Chronic kidney disease (CKD) can be defined as a sustained reduction in the glomerular filtration rate (GFR) and/or urinary abnormalities or structural abnormalities of the renal tract.
The impact of CKD
Chronic kidney disease has a global prevalence of 9.1% and is more common in females but men are more likely to progress to kidney failure. Kidney failure is defined as GFR <15 mL/min/1.73 m2 or treatment by dialysis therapy. CKD increases in prevalence with age and high-income countries report more kidney disease than low income countries, probably as a consequence of both demography and under-reporting.
Where studied, social deprivation is associated with a higher prevalence of CKD. The scale of CKD and the consequences for health care delivery are profound; CKD is now the 4th most common global cause of non-communicable disease death.
Outcomes for those with CKD
The large majority of those affected by CKD never progress to kidney failure, the major clinical outcome burden of CKD relates to the major increased risk of cardiovascular disease events in those with CKD compared to those without CKD. This increased risk is directly related to the severity of kidney disease, as measured both by excretory kidney function (eGFR), so the lower the eGFR the higher the risk, and albuminuria quantified in clinical practice by albumin-to-creatinine ratio.
CKD is often referred to as 'silent'. This is incorrect. Whilst CKD does not have a clear symptom complex in the same way as other long-term conditions, persons with CKD have a major symptom burden including severe fatigue, pain, breathlessness, and a high prevalence of psychological health problems. These symptoms increase with the severity of CKD.
