Complication of ckd

Chronic kidney disease (CKD) is associated with multiple potential complications affecting various organ systems and overall health. The key complications include:

• Progression to end-stage renal disease (ESRD): CKD can progress to kidney failure classified as GFR category G5 (<15 ml/min/1.73 m2), necessitating renal replacement therapy such as dialysis or kidney transplantation NICE NG203.
• Cardiovascular disease (CVD): Adults with CKD have an increased risk of cardiovascular complications, including heart failure, ischemic heart disease, and stroke, independent of traditional risk factors. This risk remains heightened post-COVID-19 infection as well Loutradis et al. 2022 [1, Loutradis et al. 2022].
• Renal anaemia: The reduced erythropoietin production in CKD leads to anaemia, which may require treatment with erythropoiesis-stimulating agents and iron supplementation NICE CKS,NICE CKS.
• Mineral and bone disorder: CKD results in disturbances in phosphate and calcium metabolism causing renal osteodystrophy. Management may require phosphate restriction, phosphate binders, and endocrinology input NICE CKS,NICE CKS.
• Metabolic acidosis: Persistent metabolic acidosis occurs due to impaired acid excretion in CKD, contributing to progression and bone disease NICE CKS,NICE CKS.
• Hyperkalaemia: Elevated serum potassium due to reduced renal excretion can complicate CKD and requires specialist dietary advice and monitoring NICE CKS,NICE CKS.
• Nutritional decline and malnutrition: CKD patients are at risk of worsening nutritional status, requiring dietary supervision to prevent malnutrition NICE CKS,NICE CKS.
• Urinary outflow obstruction and hydronephrosis: Structural causes of CKD or complications may lead to obstruction, sometimes requiring urological referral and potentially emergency intervention NICE CKS,NICE CKS.
• Risk of acute kidney injury (AKI): Patients with CKD are predisposed to AKI, especially with intercurrent illness or exposure to nephrotoxic drugs such as NSAIDs NICE NG203,NICE NG148.
• Psychosocial impact: Anxiety, depression, and reduced quality of life are common in CKD patients, necessitating psychological support as part of management NICE NG203.

In summary, CKD complications are systemic, affecting cardiovascular health, bone metabolism, haematopoiesis, acid-base balance, nutritional status, and urinary tract integrity. These complications highlight the importance of regular monitoring, comprehensive management, and specialist referral as appropriate to mitigate morbidity and mortality [1, 2, 3, 4, Loutradis et al. 2022].