Complications of chronic kidney disease (atherosclerosis, anaemia, disturbances of Ca-P metabolism)

1. Big picture

Chronic kidney disease (CKD) is not only a kidney problem. As kidney function declines, the kidney loses three major roles:

1. Excretory role → accumulation of urea, phosphate, acids, potassium, water.
2. Endocrine role → reduced erythropoietin and reduced active vitamin D production.
3. Cardiovascular-protective role → CKD promotes hypertension, endothelial dysfunction, vascular calcification, inflammation, and accelerated atherosclerosis.

The examiner usually wants you to connect:

CKD → cardiovascular disease + anaemia + CKD-mineral and bone disorder

These are the major chronic complications that determine prognosis, quality of life, hospitalization, and mortality.

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