Chronic kidney disease (CKD)
Gradual loss of kidney function over months to years, staged by eGFR. Early stages are usually silent and only revealed by routine blood and urine testing.
What it is
Chronic kidney disease (CKD) is defined as kidney damage or eGFR <60 mL/min/1.73m² for ≥3 months, staged G1–G5 by eGFR and A1–A3 by urine albumin (KDIGO 2012). Most patients have no symptoms until eGFR drops below 30 mL/min. The two dominant drivers globally are diabetes (~40%) and hypertension (~25%); both damage glomeruli silently for years. Early identification lets clinicians slow progression with SGLT2 inhibitors, ACE inhibitors / ARBs and aggressive blood-pressure control — interventions that have transformed CKD outcomes in the last decade.
Key lab markers
- eGFR (calculated from creatinine) — the staging variable: G1 ≥90, G2 60–89, G3a 45–59, G3b 30–44, G4 15–29, G5 <15.
- Creatinine — the raw input; rises late, so a normal creatinine does not exclude CKD in older or low-muscle-mass patients.
- Urine albumin-creatinine ratio (UACR) — A1 <30, A2 30–300, A3 >300 mg/g; albuminuria multiplies cardiovascular risk independently of eGFR.
- BUN, potassium, phosphate, calcium, PTH, haemoglobin — track downstream consequences in advanced stages.
Symptoms
Usually absent in G1–G3. Advanced disease (G4–G5) may bring:
- Fatigue
- Reduced appetite, nausea
- Leg swelling
- Itching (uraemic pruritus)
- Foamy urine (proteinuria)
- Difficulty concentrating
When to discuss with a doctor
Any sustained eGFR <60 or persistent albuminuria warrants a primary-care visit. eGFR <30 or rapidly declining trajectory (>5 mL/min/year) needs nephrology referral. Most CKD progression slows substantially with tight blood-pressure control (<130/80), SGLT2 inhibitors when indicated, and avoidance of NSAIDs and contrast-loaded scans. Mediora.AI tracks eGFR trajectory inside its early-warning module; management belongs with a clinician.