Chronic kidney disease is a medical condition illustrating a gradual decline in the potential of the kidney functioning. The various stages of this disease can be exemplified as diminished renal reserve, renal insufficiency or renal failure. At the preliminary stage of the disease, not many symptoms are evident as the failure of certain renal tissues is taken over by the rest of tissues.

Any lack of functioning on part of the renal tissues results in a decreased capability of the kidney to eliminate the waste products from the body and regulate fluid and electrolyte homeostasis. At the initial stage itself, the kidney is unable to perform several other functions such as concentrating urine, excretion of phosphate acid and potassium. When the kidney failure reaches a stage indicated in the test levels as GFR ≤ 10 mL/min/1.73 m2, the organ can no more dilute urine. At this juncture, urine osmolality is usually quite close to the osmolality of plasma, and the volume of urine does not correspond to consumption of water.

As the GFR gradually reduces, there is a surge in the plasma concentrations of creatinine and urea. In fact, once the GFR falls to below 10 mL/min/1.73 m2, there is a major swell in their levels. However, even under these circumstances the plasma sodium concentration remains normal. Problems arising at this phase include abnormalities of calcium, phosphate, parathyroid hormone (PTH), Vitamin D metabolism, renal osteodystrophy, hypocalcemia and hyperphosphatemia. Apart from this malfunctioning, moderate acidosis and anemia are also typical problems in this disease. Occurrence of anemia is mainly a consequence of reduced production of erythropoietin production. Additional reasons for anemia include deficiencies of iron, folate and Vitamin B12.

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