INTRODUCTION Chronic kidney disease also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.  Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death.

SYMPTOMS

Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include: Nausea, Vomiting, Loss of appetite, Fatigue and weakness, Sleep problems, Changes in how much you urinate, Decreased mental sharpness, Muscle twitches and cramps, Swelling of feet and ankles, Persistent itching, Chest pain, if fluid builds up around the lining of the heart, Shortness of breath, if fluid builds up in the lungs, High blood pressure (hypertension) that’s difficult to control.

CAUSES

Diseases and conditions that cause chronic kidney disease include:

• Type 1 or type 2 diabetes
• High blood pressure
• Glomerulonephritis, an inflammation of the kidney’s filtering units (glomeruli)
• Interstitial nephritis, an inflammation of the kidney’s tubules and surrounding structures
• Polycystic kidney disease
• Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
• Vesicoureteral  reflux, a condition that causes urine to back up into your kidneys
• Recurrent kidney infection, also called pyelonephritis.

RISK FACTORS

Factors that may increase your risk of chronic kidney disease include: Diabetes, High blood pressure, Heart and blood vessel (cardiovascular) disease, Smoking Obesity, Family history of kidney disease, Abnormal kidney structure and Older age.

COMPLICATIONS

Chronic kidney disease can affect almost every part of your body. Potential complications may include: Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema), A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart’s ability to function and may be life-threatening, Heart and blood vessel (cardiovascular) disease, Weak bones and an increased risk of bone fractures, Anemia, Decreased sex drive, erectile dysfunction or reduced fertility, Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures, Decreased immune response, which makes you more vulnerable to infection, Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium), Pregnancy complications that carry risks for the mother and the developing fetus, Irreversible damage to your kidneys (end-stage kidney disease etc. DIAGNOSE The following diagnostic tests are performed generally for CKD: Blood Test for GFR ,  Test for Albumin:- Dipstick test for albumin and Urine albumin-to-creatinine ratio (UACR), An ultrasound scan, magnetic resonance imaging (MRI) scan or computerised tomography (CT) scan, Ultrasound, A kidney biopsy, Kidney Function Tests, Nuclear Medicine Mag3 Scan, Genetic Testing. TREATMENTS The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. Treatment for Early-Stage CKD

• High blood pressure medications— commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers — and to preserve kidney function.
• Medications to lower cholesterol levels.
•  Medications to treat anemia. Erythropoietin supplements aid in production of more red blood cells
• Medications to relieve swelling. Medications called diuretics can help maintain the balance of fluids in your body.
• Medications to protect your bones.
• A lower protein diet to minimize waste products in your blood.

Treatment for End-Stage CKD There are many options for treating kidney failure including kidney transplant and several types of dialysis. The management of CKD as following: Hemodialysis: This type of treatment uses a machine to clean your blood, and it can be done at a dialysis center or at home. Peritoneal Dialysis: Peritoneal dialysis is a treatment that uses the lining of your abdomen (belly area) called your peritoneum and a cleaning solution called dialysate to clean your blood. Kidney Transplant