Stage-Specific Pathological Features Of Chronic Kidney Disease: An Article Review
DOI:
https://doi.org/10.51601/ijhp.v5i1.402Abstract
Chronic Kidney Disease (CKD) is a major global health challenge, with increasing prevalence, particularly in developing countries. CKD is characterized by a gradual and irreversible decline in kidney function, often progressing to End-Stage Renal Disease (ESRD). The pathophysiology of CKD involves structural and functional deterioration in various renal compartments, including the glomerulus, tubules, interstitial tissue, and blood vessels. Histopathological changes play a critical role in disease progression, with interstitial fibrosis, glomerulosclerosis, and tubular atrophy being the hallmark lesions observed across different CKD stages. This review highlights the anatomical pathology of CKD at various stages, focusing on histopathological changes, diagnostic techniques, and factors influencing disease progression. Renal biopsy remains the gold standard for assessing kidney damage, utilizing special stains such as Periodic Acid-Schiff (PAS) to identify fibrosis and sclerosis. However, noninvasive biomarkers like Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Kidney Injury Molecule-1 (KIM-1) have emerged as promising tools for early detection. Studies indicate that histopathologic findings, including interstitial fibrosis and glomerulosclerosis, often correlate with CKD progression more accurately than estimated glomerular filtration rate (eGFR) alone. This review underscores the need for integrating histopathological, clinical, and molecular biomarkers to improve CKD diagnosis and management. A better understanding of kidney pathology can facilitate early detection, refine prognostic assessments, and enhance treatment strategies. Future research should focus on noninvasive diagnostic alternatives and novel therapeutic targets to slow CKD progression and mitigate its global health burden.
References
V. Jha et al., “Chronic Kidney Disease: Global Dimension and Perspectives,” Lancet, vol. 382, no. 9888, pp. 260–272, Jul. 2013, doi: 10.1016/S0140-6736(13)60687-X.
B. Bikbov et al., “Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017,” Lancet, vol. 395, no. 10225, pp. 709–733, Feb. 2020,
E. Goicochea-Rios, I. Yupari-Azabache, N. Otiniano, and N. Gómez Goicochea, “Associated Factors for Chronic Kidney Disease in Patients with Diabetes Mellitus 2: Retrospective Study,” Int. J. Nephrol. Renovasc. Dis., vol. 17, pp. 289–300, Nov. 2024, doi: 10.2147/IJNRD.S489891.
Kementerian Kesehatan Republik Indonesia, Hasil Utama RISKEDAS 2018. Indonesia: Badan Penelitian dan Pengembangan Kesehatan, 2018.
P. E. Stevens et al., “KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease,” Kidney Int., vol. 105, no. 4, pp. S117–S314, Apr. 2024.
Y. Wu et al., “Co‐Treatment with Erythropoietin Derived HBSP and Caspase‐3 Sirna : A Promising Approach to Prevent Fibrosis After Acute Kidney Injury,” J. Cell. Mol. Med., vol. 28, no. 23, pp. 1–14, Dec. 2024, doi: 10.1111/jcmm.70082.
S. Gupta and N. Priya, “Glycemic Variability in Different Stages of Chronic Kidney Disease with Type 2 Diabetes Mellitus: A Cross-sectional Study,” Indian J. Med. Biochem., vol. 28, no. 1, pp. 1–7, Apr. 2024, doi: 10.5005/jp-journals-10054-0228.
F. Islam, H. J. Siddiqui, A. Khalid, G. Farrukh, S. Yousaf, and A. Ahmed, “Chronic Kidney Disease and Associated Risk Factors Among Patients with Type-2 Diabetes Mellitus in a Tertiary Care Hospital,” Pakistan Armed Forces Med. J., vol. 73, no. 3, pp. 678–81, Jun. 2023, doi: 10.51253/pafmj.v73i3.3523.
Y. Zhou et al., “Valueo of [68Ga]Ga-FAPI-04 Imaging in The Diagnosis of Renal Fibrosis,” Eur. J. Nucl. Med. Mol. Imaging, vol. 48, no. 11, pp. 3493–3501, Oct. 2021, doi: 10.1007/s00259-021-05343-x.
F. Juszczak, N. Caron, A. V. Mathew, and A.-E. Declèves, “Critical Role for AMPK in Metabolic Disease-Induced Chronic Kidney Disease,” Int. J. Mol. Sci., vol. 21, no. 21, p. 7994, Oct. 2020, doi: 10.3390/ijms21217994.
