Chronic Kidney Disease and Uremia

Chronic Kidney Disease and Uremia is a topic covered in the Harrison's Manual of Medicine.

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EPIDEMIOLOGY

The prevalence of chronic kidney disease (CKD), generally defined as a long-standing, irreversible impairment of kidney function, is substantially greater than the number of pts with end-stage renal disease (ESRD), now ≥500,000 in the United States. There is a spectrum of disease related to decrements in renal function; clinical and therapeutic issues differ greatly depending on whether the glomerular filtration rate (GFR) reduction is moderate (stage 3 CKD, 30–59 mL/min per 1.73 m2) (see Table 46-1), severe (stage 4 CKD, 15–29 mL/min per 1.73 m2), or “end-stage renal disease” (stage 5 CKD, <15 mL/min per 1.73 m2). Dialysis is usually required once GFR <10 mL/min per 1.73 m2. Common causes of CKD are outlined in Table 139-1.

TABLE 139-1: COMMON CAUSES OF CHRONIC RENAL FAILURE
Diabetic nephropathy
Hypertensive nephropathya
Glomerulonephritis
Renovascular disease (ischemic nephropathy)
Polycystic kidney disease
Reflux nephropathy and other congenital renal diseases
Interstitial nephritis, including analgesic nephropathy
HIV-associated nephropathy
Transplant allograft failure (“chronic rejection”)
aOften diagnosis of exclusion; very few pts undergo renal biopsy; may be occult renal disease with hypertension.

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Citation

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TY - ELEC T1 - Chronic Kidney Disease and Uremia ID - 623056 Y1 - 2017 PB - Harrison's Manual of Medicine UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623056/all/Chronic_Kidney_Disease_and_Uremia ER -