How is it Diagnosed?
Chronic Kidney Disease is diagnosed based on the presence of kidney damage or
decreased kidney function for a duration of three months or more. Diagnosis typically
begins with a review of the patient's medical history, including diabetes, hypertension,
recurrent urinary tract infections, or use of nephrotoxic drugs.
Laboratory investigations play a central role. Estimated glomerular filtration rate (eGFR)
is calculated using serum creatinine levels, and a persistent reduction below 60
mL/min/1.73 m² indicates CKD. Urinalysis detects proteinuria, hematuria, or casts
suggestive of glomerular or tubular damage. The urine albumin-to-creatinine ratio
(UACR) is a sensitive marker for early renal damage.
Imaging studies such as renal ultrasound help assess kidney size, structure, and
echogenicity. Shrunken or echogenic kidneys are often seen in chronic disease.
Advanced imaging like CT or MRI may be used if structural abnormalities or obstructive
uropathy are suspected.
Further blood tests including serum urea, electrolytes, and bicarbonate help evaluate
complications like acidosis, hyperkalemia, or anemia. A renal biopsy may be warranted in
certain cases of unexplained CKD or rapidly progressing disease, particularly when
autoimmune or glomerular diseases are suspected.
The staging of CKD is essential for treatment planning and is based on eGFR and
albuminuria levels. Regular monitoring and early intervention are crucial to prevent
progression to end-stage renal disease (ESRD).