“Chronic Kidney Disease: A Comprehensive Review of Pathophysiology, Diagnosis, and Management”

Abstract

Chronic kidney disease (CKD) is a chronic disorder defined by persistent abnormalities in kidney structure or function that have serious health effects, such as increased cardiovascular morbidity and mortality and the ultimate need for renal replacement treatment.  Globally, the prevalence of CKD is large and increasing, owing to an ageing population and increased rates of diabetes, hypertension, and obesity.  Pathophysiology reveals a final common process that includes nephron loss, maladaptive repair, inflammation, oxidative stress, and fibrosis. KDIGO's CGA (Cause-GFR-Albuminuria) framework remains the norm for diagnosing kidney disease, which is characterized by lower glomerular filtration rate (GFR) and/or kidney damage markers (mostly albuminuria) lasting at least 3 months.  Management consists of risk-factor modification (blood pressure and glycemic control, lifestyle), disease-modifying pharmacotherapy (RAAS blockade, SGLT2 inhibitors, and mineralocorticoid receptor antagonists in selected patients), complication treatment, and timely preparation for renal replacement therapy when indicated. Recent trials have extended disease-modifying possibilities while also refining blood-pressure targets and monitoring systems.  This review outlines current knowledge of CKD epidemiology, pathophysiology, diagnosis, and evidence-based management, highlighting research and implementation objectives-