medskl.com is a global, free open access medical education (FOAMEd) project covering the fundamentals of clinical medicine with animations, lectures and concise summaries. medskl.com is working with over 170 award-winning medical school professors to provide content in 200+ clinical presentations for use in the classroom and for physician CME. Nephrology – Chronic Kidney Disease Whiteboard Animation Transcript with Steven Cheng, MD https://medskl.com/Module/Index/chronic-kidney-disease Chronic Kidney Disease (CKD) is caused by a wide variety of pathologic processes, including diabetes, hypertension, and autoimmune diseases. The stages of CKD, from stage 1 to stage 5, reflect progressive loss of function as quantified by the glomerular filtration rate or GFR. GFR is commonly estimated using serum creatinine levels, which increase as renal function falls. In early CKD, patients are frequently asymptomatic due to the large amount of “backup function” in the kidneys. However, as more function is lost, this ability to compensate is overwhelmed. Fluids, electrolytes, minerals, and acids, which are usually flushed out of the body, begin to accumulate, and patients develop anemia and bone/mineral disorders. While we cannot undo this damage, we can prevent the complications of chronic kidney disease. Dietary restrictions to lower sodium and potassium intake can prevent electrolyte abnormalities and diuretics can remove excess fluid. We can also prevent progressive damage from hypertension and proteinuria, using medications that target the renin-angiotensin-aldosterone axis. In some, GFR may continue to fall despite intervention, especially when the underlying disease is poorly controlled or chronic damage is extensive. Patients subsequently develop symptoms of uremia, including persistent fatigue, nausea, vomiting, anorexia, and confusion. Treatment includes dialysis – through a variety of methods – to remove toxins and prolong life. However, the best option for uremic patients is renal transplantation. With a carefully supervised anti-rejection regimen, these patients can again enjoy life with a new kidney.