Chronic kidney disease (CKD) is formally defined as a sustained decline in glomerular filtration rate (GFR) developing over a minimum of three months, distinguishing it from acute kidney injury, in which deterioration occurs in less than three months. The underlying mechanism is progressive nephron loss via glomerulosclerosis — driven principally by hypertensive ischemic injury and diabetic non-enzymatic glycation with hyaline arteriolosclerosis — in which mesangial cells, stimulated by growth factors such as TGF-ß1, secrete excess extracellular matrix that scars the glomerulus and irreversibly reduces filtration capacity. Belonging to nephrology within internal medicine pathophysiology, the concept explains how the loss of the kidney's excretory, electrolyte-regulatory, and endocrine functions generates the characteristic complications of azotemia/uremia, hyperkalemia, hypocalcemia and renal osteodystrophy, renin-driven hypertension, and erythropoietin-deficiency anemia.
Chronic kidney disease (CKD) is formally defined as a sustained decline in glomerular filtration rate (GFR) developing over a minimum of three months, distinguishing it from acute kidney injury, in w…