Pathophysiology of CKD

As the article "Common Problems in CKD" points out, it is of upmost importance to study the etiology and pathophysiology of CKD not only to find out the best way to treat it, but also how to prevent it all together. 

In the presence of disease the kidneys must work harder to filter waste products out of the blood and hold onto nutrients the body needs.  For a long time the kidneys can manage quite well with the extra work, and people do not know there is anything wrong.  However, as the years pass scar tissue builds up and they can no longer do their jobs.  Here is a picture to show you how CKD can affect filtration: 

CKD makes the kidneys less effective at filtration 

Image source http://nkdep.nih.gov/resources/kidney-disease-mean-for-me.shtml

Diabetes and hypertension are the leading cause of CKD; both have similar effects on the kidneys.  Both diseases cause the kidneys to work extra hard at first.  This means that as parts of the kidney break down, the parts that are left need to do the same amount of filtering as the entire kidney used to do.  Also, when parts of the kidney breakdown they release toxic chemicals, which in turn causes more toxic chemicals to enter the kidney – thus causing further damage!  Over the years the parts of the kidney that have broken down turn into scar tissue.  If that wasn’t bad enough, it turns out that the scar tissue raises the pressure inside the kidneys even more.  This causes more blood to enter to be filtered, and the kidneys have to work even harder!!  Over time not enough working parts are left, and the kidneys no longer filter the blood or hold onto valuable nutrients.  This is when the noticeable symptoms start. 

While it is important for the medical community to search for ways to help people deal with chronic illness, please remember that the patient can have a profound impact on their own health.  And now, a word from Ms. Sheila Shaw, a woman living strong with multiple chronic illnesses.  She is living proof that you can take control of your life-- no matter the physiology behind it!  

References:

Huether S. Chapter 29: Alterations of Renal and Urinary Tract Function.  In: Huether S, McCance K.  Understanding Pathophysiology.  5^th edition.  St. Louis, MO: Mosby/Elsevier; 2012: 757-760. 

Lopez-Novoa JM, Martinez-Salgado C, Rodriguez-Pena AB, Lopez Hernandez FJ.  Common Pathophysiological mechanisms of chornic kidney disease: Therapeutic perspectives.  Pharmacol Therapeut, 2010; 128: 60-81. Doi: 10.1016/j.pharthera.2010.05.006.