Chronic kidney disease (CKD) is a condition in which the kidneys gradually lose their function and stop working properly. CKD is defined as a disease in which the glomerular filtration rate (GFR) is less than 60 mL/min/1.73 m² (60% of that of a healthy person) for more than 3 months or proteinuria is present and is often asymptomatic. CKD is a risk factor for end-stage renal disease and cardiovascular diseases. Patients with end-stage renal disease often require dialysis or transplantation for saving the time of your life. In this age of longevity, we should slow down CKD progression and protect our future health.

The nephron is a structural and functional unit of the kidney. They are microscopic structures composed of a renal corpuscle and tubules. It is responsible for filtering waste products from blood; separating water, ions, and small molecules; and returning the required molecules to the blood.

Loss of these nephrons significantly impacts the kidney filtration function (GFR). Therefore, it is important to manage the risk factors for nephron loss to delay kidney damage.

Glomerular diseases can damage the kidneys. Glomerulonephritis is the inflammation of tiny filters in the kidneys called glomeruli. Damaged glomeruli allow proteins and sometimes red blood cells to leak into the urine. The treatment aims to control inflammation, improve symptoms, avoid complications, and delay kidney damage.

Glomerular hyperfiltration can occur in various clinical conditions, including kidney disease. Glomerular hyperfiltration can be caused by the dilation of blood vessels entering the glomerulus, as seen in patients with diabetes or after a high-protein meal, and/or by the contraction of blood vessels leaving the glomerulus via the activation of blood pressure regulators called the renin-angiotensin-aldosterone system, thus leading to glomerular hypertension. The goals of treatment are to control glomerular hypertension by managing the systemic blood pressure, reducing proteinuria, and delaying kidney damage.

Excessive protein intake and obesity/metabolic syndromes can damage the kidneys. In contrast, disease-related frailty and sarcopenia can decrease life expectancy. It is important to balance protein and energy intake while considering the kidney’s reserve capacity and nutrition-related health issues.

Cardiorenal syndrome (CRA) is a medical condition in which the heart and kidneys affect each other’s function. Heart failure and kidney disease can be managed by using a low-salt diet and treating blood pressure and renal anemia.

Renal fibrosis is characterized by atrophy of renal tubules and accumulation of extracellular matrix. Decreased blood flow to damaged kidney tissue leads to glomerular sclerosis and fibrosis of the tubules and interstitium. Excessive hypotension and dehydration with changes in physical condition or overuse of drugs, such as antipyretic analgesics, should be avoided.