Chronic kidney disease (importance, classification, screening, referral, progression inhibition)

1. Big picture

Chronic kidney disease (CKD) is not only “low kidney function.” It is a long-term systemic disease that increases the risk of:

• end-stage kidney disease requiring dialysis or transplantation
• cardiovascular death
• anaemia
• bone-mineral disease
• hyperkalaemia
• metabolic acidosis
• fluid overload
• drug toxicity

The examiner wants you to think in this order:

Detect CKD early → classify by eGFR + albuminuria → identify cause → slow progression → treat complications → refer at the right time → prepare renal replacement therapy if needed.

The most important practical point: A patient can have CKD with normal eGFR if albuminuria, haematuria, structural kidney disease, or biopsy-proven kidney damage persists for >3 months.

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