Chronic kidney disease can be caused by a wide variety of problems. In the US, diabetes and high blood pressure
are two very common causes. Other etiologies include primary problems of the kidneys themselves, such as scarring of the kidney cells as seen in Focal Segmental Glomerulosclerosis, or inherited syndromes such as Polycystic Kidney Disease. Autoimmune diseases can also lead to chronic kidney disease, as is the case in Lupus. Often, a biopsy
of the kidney will be needed to help determine the exact cause of the decline in kidney function.
The kidneys play a major role in the body's regulation of acid/base status, electrolytes and blood pressure. Subsequently, chronic kidney disease may lead to electrolyte derangements such as high potassium and phosphate, elevated acid levels, and elevated blood pressure. These problems can cause non-specific feelings of fatigue, poor appetite, itching, headaches, and nausea. If the electrolyte disturbances become severe, then irregular heart rhythms can occur. Increased loss of protein in the urine can cause foamy urine, and can lead to elevated cholesterol levels and increased swelling all over the body. For all of these reasons, it is important for patients with chronic kidney disease to maintain regular follow-up with a nephrologist
(kidney specialist) who can monitor serial blood and urine tests and vital signs and tailor therapy appropriately.