Causes of chronic kidney disease (CKD) include the

following:
• Diabetic kidney disease
• Hypertension
• Vascular disease
• Glomerular disease (primary or secondary)
• Cystic kidney diseases
• Tubulointerstitial disease
• Urinary tract obstruction or dysfunction
• Recurrent kidney stone disease
• Congenital (birth) defects of the kidney or bladder
• Unrecovered acute kidney injury
 Creatinine Serum

(𝟏𝟒𝟎 − 𝐔𝐬𝐢𝐚)(𝐁𝐞𝐫𝐚𝐭 𝐁𝐚𝐝𝐚𝐧)

𝐂𝐥𝐜𝐫 𝐏𝐫𝐢𝐚 𝐦𝐥 /𝐦𝐞𝐧𝐢𝐭 =
(𝟕𝟐)(𝐒𝐂𝐫𝐬𝐬)

𝟎. 𝟖𝟓 (𝟏𝟒𝟎 − 𝐔𝐬𝐢𝐚)(𝐁𝐞𝐫𝐚𝐭 𝐁𝐚𝐝𝐚𝐧)

𝐂𝐥𝐜𝐫 𝐖𝐚𝐧𝐢𝐭𝐚 𝐦𝐥 /𝐦𝐞𝐧𝐢𝐭 =
(𝟕𝟐)(𝐒𝐂𝐫𝐬𝐬)
Staging Of CKD
 Evaluation of GFR
1. Initial assessment : Kreatinin serum dan estimasi GFR.
2. Additional test :
 Cystatin C untuk mengkonfirmasi ketika nilai GFR
berdasarkan serum kreatinin dirasa kurang akurat).
 USG atau CT scan untuk mendapatkan gambaran dari
ginjal dan saluran kemih.
 Kidney Biobsy untuk memeriksa jenis penyakit ginjal tertentu,
melihat berapa banyak kerusakan ginjal yang terjadi.
 Evaluation of Albumin
Albumin-to-creatinine ratio (ACR) is the first method of preference to detect
elevated protein.

albumin cons (mg)

𝐴𝐶𝑅 =
creatinine cons (gr)
Continuum of development, progression, and complications of
CKD and strategies to improve outcomes

• Normal
• Screening for CKD risk factors

• Increased Risk
• CKD risk factors reduction, screening for CKD

• Damage
• Diagnosis and treatment, treat comormid conditions, slow progression,

• ⇩ GFR
• Estimate progression, treat complications, prepare for replacement,

• Kidney Failure
• Replacement by dialysis and transpalnt

• EOL/death
 Modification of Risk Factors
1. Smoking cessation
2. Exercise
3. Weight reduction to optimal targets
4. Lipid modification (statin therapy)
5. Optimal diabetes control HbA1Co7% (53 mmol/mol)
6. Optimal BP control too140/90 mmHg or 130/80
mmHg
7. Aspirin is indicated for secondary prevention but not
primary prevention
8. Correction of anemia