Kidney disease is the fastest-growing noncommunicable disease in the U.S., with 15% or 1 in 7 adults affected.
Recognizing the causes and risk factors for CKD is essential to reduce or prevent associated adverse outcomes such as acute kidney injury (AKI), increased risk for stroke, and progression to kidney failure or end-stage renal disease (ESRD).
- Chronic Kidney Disease (CKD) is characterized by gradual and often irreversible damage to the kidneys.
- Kidney disease is developing in the U.S. at an increased rate, with nearly 15% of adults being affected.
- CKD is generally caused by other conditions that place additional stress on the kidneys.
- The leading cause of CKD is diabetes and hypertension.
- Children develop CKD for different reasons than those of the adult population.
Chronic Kidney Disease Overview
The kidneys play an essential role in ensuring that waste products and excess fluids are removed from the bloodstream. Chronic kidney disease is characterized by an abnormality in kidney function or structure. A variety of conditions are known to cause damage to the kidneys, acutely or over a period of time.
Symptoms of early-stage kidney damage often do not present until there is permanent and often irreversible damage to the kidneys. The slow presentation of symptoms results in many people not knowing they have CKD or end-stage renal disease (ESRD). Symptoms of advanced CKD may include:
- Blood in your urine
- Hypertension (high blood pressure)
- Swelling in feet, hands, ankles, and legs
- Pain in the lower back
CKD is diagnosed by simple blood (Glomerular filtration rate- GFR) and urine (albumin) tests. Serum creatinine tests can also be administered to determine how well the waste is filtered out of the blood.
CKD is divided into five stages that define how well the kidneys are working. The stages of CKD are determined by eGFR test results. GFR determines how well your kidneys can filter waste products and extra fluid out of your blood. As the stages of CKD increase, the damage to the kidneys gets worse, and their function decreases.
Causes of Chronic Kidney Disease
CKD is typically caused by other conditions that add additional pressure on the kidneys or as a result of a combination of different issues. Common causes of CKD include:
Other conditions that may cause CKD:
- Autoimmune diseases. Autoimmune diseases occur when the body’s immune (defense) system malfunctions and turns against the body. Some autoimmune diseases that cause CKD include Lupus nephritis, Goodpasture Syndrome, IgA nephropathy, and ANCA-associated vasculitis.
- Inherited diseases. There are over 60 known inherited diseases that affect the kidneys. Some inherited diseases include ADPKD (autosomal dominant polycystic kidney disease), Gitelman syndrome, Nephronophthisis, and Cystinosis.
- Congenital kidney and urinary tract abnormalities. These congenital disabilities affect the shape and function of the urinary tract and the kidneys. Abnormalities of the kidneys may include renal agenesis, renal dysplasia, polycystic kidney disease, and horseshoe kidney.
- Glomerulonephritis. Glomerulonephritis is characterized as damage to the glomeruli (tiny filters) inside the kidneys. A problem with your immune system often causes it.
- Other causes. Conditions such as kidney stones or tumors can cause obstructions which may result in kidney damage. Repeated urinary infections can also cause CKD.
While anyone can develop CKD, some people may have an increased risk of developing CKD, especially if they have:
- A family history of kidney disease
- Hypertension (high blood pressure)
- Heart disease, or they
- Are over the age of 60
- Are obese
- Are Native American, African American, or Asian American
- Smoke or use tobacco products
Having one or more of these CKD risk factors does not mean that you will develop CKD. If you have any of these risk factors, it is advisable to consult your healthcare provider about how often you should have your kidney function tested.
If your healthcare provider suspects CKD, the earlier it is diagnosed, the earlier effective treatment can be started. Early diagnosis and intervention may help slow disease progression and preserve kidney function. Early detection and intervention also reduce the patient’s risk of developing other serious complications, such as kidney failure, stroke, or heart attack.
The Leading Cause of Chronic Kidney Disease
The two most common leading causes of CKD are high blood pressure and diabetes.
Diabetes is the leading cause of ESRD and kidney failure, with approximately 1 in 3 diabetic adults having CKD. Damage to the kidneys caused by diabetes is referred to as diabetic nephropathy. Diabetes is characterized as a chronic disease where the body is unable to make enough insulin or use insulin effectively to control the body’s blood sugar levels.
The fluctuating or frequently high blood sugar levels damage the nephrons and small blood vessels in the kidneys. The kidneys are unable to filter out water and waste products effectively. Diabetes can also damage the body’s nervous system. This negatively affects the bladder’s ability to empty when full, increasing pressure on the kidneys. If urine sits in the urinary tract for extended periods, kidney infections may occur.
People with type 2 diabetes may be at an increased risk of developing kidney disease.
Hypertension (high blood pressure) is the second leading cause of ESRD and kidney failure, with 1 in 5 hypertensive adults having CKD.
Blood pressure and the kidneys are related in two ways. Firstly, hypertension is one of the leading causes of the development of CKD. High blood pressure puts increased strain on the blood vessel walls due to the increased pressure. Over time, this damages the blood vessel walls in the body, causing inadequate blood supply to flow to the kidneys. The glomeruli in the kidneys are damaged, causing CKD.
Secondly, hypertension is a known complication of CKD, as the kidneys produce hormones that play an essential role in regulating arterial blood pressure in the body. When the kidneys are damaged, they can no longer regulate blood pressure, resulting in hypertension.
Causes of Kidney Disease in Children
CKD is not as prevalent in children than the adult population, with figures unknown, as many children do not present with symptoms in the early stage of the disease. Children often develop CKD for reasons that differ from adults. The most common causes of CKD in children are:
- Kidney trauma or injury
- Kidney congenital disabilities
- Systemic disease
- Kidney infection
- Genetic disease
- Abnormalities with the urinary system
CKD is complex and expensive. Payers and providers create transformative solutions that can address the shortcomings of kidney care while improving patient quality of life. Panoramic Health understands the role both payers and providers play in healthcare. Through our value-based kidney care platform, we are able to:
- Improve planned dialysis starts and cost savings
- Help slow disease progression
- Minimize treatment delays and reduce hospital readmissions
- Increase patient engagement, education, and access to care