lupus erythematosus (SLE) which may cause lupus nephritis.
o Vasculitis.
o Myeloma.
A family history of CKD stage 5, or hereditary kidney disease such as autosomal
dominant polycystic kidney disease, Alport's syndrome (a sex-linked recessive
disease which typically causes haematuria), and familial glomerulonephritis.
Cardiovascular disease.
Diagnosis:
1. Serum creatinine: