Causes of chronic kidney diseases
Chronic kidney disease is the disorder of the renal glands where the glomerular filtration rate (GFR) is less than 5% of normal GFR. Various factors like intake, underlying conditions, general health, medication, fitness, predisposing factors, agents, lifestyle contribute to the wellness of the two small bean shaped organs. Most of the causes for chronic renal failure are idiopathic which means unknown. but a few known factors to humans are mentioned here. There are various causes of CKD as mentioned below.
CKD is caused due to glomerular dysfunction.
- Glomerular dysfunction due to kidney disorders: glomerulonephritis, nephrosis, basal membrane nephritis.
- Glomerular dysfunction due to non- kidney disorder or other disorders: Diabetes, systemic lupus erythematosus, other nephropathies.
Infective causes of CKD
- Bacterial causes: mycobacterium tuberculosis, Escherichia coli, streptococcal infection.
- Viral causes: hepatitis C, hepatitis E, Human immunodeficiency virus (HIV), cytomegalovirus (CMV), Epstein Barr virus(EB virus).
- Nematode infection.
Obstructive causes of CKD.
Obstruction or decrease in the lumen of the ureter causes damage to the renal glands. Obstruction can be due to:
- Formation of a thrombus in ureter.
- Lodging of an emboli.
- Formation or presence of a tumor.
- Presence of cyst.
- Prostatic hypertrophy.
- Renal calculi or stones.
As the filtrate is more accumulated in the renal glands the pressure and tension of the kidneys increase leading to its failure or disorders.
Congenital causes of chronic kidney disorders.
Developmental disorder in the fetal life due to abnormal gene expression or other unknown pathologies is called congenital disorders. These can occur due to heavy metal exposure of the mother, alcohol consumption during pregnancy, poisoning, or history of renal carcinoma. The causes are:
- Fused kidney.
- Ectopic kidney.
- Cystic kidney disease.
- Hypoplastic kidney.
- Atresia of the kidney.
- Polycystic kidney disease in infants.
- Kidney underdevelopment.
Toxins causing CKD.
Toxins cause progressive or slow deterioration of the kidney function. Prolonged intake of certain drugs, medications cause kidney disorders.
- Medications as a toxin: prolonged intake of paracetamol, excessive aspirin usage, acetaminophen-based medicines, larger intake of analgesics.
- Metals as toxins: mercury, lead, cadmium, uranium, arsenic, cobalt, lithium.
- Abusive drug use: opiates, cocaine, tranquilizers, codeine, morphine.
- Alcohol: overuse of alcohol and alcohol based products and beverages cause kidney disorders in long term uses.
poisoning causing CKD
various foodstuffs or substances cause poisoning leading to kidney failure or disease.
Medications: barbiturates, salicylates, antibiotics, gentamicin.
Others: carbon tetrachloride, ethyl glycol.
Gas: chloride gas.
Vascular causes of CKD.
- Hypertension: damage to renal arteries due to increasing blood pressure due to secondary causes or obstruction in it. Excessive blood in nephrons shuts them down and thereby increases the workload on other nephrons. This can be caused due to the following:
- Loss of elastic tissue and damage to the tunica media.
- Thrombus or embolus in renal arteries lead to hypertension.
- Cardiovascular abnormalities lead to increased blood to the kidney.
- The inability of nephrons to filter the normal amount of blood.
- Atherosclerosis or plaque formation in the arteries of renal glands thereby reducing the lumen of the vessel.
- Cholesterol depositions in the renal vessels.
- Peripheral vascular diseases: Raynaud’s disease or thromboangiitis obliterans also called Berger’s disease can cause chronic renal insufficiency or disease. This causes the abnormal venous return to the heart leading to less blood in the kidneys and thus causing kidney damage.
Secondary disorders causing CKD.
- Malaria: caused due to malarial parasites.
- Kala-azar: one of the causes for CKD.
