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the causes?22,23
Chronic kidney disease (CKD) can be caused by several factors, often acting together. These causes may be medical, genetic or linked to exposure to toxic substances.
Underlying medical conditions
Certain chronic diseases directly affect the kidneys and lead to their gradual deterioration:
- Diabetes (Type 1 and Type 2) : this is the leading cause of CKD worldwide. Poorly controlled blood sugar levels damage the small blood vessels in the kidneys (diabetic nephropathy), progressively reducing their filtering capacity.
- High blood pressure : High blood pressure places excessive strain on the blood vessels of the kidneys, causing them to harden and narrow, which reduces their efficiency. Without proper control, this can accelerate the loss of kidney function.
- Autoimmune diseases: Certain diseases, such as systemic lupus erythematosus or vasculitis, attack the kidneys and cause chronic inflammation of kidney structures (glomeruli and tubules), which can lead to progressive kidney failure.
- Chronic pyelonephritis : this bacterial kidney infection can cause persistent inflammation and irreversible damage to kidney tissue, especially when infections recur.
- Glomerulonephritis : this refers to inflammation of the kidney filters (glomeruli), caused by infections, autoimmune diseases or immune disorders. If left untreated, it can lead to a gradual decline in kidney function.
Genetic and hereditary factors
Some inherited diseases directly affect the kidneys and may lead to kidney failure over time:
- Autosomal dominant polycystic kidney disease (ADPKD): this genetic disorder causes fluid-filled cysts to develop in the kidneys, leading to enlargement of the kidneys and reduced filtering capacity. It is one of the main genetic causes of CKD.
- Alport syndrome : this inherited condition affects the membranes of the glomeruli, causing progressive kidney damage, often associated with hearing loss and eye disorders.
- Other hereditary forms of glomerulonephritis may also contribute to the long-term development of chronic kidney disease.
External and toxic causes
Certain environmental factors and lifestyle habits can accelerate kidney damage:
- Long-term use of certain medications : excessive or prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can impair blood flow to the kidneys, reducing their ability to filter blood. Other medications, including certain antibiotics and iodinated contrast agents, may also be nephrotoxic when used repeatedly.
- Exposure to toxic substances : heavy metals (such as lead, cadmium and mercury) and industrial solvents can damage the kidneys over time and contribute to the development of chronic kidney disease.
- Smoking and alcohol : although they are not direct causes of CKD, smoking and excessive alcohol consumption worsen risk factors such as high blood pressure and vascular disease, accelerating the progression of kidney disease.
Prevention and regular medical follow-up can help reduce these risks and slow the progression of chronic kidney disease.