Chronic kidney disease is a clinical syndrome marked by progressive and permanent decadence of nephron, resulting in failure of all of the known kidney functions – excretory, endocrine and metabolic. Chronic kidney disease is basically damage done to the functional cells inside the kidney, which reduces its function on a period longer than three months. This requires a pathological test of the urine, biochemical tests done to the blood as well as reports from roentgen and other imaging diagnosis technique. The best, but most intensive method of confirming this is to have a kidney biopsy. The main criteria for determining the stage of the chronic kidney disease is the size, or better said reduction of the glomerular filtration content.
There are five stages of chronic kidney disease to speak of – 1st stage is when the glomerular filtration is above 90mL/min, 2nd stage is at 60-89 mL/min, 3rd stage is at 30-59 mL/min, 4th stage is at 15-29 mL/min and the 5th stage is has a glomerular filtration below 15 mL/min. Patients in the fifth stage need to get on dialysis as soon as possible.
It is quite difficult to find the best time to start with dialysis treatment. When deciding for this, a lot of biochemical parameters need to be taken into account, such as concentration of urea, electrolytes, hydrogen ions etc. You also need to count the age, constitution and other diseases the patient might be suffering from into account. If the final decision is established for hemodialysis, it is necessary to enable a vascular approach. As a permanent vascular access it’s best to give head to atrium-venous fistula. Today, generally accepted opinion about this, is that the person already suffering from intensive atherosclerosis need to do a surgical procedure on the blood vessels of the elbow a couple of months before hemodialysis treatment begins.
Besides accounting for the kidney functions, one needs to keep an eye on all of the possible complications which may happen during this process. In the worst case, complications will stack one on top of the other, making the whole condition exponentially worse over time. These include anemia, hypertension, disturbance of calcium metabolism, heart failure etc.
Acute kidney failure
On the other hand, acute kidney failure is also a clinical syndrome, characterized with a disturbance in the kidney function when it comes to excretion of water, electrolytes, hydrogen ions as well as products of the protein metabolism. This syndrome is today being looked in a group of multiple kidney failure diseases. About 8% of all acute kidney failures appear as an isolated issue. Kidney diseases can therefore be a consequence of disorders affecting blood vessels, tubules and interstation tissue which is meant to divide individual nephrons. Other than kidney itself, many of its functions might deteriorate over time, causing some minor issues which will become more significant over time.
The transformation of the acute kidney failure into a chronic one is not a common appearance and happens in only about 9% of cases.