Chronic kidney failure, also called chronic kidney disease (CKD), results from kidney damage that develops slowly over time for various reasons and is usually irreversible. CKD has five stages. Although it is not contagious, the World Health Organization has described its burden as being of epidemic proportions.
According to the Turkish Society of Nephrology Registry Report 2021, the incidence of end-stage kidney disease (ESKD) in Türkiye was 138.7 per million population, and more than 10,000 new patients needed renal replacement therapy each year.
The prevalence was 996.8 per million population. The source reports a total of 83,350 affected people: 60,558 undergoing hemodialysis, 3,387 receiving peritoneal dialysis, and 19,405 who had undergone kidney transplantation.
According to 2021 figures from the Turkish Ministry of Health, of the 26,894 people on organ waiting lists in Türkiye, 22,775 were registered on the deceased-donor kidney waiting list. More than 5,000 children had CKD and more than 2,000 children were registered on the deceased-donor kidney list.
Each year, more than 1,000 patients followed for ESKD died from various complications, notably cardiovascular and cerebrovascular diseases, according to the cited figures.
Given that approximately 3,000–3,500 kidney transplants were performed annually in Türkiye, the number of patients living with ESKD was estimated to increase by about 7,000 each year.
The source reports that Türkiye had 902 hemodialysis centers, 130 peritoneal dialysis centers, and 79 kidney transplantation centers.
Stages of Chronic Kidney Disease:
- Stage 1: GFR ≥ 90 mL/min. No symptoms; lifestyle changes may help slow progression.
- Stage 2: GFR 60–89 mL/min. Protein leakage into the urine may occur. Monitoring and preventive measures should continue.
- Stage 3: GFR 30–59 mL/min. Swelling of the hands and feet, back pain, or changes in urination may occur. Diet and medication become increasingly important.
- Stage 4: GFR 15–29 mL/min. Problems such as anemia, high blood pressure, and osteoporosis may develop. Patients should receive information about renal replacement therapy.
- Stage 5: GFR < 15 mL/min. Kidney function is severely impaired; kidney transplantation or dialysis is required.
Causes of Chronic Kidney Disease:
- Hypertension (high blood pressure)
- Diabetes mellitus
- Glomerulonephritis
- Interstitial nephritis
- Polycystic kidney disease
- Amyloidosis
- Conditions that reduce blood flow to the kidneys (heart failure, heart attack, liver failure, or obstruction of kidney blood vessels)
- Inflammation of blood vessels (vasculitis)
- Autoimmune diseases (IgA nephropathy and lupus)
- Conditions causing urinary tract obstruction (posterior urethral valves, kidney stones, benign prostatic hyperplasia, and prostate or bladder tumors)
- Diseases causing urine to flow backward from the bladder toward the kidneys, such as vesicoureteral reflux and neurogenic bladder
- Medications and substances: nephrotoxic drugs, chemotherapy agents, contrast media, and long-term use of NSAIDs
- Inherited diseases (Fabry disease, Alport syndrome, primary hyperoxaluria, and cystinuria)
Diabetes and hypertension account for approximately two-thirds of CKD cases. Controlling blood pressure and blood sugar can therefore help prevent or delay CKD.