Review on Kidney Diseases

Review on Kidney Diseases

Mamlakatkhon Yusupova

Department of Internal Medicine, Central Asian Medical University, Fergana 150100, Uzbekistan

DOI: https://doi.org/10.51244/IJRSI.2024.11150078P

Received: 16 December 2024; Accepted: 20 December 2024; Published: 22 January 2025

ABSTRACT

Diabetes and hypertension are the main causes of chronic kidney disease, a global public health issue that is defined by decreased kidney function and is associated with cardiovascular disease and cancer. This illness has becoming more commonplace worldwide. This article highlights the use of the most modern diagnostic and therapeutic techniques while examining recent developments in our understanding of its etiology, progression, and therapy.

Keywords: kidney disease; chronic type; diabetes and hypertension; medical awareness; internal illnesses.

INTRODUCTION

Chronic kidney disease is a global public health issue with severe implications for both quality of life and survival, especially given its association with cardiovascular disease and cancer (Webster et al., 2017). Defined by reduced kidney function — typically indicated by a glomerular filtration rate below 60 mL/min per 1.73 m² or other markers of kidney damage for at least three months — chronic kidney disease’s major causes are diabetes and hypertension, and its prevalence has steadily increased worldwide. This article examines recent advancements in understanding the causes, progression, and management of chronic kidney disease, emphasizing the latest diagnostic and therapeutic approaches.

Epidemiology and Risk Factors

Chronic kidney disease affects approximately 8–16% of the global population, with diabetes and hypertension as the leading contributors (Jha et al., 2013). Its prevalence is growing rapidly due to an aging population and lifestyle-related diseases. According to Cockwell and Fisher (2020), the disease ranked as the 12th leading cause of death globally as of 2017, with the associated mortality rates stagnating rather than decreasing as seen with other major non-communicable diseases. Risk factors for chronic kidney disease extend beyond diabetes and hypertension to include genetic predisposition, age, and socioeconomic status. Studies emphasize that individuals from lower socioeconomic backgrounds or developing countries are disproportionately affected, likely due to limited access to healthcare, inadequate preventive measures, and exposure to environmental toxins (Jha et al., 2013).

Complications and Systemic Impacts of chronic kidney disease

Chronic kidney disease is known for its multi-organ impact, with complications ranging from cardiovascular diseases to mineral and bone disorders, anemia, and even cognitive decline (Alicic et al., 2017). As kidney function deteriorates, these complications become more severe, leading to a significantly higher mortality rate. Cardiovascular complications, for instance, account for most chronic kidney disease-related deaths, as chronic kidney disease accelerates vascular calcification and atherosclerosis. Webster et al. (2017) highlighted that chronic kidney disease patients are five to ten times more likely to die prematurely than those without the disease, with the risk increasing exponentially as kidney function worsens.

Furthermore, chronic kidney disease may affect neuroendocrine signaling and immunity, often resulting in conditions such as protein-energy wasting and chronic inflammation, which further increase the risk of morbidity and mortality (Zoccali et al., 2017). These findings underscore the need for a holistic approach in CKD treatment that addresses not only kidney function but also systemic health impacts.

Diagnostic Advancements

The diagnosis of chronic kidney disease has traditionally relied on laboratory measurements such as glomerular filtration rate and albuminuria levels. Early diagnosis remains essential for improving outcomes, as therapeutic interventions in the early stages of chronic kidney disease may slow disease progression. In clinical practice, the kidney disease: “Improving Global Outcomes” guidelines are widely utilized to stage chronic kidney disease based on glomerular filtration rate and albumin-to-creatinine ratio (Levey et al., 2005).

Webster et al. (2017) also emphasized that glomerular filtration rate remains the most accurate indicator of kidney function, while proteinuria has proven to be an essential marker for disease progression. Kidney biopsy is an invaluable tool for providing histopathological evidence of chronic kidney disease through markers such as glomerular sclerosis, tubular atrophy, and interstitial fibrosis. Such diagnostic markers allow for a more precise understanding of the disease’s severity and facilitate the personalization of treatment plans.

