DISCUSION AND ENUMERATION OF ETIOLOGIES OF CKDKD.

CKD

1. CKD BY – Dr Laxmi Nand Proof. Deptt Of Medicine IGMC Shimla

2. INTRODUCTION Chronic Kidney Disease (CKD) is a long-term condition characterized by a gradual decline in kidney function over time. CKD is often referred to as a "silent disease" because it can progress without noticeable symptoms until significant kidney damage has occurred. Globally, CKD is a major public health concern, affecting approximately 10-15% of adults.

3. Importance of Early Diagnosis in Chronic Kidney Disease (CKD) Slowing Disease Progression Preventing Complications Optimizing Treatment Improving Patient Outcomes Reducing Healthcare Costs Empowering Patients

4. PATHOPHYSIOLOGY

5. COMMON ETIOLOGIES

6. 1.DIABETES MELLITUS

7. 2.HYPERTENSION Overview: Hypertension is the second most common cause of CKD. It contributes to approximately 25% of CKD cases. Mechanism: Elevated blood pressure exerts excessive force on the blood vessels in the kidneys, causing them to thicken and narrow. This reduces blood flow to the kidneys, leading to damage and scarring (glomerulosclerosis), which impairs kidney function. Compounding Effect: CKD and hypertension have a bidirectional relationship, where CKD can worsen hypertension, and hypertension can accelerate CKD progression.

8. 3. GLOMERULONEPHRITIS Overview: Glomerulonephritis is a group of diseases that cause inflammation of the glomeruli.. It can be acute or chronic and is a significant cause of CKD. Types: Primary Glomerulonephritis: Originates in the kidneys and includes conditions like IgA nephropathy and membranous nephropathy. Secondary Glomerulonephritis: Occurs as a result of systemic diseases, such as lupus nephritis (associated with systemic lupus erythematosus), or post-infectious glomerulonephritis. Mechanism: Inflammation damages the glomeruli, leading to impaired filtration, proteinuria, hematuria (blood in urine), and progressive kidney damage.

9. 4. Polycystic Kidney Disease Overview: PKD is a genetic disorder characterized by the growth of numerous cysts in the kidneys. It is one of the most common inherited causes of CKD. Types: Autosomal Dominant PKD (ADPKD): The most common form, typically manifests in adulthood. Autosomal Recessive PKD (ARPKD): A rarer form that usually presents in infancy or childhood. Mechanism: The cysts enlarge the kidneys and interfere with normal kidney function, leading to progressive renal insufficiency. ADPKD is associated with other complications like high blood pressure, liver cysts, and aneurysms

10. 5. Obstructive Uropathy Overview: Long-term obstruction of the urinary tract can lead to CKD. Causes of obstruction include kidney stones, tumors, and enlarged prostate in men. Mechanism: The obstruction increases pressure within the kidneys, causing hydronephrosis (swelling of the kidney due to urine buildup) and damaging kidney tissue. Prolonged obstruction can lead to permanent kidney damage and CKD.

11. 6. Recurrent UTI Overview: Frequent UTIs, particularly those that affect the kidneys (pyelonephritis), can lead to CKD. Mechanism: Recurrent infections can cause scarring of the kidney tissue, impairing kidney function over time. Individuals with underlying conditions like vesicoureteral reflux (backward flow of urine from the bladder into the kidneys) are at higher risk.

12. 7. Autoimmune diseases Overview: Autoimmune conditions, where the body's immune system mistakenly attacks its own tissues, can target the kidneys, leading to CKD. Examples: Systemic Lupus Erythematosus (SLE): Can cause lupus nephritis, where immune complexes deposit in the kidneys, causing inflammation and damage. Vasculitis: Inflammation of blood vessels can restrict blood flow to the kidneys, causing damage.

13. 8. Drugs and Toxins Overview: Exposure to certain toxins and long-term use of certain medications can lead to CKD. Examples: Medications: Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, and some chemotherapy drugs can damage the kidneys. Environmental Toxins: Exposure to heavy metals (e.g., lead, cadmium) and organic solvents can also contribute to CKD. Mechanism: These substances can cause direct damage to kidney cells, disrupt normal kidney function, and lead to chronic kidney injury.

14. 9. Other risk factors Aging: The risk of CKD increases with age, as kidney function naturally declines over time. Obesity: Excess body weight increases the risk of diabetes and hypertension, both of which are major causes of CKD. Ethnicity: Certain ethnic groups, such as African Americans, Hispanics, Asians, and Native Americans, have a higher prevalence of CKD due to genetic predisposition and higher rates of diabetes and hypertension.