Chronic Kidney Disease (CKD): Pathophysiology

00:01 Okay, so we've talked about the different causes of chronic kidney disease, let's talk a little bit about the pathophysiology behind it.

00:08 What's interesting is that regardless of the underlying disease or inciting event the final common pathway to Progressive CKD is really a shared mechanism.

00:17 And this is a schematic that illustrates my point.

00:20 So we have our initiating factor, it could be things like diabetes hypertension, it could be nephrotoxic exposures or immune complex depositions, different autoimmune diseases regardless of that cause over time what's going to happen is you lose nephrons.

00:36 So we have a decrease in number of nephrons and then we have activation of vasoactive mediators cytokines activation of the RAAS system growth factors that get activated and that will induce structural and functional changes of the surviving nephrons.

00:52 We then end up hyper filtering so we have an increase in intraglomerular capillary pressure.

00:57 And then finally that leads to an accelerated sclerosis of the remaining nephrons.

01:02 So you can see regardless of that cause you have a shared pathway in terms of acceleration and progression of disease.