Chronic kidney disease affects multiple organ systems and can lead to numerous complications, including:
Cardiovascular Disease (CVD): CVD is the leading cause of death in patients with chronic kidney disease. The mechanisms include hypertension, dyslipidemia, and accelerated atherosclerosis. Management of cardiovascular risk factors is critical in CKD patients, with emphasis on blood pressure and lipid control.
Electrolyte Imbalances: Hyperkalemia is a common complication, particularly in advanced CKD, due to impaired potassium excretion. Metabolic acidosis also develops as the kidney's ability to excrete hydrogen ions diminishes, necessitating bicarbonate supplementation.
Fluid Overload: Patients with CKD are prone to fluid retention, leading to hypertension, peripheral edema, and pulmonary congestion. Diuretics, particularly loop diuretics at escalating doses, are often required to manage volume overload while the patient still produces urine; once a patient is anuric, diuretics have nothing to act on and volume can be removed only by dialysis or ultrafiltration.
Anemia and Bone Disease: Anemia and bone mineral disorders are common in advanced CKD due to reduced erythropoietin production and impaired phosphate excretion. These complications contribute to decreased quality of life and increased morbidity.
