DIAGNOSIS AND MANAGEMENT OF CHRONIC KIDNEY DISEASE: A REVIEW OF CURRENT METHODS AND THEIR EFFICACY IN EARLY DETECTION

Abstract

Chronic Kidney Disease (CKD) is a growing public health concern, affecting approximately 10% of the global population. It is characterized by the progressive and irreversible loss of renal function, often asymptomatic in its early stages, which hinders early detection. The main causes include diabetes mellitus, hypertension, and glomerulonephritis. Early detection is essential to slow disease progression and improve patient quality of life. This systematic review aimed to evaluate the effectiveness of diagnostic methods used for the early detection of CKD and discuss their importance in improving clinical outcomes for patients. Scientific articles published between 2010 and 2023 were analyzed from PubMed, Scielo, and Web of Science databases. Studies that addressed diagnostic methods for CKD, focusing on serum biomarkers, renal function tests, and imaging techniques, were included. The methodological quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool. The review included 45 studies with approximately 20,000 participants. The main findings were: serum creatinine showed sensitivity of 70%-85% and specificity of 65%-80%, while cystatin C demonstrated higher sensitivity (85%-95%) and specificity (80%-90%). The combination of both improved diagnostic accuracy. The estimated glomerular filtration rate (eGFR), especially using the CKD-EPI formula, showed sensitivity of 80%-95% and specificity of 75%-90%. Renal ultrasound showed sensitivity of 75%-90% and specificity of 70%-85%, while magnetic resonance imaging and computed tomography were recommended for specific cases. The integration of these methods into a combined diagnostic protocol is crucial for the early and accurate detection of CKD, allowing for faster and personalized interventions. In conclusion, the combination of serum biomarkers, renal function tests, and imaging techniques offers a comprehensive and effective approach for the early detection of CKD. Implementing these methods into clinical protocols can significantly improve patient outcomes, slow disease progression, and reduce the need for renal replacement therapies.