B. Wang, Z.-L. Li, Y.-L. Zhang, Y. Wen, Y.-M. Gao, and B.-C. Liu, “Hypoxia and chronic Kidney Disease,” eBioMedicine, vol. 77, pp. 1–11, Mar. 2022, doi: 10.1016/j.ebiom.2022.103942.
B. Jiao et al., “STAT6 Deficiency Attenuates Myeloid Fibroblast Activation and Macrophage Polarization in Experimental Folic Acid Nephropathy,” Cells, vol. 10, no. 11, p. 3057, Nov. 2021, doi: 10.3390/cells10113057.
E. M. Senan et al., “Diagnosis of Chronic Kidney Disease Using Effective Classification Algorithms and Recursive Feature Elimination Techniques,” J. Healthc. Eng., vol. 2021, pp. 1–10, Jun. 2021, doi: 10.1155/2021/1004767.
W. Mao et al., “Pathological Assessment of Chronic Kidney Disease with Dwi: Is There An Added Value For Diffusion Kurtosis Imaging?,” J. Magn. Reson. Imaging, vol. 54, no. 2, pp. 508–517, Aug. 2021, doi: 10.1002/jmri.27569.
A. V. Blagov, V. A. Orekhova, A. D. Zhuravlev, A. A. Yakovlev, V. N. Sukhorukov, and A. N. Orekhov, “Development of Mitochondrial Dysfunction and Oxidative Stress in Chronic Kidney Disease,” Eur. J. Inflamm., vol. 12, no. 88, pp. 1–29, Jan. 2024, doi: 10.1177/1721727X241227349.
Y. Wang, J. Yang, Y. Zhang, and J. Zhou, “Focus on Mitochondrial Respiratory Chain: Potential Therapeutic Target for Chronic Renal Failure,” Int. J. Mol. Sci., vol. 25, no. 2, pp. 1–26, Jan. 2024, doi: 10.3390/ijms25020949.
K. Kalantar-Zadeh, T. H. Jafar, D. Nitsch, B. L. Neuen, and V. Perkovic, “Chronic Kidney Disease,” Lancet, vol. 398, no. 10302, pp. 786–802, Aug. 2021, doi: 10.1016/S0140-6736(21)00519-5.
T. W. C. Tervaert et al., “Pathologic Classification of Diabetic Nephropathy,” J. Am. Soc. Nephrol., vol. 21, no. 4, pp. 556–563, Apr. 2010, doi: 10.1681/ASN.2010010010.
S. Lopez-Giacoman, “Biomarkers in Chronic Kidney Disease, From Kidney Function to Kidney Damage,” World J. Nephrol., vol. 4, no. 1, pp. 57–73, 2015, doi: 10.5527/wjn.v4.i1.57.
U. Panzer and T. B. Huber, “Immune-Mediated Glomerular Diseases: New Basic Concepts and Clinical Implications,” Cell Tissue Res., vol. 385, no. 2, pp. 277–279, Aug. 2021, doi: 10.1007/s00441-021-03509-5.
L. López-Marín, “Histopathology of Chronic Kidney Disease of Unknown Etiology in Salvadoran Agricultural Communities,” MEDICC Rev., vol. 16, no. 2, pp. 49–54, 2014, doi: 10.37757/MR2014.V16.N2.8.
F. Trevisani, M. Floris, A. Cinque, A. Bettiga, and G. Dell’Antonio, “Renal Histology in CKD Stages: Match or Mismatch with Glomerular Filtration Rate?,” Nephron, vol. 147, no. 5, pp. 266–271, 2023, doi: 10.1159/000527499.
S. Gunawardena, M. Dayaratne, H. Wijesinghe, and E. Wijewickrama, “A Systematic Review of Renal Pathology in Chronic Kidney Disease of Uncertain Etiology,” Kidney Int. Reports, vol. 6, no. 6, pp. 1711–1728, Jun. 2021, doi: 10.1016/j.ekir.2021.03.898.
F. Trevisani et al., “Renal Histology Across The Stages of Chronic Kidney Disease,” J. Nephrol., vol. 34, no. 3, pp. 699–707, Jun. 2021, doi: 10.1007/s40620-020-00905-y.
S. Wijetunge, N. V. I. Ratnatunga, T. D. J. Abeysekera, A. W. M. Wazil, and M. Selvarajah, “Endemic Chronic Kidney Disease of Unknown Etiology in Sri Lanka: Correlation of Pathology With Clinical Stages,” Indian J. Nephrol., vol. 25, no. 5, p. 274, 2015, doi: 10.4103/0971-4065.145095.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Intan Indriani, Wely Dwi Nopriansyah, Januar Ishak Hutasoit

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.