CKD Pathogenesis

Published on Sep 20, 2018

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PRESENTATION OUTLINE

CKD Pathogenesis

  • Chronic kidney disease (CKD) is the progressive, as well as, steady loss in kidney function where estimated glomerular filtrate rate (eGFR) is below 60ml/min for over three months.

1.CKD is irreversible

  • Once CKD occurs, it is generally irreversible; hence can progress to end-stage renal disease (ESRD). Studies show CKD progression in patients with diabetes and hypertension. Thus, examining the pathogenesis of each of the highlighted diseases about CKD gives an overview of the pathogenesis CKD as it progresses leading to kidney function loss.
  • 2. Hypertension and CKD CKD is an irreversible renal failure that can likely progress without the appropriate therapeutic approaches. Most patients with CKD suffer from hypertension; as kidney function worsens, hypertension prevalence increases. Thus, hypertension and CKD have a cause and effect correlation.
  • i. vascular and glomerular changes Uncontrolled blood pressure destroys the tiny filtering units found in the kidneys. Thus, hypertension induces vascular and glomerular changes within the kidneys. ii. Systemic blood pressure Systemic blood pressure increases causing hyperplasia and necrosis due to hypertrophic responses resulting in electron-dense deposits thickening the smooth muscle cells.

Glomerulosclerosis

  • Glomerulosclerosis The hardening of the smooth muscle cells, damage of endothelial cells and glomerular basement membrane causes glomerulosclerosis indicating glomerular changes. Glomerulosclerosis results in tubular atrophy and interstitial fibrosis. iv. interstitial fibrosis Interstitial fibrosis in combination with renal ischemia results in progressive renal insufficiency. Both the vascular and glomerular changes cause nephrons loss due to glomerular, as well as, tubular loss. Glomerular filtrate rate (GFR) gradually declines as the nephrons loss function. Therefore, GFR is directly associated with interstitial fibrosis and Tubular atrophy.

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  • i. Glomerulosclerosis The hardening of the smooth muscle cells, damage of endothelial cells and glomerular basement membrane causes glomerulosclerosis indicating glomerular changes. Glomerulosclerosis results in tubular atrophy and interstitial fibrosis. ii. interstitial fibrosis Interstitial fibrosis in combination with renal ischemia results in progressive renal insufficiency. Both the vascular and glomerular changes cause nephrons loss due to glomerular, as well as, tubular loss. Glomerular filtrate rate (GFR) gradually declines as the nephrons loss function. Therefore, GFR is directly associated with interstitial fibrosis and Tubular atrophy.

References
Mandal, A. K. (2015). Pathogenesis and Prevention of Progression of Chronic Kidney Disease. Open Journal of Internal Medicine, 5(03), 58.

Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic kidney disease. The Lancet, 389(10075), 1238-1252.

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Gloria Walker

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