CHRONIC KIDNEY DISEASE: AN OVERVIEW OF PATHOPHYSIOLOGY, DIAGNOSIS, MANAGEMENT AND RECENT ADVANCES

Vaishnavi Balaji Jadhav*, Dr. Prajakta Kelgaonkar, Shaikh Sadiya Hamid, Maheshvri Kudke

Chronic Kidney Disease (CKD) is a long-term disorder characterized by abnormalities of kidney structure or function that persist for at least three months. It is an important cause of morbidity, mortality and healthcare burden worldwide. Diabetes mellitus and hypertension are major causes, while glomerular, hereditary, autoimmune, obstructive, infectious and drug-related conditions may also contribute. Progressive nephron loss reduces the kidney’s ability to maintain filtration, fluid and electrolyte balance, acid–base homeostasis and endocrine functions. CKD is frequently silent in its early stages, making timely identification through estimated glomerular filtration rate (eGFR) and urine albumin assessment particularly important. As disease severity increases, patients may develop anemia, cardiovascular disease, hypertension, electrolyte abnormalities, metabolic acidosis, chronic kidney disease–mineral and bone disorder (CKD-MBD), and eventually kidney failure requiring renal replacement therapy. Management aims to identify and treat the underlying cause, slow progression, reduce cardiovascular risk, manage complications and prepare patients for kidney replacement therapy when required. Renin–angiotensin system blockade, sodium–glucose cotransporter-2 (SGLT2) inhibitors, lipid management, dietary measures and appropriate treatment of anemia and CKD-MBD form important components of care. Recent advances, including non-steroidal mineralocorticoid receptor antagonists, newer biomarkers, precision medicine, artificial intelligence and innovations in dialysis and transplantation, are expanding the possibilities for individualized management. This review summarizes the epidemiology, causes, pathophysiology, staging, clinical manifestations, diagnosis, complications, pharmacological and non-pharmacological management, drug interactions, and emerging approaches in CKD.[1–14]