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Chronic Kidney Disease

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Chronic Kidney Disease
Introduction
Chronic kidney disease is defined as presence of kidney damage or decreased kidney function for three or more months, irrespective of the cause[1]. Persistent damage or decrease in kidney function for at least three months, is necessary to differentiate between acute and chronic renal disease. There are different stages of CKD and different diagnostic methods by which it can be diagnosed.
Stages of CKD:
 Stage1 − GFR >90 mL/min per 1.73 m2
 Stage 2 − GFR 60 to 89 mL/min per 1.73 m2
 Stage 3a − GFR 45 to 59 mL/min per 1.73 m2
 Stage 3b − GFR 30 to 44 mL/min per 1.73 m2
 Stage 4 − GFR 15 to 29 mL/min per 1.73 m2
 Stage 5 − GFR <15 mL/min per 1.73 m2 or treatment by dialysis.
…show more content…
The prevalence of CKD is increasing day by day. Numerous studies have been conducted to know the prevalence of the disease in UK and worldwide. According to the study conducted by Quality and Outcomes Framework (QOF) in 2010 , data showed that 4.3% of population 18 or over in England have confirmed diagnosed CKD.

There are many risk factors which can cause CKD , one of the most important factor among them Coronary Artery Disease(CAD). Many studies have been conducted which have proven correlation between CKD and CAD. A large number risk factors have been identified for CAD in CKD which includes diabetes mellitus, hypertension and increased levels of cardiac biomarkers. Cardiac biomarkers include Creatinine Phosphokinases and Troponins. Cardiac Troponins (Troponin T , Troponin I ) are preferred over creatinine phosphokinase( CPK-MB) because their higher sensitivity and specificity for myocardium[3]. Preferred marker for any myocardial injury in any patient are Cardiac Troponins T and I only including patients suffering from CKD, acute kidney injury. Patients who are having CKD and present with clinical signs and symptoms corresponding towards acute myocardial infarction[MI], series of Troponin levels should be considered , i.e change in over three to six hours after presentation, should be taken into account, instead of the single titre[4]. Some studies have been conducted which attempted to set upper limit of Troponin T in patients suffering from CKD.

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