Signs and Symptoms
CKD is initially without specific symptoms and can only be detected as an increase in serum creatinine or protein in the urine. As the kidney function decreases:
- Blood pressure is increased due to fluid overload and production of vasoactive hormones created by the kidney via the RAS (renin-angiotensin system), increasing one's risk of developing hypertension and/or suffering from congestive heart failure
- Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). Urea is excreted by sweating and crystallizes on skin ("uremic frost").
- Potassium accumulates in the blood (known as hyperkalemia with a range of symptoms including malaise and potentially fatal cardiac arrhythmias)
- Erythropoietin synthesis is decreased (potentially leading to anemia, which causes fatigue)
- Fluid volume overload — symptoms may range from mild edema to life-threatening pulmonary edema
- Hyperphosphatemia — due to reduced phosphate excretion
- Hypocalcemia — due to 1,25 dihydroxyvitamin D3 deficiency. The 1,25 dihydroxyvitamin D3 deficiency is due to stimulation of fibroblast growth factor-23.
- Later this progresses to secondary hyperparathyroidism, renal osteodystrophy and vascular calcification that further impairs cardiac function.
- Metabolic acidosis, due to accumulation of sulfates, phosphates, uric acid etc. This may cause altered enzyme activity by excess acid acting on enzymes and also increased excitability of cardiac and neuronal membranes by the promotion of hyperkalemia due to excess acid (acidemia)
People with chronic kidney disease suffer from accelerated atherosclerosis and are more likely to develop cardiovascular disease than the general population. Patients afflicted with chronic kidney disease and cardiovascular disease tend to have significantly worse prognoses than those suffering only from the latter.
Read more about this topic: Chronic Kidney Disease
Famous quotes containing the words signs and, signs and/or symptoms:
“For Jews demand signs and Greeks desire wisdom, but we proclaim Christ crucified, a stumbling block to Jews and foolishness to Gentiles...”
—Bible: New Testament, 1 Corinthians 1:22-3.
“The whole visible universe is but a storehouse of images and signs to which the imagination will give a relative place and value; it is a sort of pasture which the imagination must digest and transform.”
—Charles Baudelaire (1821–1867)
“There is one great fact, characteristic of this our nineteenth century, a fact which no party dares deny. On the one hand, there have started into life industrial and scientific forces which no epoch of former human history had ever suspected. On the other hand, there exist symptoms of decay, far surpassing the horrors recorded of the latter times of the Roman empire. In our days everything seems pregnant with its contrary.”
—Karl Marx (1818–1883)