CHRONIC KIDNEY DISEASE

Stages

All individuals with a Glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months are classified as having chronic kidney disease, irrespective of the presence or absence of kidney damage. The rationale for including these individuals is that reduction in kidney function to this level or lower represents loss of half or more of the adult level of normal kidney function, which may be associated with a number of complications.

All individuals with kidney damage are classified as having chronic kidney disease, irrespective of the level of GFR. The rationale for including individuals with GFR 60 mL/min/1.73 m2 is that GFR may be sustained at normal or increased levels despite substantial kidney damage and that patients with kidney damage are at increased risk of the two major outcomes of chronic kidney disease: loss of kidney function and development of cardiovascular disease.

The loss of protein in the urine is regarded as an independent marker for worsening of renal function and cardiovascular disease. Hence, British guidelines append the letter "P" to the stage of chronic kidney disease if there is significant protein loss.

• Stage 1 CKD
  Slightly diminished function; Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2). Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.
• Stage 2 CKD
  Mild reduction in GFR (60-89 mL/min/1.73 m2) with kidney damage. Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.
• Stage 3 CKD
  Moderate reduction in GFR (30-59 mL/min/1.73 m2). British guidelines distinguish between stage 3A (GFR 45-59) and stage 3B (GFR 30-44) for purposes of screening and referral.
• Stage 4 CKD
  Severe reduction in GFR (15-29 mL/min/1.73 m2)
• Stage 5 CKD
  Established kidney failure (GFR <15>

SUGAR IN URINE

Sugar in the urine, or glycosuria

Sugar when present in the urine requires further study in order to determine its significance.
sugar in the urine maybe be a temporry condition, due to eating large quantities of sweet, or to temporary emotional exitement, business worries, etc. it may be a chronic condition, due to derangement of disease of certain organs; this constitutes diabetes mellitus.

A temporary glycosuria is not of any importance exept that it may show a tendency toward the development of diabetes mellitus. Therefore, the sugar in your urine may depend upon your diet, and may bepresent only on certain days and not on others.

The amount of sugar in the urine usually indicates the severity of the condition. a mild diabetes is very amenable to treatment without much discomfort to the patients. It cannot always be entirely cured but it can be arrested or ameliorated.

The new remedy, insulin, is unquestionably of great value, especially in controling the advanced or complicated cases. It furnishes the body with a substance that helps utilize its sugar. It can, therefore, be used over a long period of time but its use must be under the supervision of a competent physician.