CKD involves a loss of nephron function, and deterioration of glomerular filtration, tubular reabsorption, and endocrine capability of the kidneys over time.

Risk factors include; proteinuria, congenital defects, polycystic kidney disease (PKD), obesity, diabetic nephropathy, hypertension, IgA nephropathy, chronic, polynephritis, vasculitis, systemic inflammation, systemic lupus erethematosus.

CKD brings a major risk for developing cardiovascular disease especially atherosclerosis and left ventricular hypertrophy. This will be exacerbated by any existing hypertension that may be present.

Other complications includes metabolic acidosis, hyperkalemia, vitamin D deficiency, hyperparathyroidism, and anemia.

Uremic Complications:

• Impaired immune function
• Inability for vitamin D to activate, resulting in hypertension and osteotrophy
• Chronic GIT symptoms (such as nausea and vomiting) due to nitrogen buildup in bloodstream
• Increased intravascular volume, left ventrical needs to pump harder and often atrophies

Early chronic kidney disease is often asymptomatic. As function declines, symptoms may include fatigue, swelling of the legs and ankles, reduced or foamy urine, nausea, loss of appetite, itching, and difficulty concentrating.

May be indicated by increased creatinine lab results in combination with hypertension, proteinuria, and anemia.

Serum eGFR, urinary albumin:creatinine ratio (UACR), and blood pressure should all be considered. Blood urea nitrogen (BUN) and urine dipstick testing are also useful in the initial assessment.

herbal medicine approaches not recommended as first line of treatment for chronic kidney disease past stage 2. The introduction of more metabolites into the bloodstream may increase the rate of damage to the basement membrane of the kidneys.