- Bacterial endocarditis: the flow of bacteria from the endocardium to the renal focus by blood, lymph, etc. leads to the development of renal disease.
- Acquired immunodeficiency syndrome.
- Polyarteritis nodosa.
- Inflammatory bowel disease.
- Ankylosing spondylitis
- Multi organ failure.
Necrosis causing CKD
Necrosis is the death of tissue of an organ further leading to its degeneration by hydrolytic enzymes leading to organ failure and inflammation.
- Coagulative necrosis: due to bacterial and environmental factors there occurs localized death of cells. This also causes inflammation and hampered kidney function leading to chronic kidney failure.
- Caseous necrosis: tuberculosis of the kidney causes the cheese-like appearance of foci. This leads to renal failure.
Ischemia of kidney causing CKD
Lack of oxygen supply to the kidneys causes a lack of nutrition. Lack of nutrition further leads to improper clearance of metabolites and accumulation of the waste in cells. Due to lack of nutrition, there is less energy to carry out the life cycle of the cell leading to diminished cellular response. This leads to chronic kidney damage. It is irreversible.
Syndromes associated with CKD.
- Alport syndrome.
- IgA nephropathy.
- Wegner’s disease.
- Goodpasture’s syndrome.
- Sjogren syndrome.
Cardiac factors causing CKD.
- Congestive cardiac failure
- Ischemic heart disease.
- Angina pectoris.
- Unstable angina
- Increased cardiac output and stroke volume.
Hepatobiliary causes of CKD.
- Portal hypertension.
- Alcoholic liver disease.
- Jaundice if untreated.
Untreated acute kidney diseases.
When the acute renal disorder is left untreated or not treated appropriately it leads to a chronic stage subsequently. Untreated acute kidney diseases can be:
- Trauma to kidneys like stab injury, gunshot injury, fall from height.
- Urinary retention.
- Uncontrolled diabetes and hypertension.
- Surgical interventions of spleen, liver, etc.
- Acute pyelonephritis.
- Perinephric abscess or empyema.
- Renal infarct.
Anesthesia causes for CKD
Anesthetic medications are used to induce temporary depression of functioning of a localized area of the body or entire body. These medications can be a causative agent for chronic kidney diseases. These medications include
- nitric oxide.
These also cause retention of secretions in the respiratory system in turn causing infection of the lung.
Risk factors that can cause CKD
- age: advancing age is a risk factor for CKD.
- Obesity: excessive fat accumulation can be a causative factor for CKD later.
- Tobacco and cigarette smoking can lead to vasodilation of arteries leading to kidney failure eventually.
- Diabetes: most common cause for CKD. Hyperglycemia leads to kidney damage. It also can cause death in uncontrolled cases. Both types of diabetic individuals are at risk of developing chronic kidney disease.
- ACE inhibitors medication, spironolactone, proton pump inhibitors usage.
- Sedentary lifestyle with insufficient exercise.
- Frequent urinary tract infections and unhygienic environment.
- Excessive potassium intake.
- High calorie diet without exercise.
- Stress and anxiety.
- Pre-existing cardiovascular illness.
- Recent transplant surgeries.
- Open heart surgeries, peritoneal aspiration process.
- Nephrectomy can cause another kidney to fail sometimes.
- Suprarenal gland necrosis or tuberculosis.
- Hormonal disturbances.
- Hereditary factor.
Effects due to CKD on body
- Anemia: as the kidney releases erythropoietin which is the precursor for RBC production. Which leads to less erythropoietin leading to anemia.
- Metabolic imbalance: acid base balance is not maintained.
- Retention of urea in the blood leads to pH variation.
- Death if untreated.
Signs and symptoms of CKD
- Asymmetric heart rhythm.
- Urea is excessive in blood.
- Improper creatinine and creatinine levels.
- Pain in the abdomen.
- Unexplained weight loss.
- Mental confusion.
- Headache and lightheadedness.
- Discomfort and history leading to the diagnosis of CKD.