Chronic Kidney Disease

Drag the GFR down and watch the whole body change · Week 11
In CKD the kidneys are slowly and permanently damaged. So the GFR falls, and waste and fluid build up. But the kidney does more than filter. It also makes EPO, turns on vitamin D, and balances acid & electrolytes. Drag the GFR down below and watch every one of those jobs fail.

Kidney function

—
95 mL/min GFR
◀ worse · Glomerular Filtration Rate · better ▶

Drag the slider to lower the filtering rate, and the kidney above it shades darker as the filter fails. The stage name changes with the number, and every lab on the right moves at the same time. Waste climbs first. Then the jobs that have nothing to do with filtering start to fail: fewer red cells, softer bones, acid left in the blood, and potassium that cannot get out.

Most common causes: Diabetes and Hypertension. They are the same two that harm every other blood vessel.  Diet in CKD: go low on salt & potassium, limit magnesium laxatives, and take vitamin D + calcium supplements.

Bloodwork

The values shift as filtering fails. Red = out of range.

Why patients feel awful (what it leads to)

Anemia & fatigue. The failing kidney makes less erythropoietin (EPO), so the marrow makes fewer red cells.
Weak bones (renal osteodystrophy). The kidney cannot turn on vitamin D, so calcium drops and phosphate rises.
Metabolic acidosis. The kidney cannot excrete H⁺, so acid builds up in the blood.
Hyperkalemia. Potassium is not excreted → dangerous heart arrhythmias.
Fluid overload. Salt & water are held back → edema, hypertension, and strain on the heart.