Chronic renal insufficiency (CNI) – colloquially called chronic kidney disease or renal impairment – (synonyms: chronic renal insufficiency; renal insufficiency, chronic; renal insufficiency; terminal kidney disease; renal insufficiency requiring dialysis; chronic renal impairment; ICD-10-GM N18.-: Chronic kidney disease) refers to a process that leads to a slowly progressive reduction in kidney function.
The most common causes are diabetes mellitus (diabetes) and hypertension (high blood pressure).
In chronic renal insufficiency, the so-called urinary substances (substances that must be excreted from the body in the urine) such as urea, uric acid and creatinine increase in the blood. This process is called azotemia.
Frequency peak: From the age of 50, the frequency for chronic renal failure increases continuously.
The prevalence (disease frequency) for renal insufficiency with a glomerular filtration rate (GFR; volume filtered per unit time by the glomeruli of the kidneys) < 60 ml/urine is 2.3 % (in Germany) in the population under 80 years of age. This corresponds to approximately 1.5 million people; in addition, there are one million people over 80 years of age. Under 50 years of age, hardly any patients have a GFR below 60 ml/min; in the sixth decade, it is already 3 %; in those over 70 years of age, it is just under 13 %, with the proportion of women with a GFR below 60 ml/min being 15 %. For men, it is one-third less. The number of dialysis patients in 2013 was approximately 100,000, with 20,000 living with a kidney transplant (Germany). The incidence (frequency of new cases) in Western Europe is approximately 10 cases per 100,000 population per year and in the U.S. approximately 60 cases per 100,000 population per year.
Course and prognosis: The main focus is on treatment of the underlying disease. Treatment of chronic renal failure is aimed at slowing the progression (progression) of the disease. The prognosis depends on the stage to which the renal failure is assigned at the start of therapy. Chronic renal failure ends in terminal renal failure, where only dialysis (blood washing) or kidney transplantation (implantation of a donor organ) can protect against death from uremia (occurrence of urinary substances in the blood above normal levels). The 10-year survival rate for ESRD is approximately 55%.
