What can lead to CKD? A glance at Etiology.

           

So far we have discussed what Chronic Kidney Disease is, and its epidemiology… but what causes CKD? As I previously mentioned, Chronic Kidney Disease is a result of impaired glomerular and tubular filtration within our kidneys. So, to discover what ultimately results in CKD, we have to look at factors that would affect those natural filters. The two major causes that lead to Chronic Kidney Disease are Diabetes and Hypertension, both affecting our bloodstream and vessels, and consequently, our kidneys' ability to filter properly.

1. Diabetes is a disease in which the body is unable to effectively manage its blood glucose levels due to an inability to produce insulin. Insulin is a hormone that lowers blood glucose levels, so in it's absence, the BG in our blood is very high. These high levels damage our blood vessels if not managed correctly, and eventually begin to impair our kidney function as well if the problem persists over time. The lack of function will, in turn, lead to Chronic Kidney Disease.

2. The second problem that contributes to CKD, is hypertension, or high blood pressure. The constant pressure of blood on our vessels is another way in which they can begin to get damaged. Once those vessels get damaged in our kidneys, once again the kidneys will begin to lose function. Often, blood pressure rises as a result of Chronic Kidney Disease, so that can further damage kidney function even when another medical condition may have initially caused the disease.

Although those are the two main factors contribution to CKD's etiology, there are several other conditions that can damage the kidneys. Some (but not all) of these conditions include:

• Kidneys diseases/ infections such as polycystic kidney disease, pyelonephritis, glomerulonephritis, or other conditions you may have been born with.
• Damaged renal arteries. The renal artery carries blood to the kidneys, so narrowing or blockage of this artery can impair kidney function.
• Certain medicines that may cause damage to kidneys. For example, ibuprofen, NSAIDS, or certain antibiotics.

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How is it affecting our world? Epidemiology unfolded

    Epidemiology is the branch of medicine that deals with the incidence, distribution, and possible control of diseases and other factors relating to health. In this week's blog post, I am going to dive into some of the epidemiology of Chronic Kidney Disease so that we can begin to understand the disease on a larger scale.

     It is important when looking at this branch of medicine to consider the different diseases that are correlated with CKD. In his article discussing the epidemiology of CKD, Robert Atkins stated that  "in this century, noncommunicable, noninfectious diseases have become the major cause of mortality and morbidity around the world. This change is reflected in the type of diseases causing chronic kidney failure and in their presentation and progression." There are many causes and different diseases that bridge to Chronic Kidney Disease, but the most major of those is Diabetes. The global pandemic of Type 2 Diabetes is progressing rapidly and is leading to a corresponding increase in the number of patients who are diagnosed with CKD. 
      According to the CDC, 1 in every 10 adults have Chronic Kidney Disease, over 20 million people in the U.S. Because the only way to find out if you have CKD is to take specific blood and urine tests, most adults are not aware of their disease and do not seek the appropriate treatment. This allows the disease to progress into later stages and eventually will begin to fatally affect the heart or result in total renal failure. Because it is closely associated with risk factors like diabetes and hypertension, the disease is distributed across the U.S. in areas where those factors are more prevalent. 

Atkins, Robert. "The Epidemiology of Chronic Kidney Disease." Nature.com. Nature Publishing              Group. Web. 18 Sept. 2015. <http://www.nature.com/ki/journal/v67/n94s/full/4496031a.html>.

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What is it?

              So what is Chronic Kidney Disease after all? The kidneys are one of our body's largest aspects of filtration. When blood is being pumped through our bodies, it passes through our kidneys, and navigates its way through a series of twisted tubules. As it passes through these tubes it is constantly being sifted through and filtered. Nutrients, salts, and water pass between our blood and the tube membranes, balancing our blood until its just right. The wastes that are taken out of the blood are excreted as urine, and the filtered blood exits the kidney and continues through circulation. When this network of filtration within our kidneys begins to stop working, you can guess it might cause some problems.

            Imagine you are making a pot of coffee but there is a hole in your coffee filter, the grounds would drip through, and your coffee wouldn't taste very good. When you develop Chronic Kidney Disease, the same thing is essentially happening in your body with your blood. Those simple processes of filtration, re-absorption, and secretion become very hard to carry out. All the waste in your blood is not properly taken care of and excreted, but instead begins to build up in your bloodstream. The fault in blood filtration then has the potential to eventually lead to many other significant health problems.

Click here to watch this short video and get a little more background on how our kidneys work!