Pathophysiology | 12/16/2011, 10:18 pm

Chronic Kidney Disease Pathophysiology & Schematic Diagram

The National Kidney Foundation (NKF) Kidney Disease Outcome Quality Initiative (K/DOQI) defined CKD as kidney damage with a glomerular filtration rate (GFR) of <60ml/minute/1.73m² for more than 3 months.

There are many diseases that cause CKD; each has its own pathophysiology. However, there are common mechanisms for disease progression.Pathologic features include fibrosis, loss of renal cells, and infiltration of renal tissue by monocytes and macrophages. Proteinuria, hypoxia, and extensive angiotensin II production all contribute to the pathophysiology. In an attempt to maintain GFR, the glomerulus hyperfiltrates; this results in endothelial injury. Proteinuria results from increased glomerular permeability and increased capillary pressure. Hypoxia also contributes to disease progression. Angiotensin II increases glomerular hypertension, which further damages the kidney.

Predisposing Factors

• Diabetes, which is the most common risk factor for chronic kidney failure in the United States
• Age 60 or older
• Kidney disease present at birth (congenital)
• Family history of kidney disease
• Autoimmune Disorder (Lupus eryhtematosus)
• Bladder outlet obstruction (BPH and Prostitis)
• Race (Sickle cell disease)