Innovations in Treatment and Management

The primary approach to chronic kidney disease management emphasizes early detection, lifestyle modifications, and pharmacological interventions targeting underlying conditions such as diabetes and hypertension. Blood pressure control, particularly through the use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, is central to slowing chronic kidney disease progression by reducing intraglomerular pressure and proteinuria (Romagnani et al., 2017). Pharmacotherapies designed to target chronic kidney disease-related complications, such as anemia, metabolic acidosis, and mineral bone disorders, also play a critical role in improving patient outcomes and quality of life.

In recent years, dietary interventions have gained recognition for their role in chronic kidney disease management. Kalantar-Zadeh et al. (2021) suggested that a plant-dominant, low-protein, low-salt diet helps mitigate glomerular hyperfiltration, thereby preserving kidney function. This dietary approach can reduce the kidney’s workload by limiting the intake of substances that must be filtered out, such as sodium and protein metabolites.

The research has also introduced promising pharmacotherapies beyond traditional antihypertensive drugs. Non-steroidal mineralocorticoid receptor antagonists, for example, have shown potential in reducing inflammation and fibrosis within the kidneys. Additionally, novel agents are being explored to target fibrotic pathways and epigenetic modulators, such as microRNAs, which could slow or even reverse chronic kidney disease progression (Ruiz-Ortega et al., 2020).

The Impact of New Biomarkers and Technological Innovations

Biomarkers have become critical in understanding the progression and prognosis of chronic kidney disease. New biomarkers, including kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL), provide earlier indications of kidney damage, even before glomerular filtration rate declines. Such biomarkers enable the early identification of high-risk individuals, particularly those with diabetic kidney disease, as highlighted by Alicic et al. (2017).

Furthermore, advances in artificial intelligence and imaging techniques are enhancing diagnostic accuracy and enabling more personalized treatment plans. For instance, artificial intelligence algorithms can now analyze large datasets from imaging studies, laboratory tests, and patient histories to predict disease progression. This integration of technology and medicine could pave the way for precision nephrology, where treatments are customized to a patient’s unique risk profile and disease progression pattern.

Public Health and Global Implications

The increasing global prevalence of chronic kidney disease presents substantial public health challenges. The disease burden is disproportionately high in low- and middle-income countries, where healthcare resources are often limited, and access to early diagnostic and preventive measures is scarce. Cockwell and Fisher (2020) reported that chronic kidney disease mortality rates have risen by approximately 60% in regions such as Central Latin America and Central Asia over recent decades. This growing burden highlights the need for national and international programs aimed at reducing the economic and healthcare impact of chronic kidney disease, especially in vulnerable populations.

According to Zoccali et al. (2017), chronic kidney disease is a complex, multifactorial disease requiring an integrated approach to manage its systemic effects. Advances in “omics” sciences, such as genomics and proteomics, are increasingly used to unravel chronic kidney disease’s molecular underpinnings and enable personalized treatment approaches. These developments could provide new opportunities for managing chronic kidney disease as part of a broader public health strategy that addresses lifestyle, environmental factors, and genetic predispositions.

CONCLUSION

Recent research on chronic kidney disease has highlighted the need for a multi-faceted approach to this progressive, life-threatening condition, emphasizing early detection, lifestyle and dietary interventions, and innovative pharmacotherapies. As chronic kidney disease impacts cardiovascular, immune, and neuroendocrine systems, it is increasingly recognized as a systemic disease with implications for public health and policy. Emerging biomarkers, AI-driven diagnostics, and novel treatment modalities are promising areas for improving outcomes, particularly in at-risk populations. Addressing chronic kidney disease’s complexities through a combination of individualized medicine and population-level strategies offers the best hope for reducing the disease burden globally. Continued research is essential to refine these approaches and improve the quality of life for individuals living with chronic kidney disease.

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