Chronic Kidney Disease Case Study

INTRODUCTION

The pattern of disease morbidity and mortality throughout the world is changing both in the developed and the developing countries. In the last century, infectious diseases were the leading cause of mortality and morbidity. Nonetheless in the current century, noncommunicable, noninfectious diseases have become the main cause of death and disability around the world (Robert Atkins 2005). Chronic kidney disease (CKD) is emerging to be an important chronic disease globally [Ruggenenti P et al 2001]. The prevalence of Chronic Kidney Disease has been rising rapidly and is causing a public health issue as a non-communicable epidemic. According to study published in Lancet in 2013 the prevalence of chronic kidney disease is estimated to be 8 to 16 % worldwide (Jha V et al 2013). In India, it has been lately predicted that the age-adjusted incidence rate of end stage renal disease (ESRD) to be 229 per million population and more than one lakh new patients enter renal replacement programs annually (Ajay S et al 2013). In Britain prevalence is

Prerenal

2. Renal

3. Postrenal.

Prerenal azotemia may be caused by reduced blood flow through the kidneys or by more production of urea in the liver due to a protein rich diet or enhanced protein catabolism (e.g stress, febrile illness, corticosteroid therapy, or gastrointestinal bleeding). Renal causes may be due to reduced renal function. The causes are acute and chronic kidney failure, acute and chronic nephritis, tubular necrosis and other renal diseases.

Post renal causes may be due to reduced excretion of urea. And these could be due to obstruction to urinary outflow such as by calculi, bladder and prostate tumours, or a severe infection (Bishop ML 6th edition). The main cause of uremia is damage to the kidneys, whether because of Bright’s disease (glomerulonephritis), hypertension, diabetes mellitus, or some other disorder that impairs kidney