Is "chronic kidney disease" a disease?

Area of Science:

• Philosophy of Medicine
• Nephrology
• Clinical Diagnosis

Background:

• The definition of "disease" remains a complex philosophical question.
• Chronic kidney disease (CKD) is an umbrella term encompassing diverse kidney health states.
• Current CKD staging (1-5) does not always correlate with clinical significance, particularly in early stages among older adults.

Purpose of the Study:

• To critically evaluate whether prevalent diagnoses of chronic kidney disease (CKD) align with philosophical definitions of disease.
• To assess the clinical utility and impact of diagnosing early-stage CKD.

Main Methods:

• Analysis of existing philosophical literature on the concept of disease.
• Application of philosophical disease concepts to current clinical diagnostic practices for CKD.
• Review of studies on patient distress associated with CKD diagnosis.

Main Results:

• The prevalent diagnoses of early-stage CKD, particularly in older patients, do not meet established philosophical criteria for disease.
• In many instances, diagnosing CKD is found to be redundant and potentially detrimental to patient well-being.
• Patient distress is often triggered by early-stage CKD diagnoses, even when asymptomatic.

Conclusions:

• The current diagnostic framework for CKD may misclassify normal aging processes or benign conditions as diseases.
• Re-evaluating the classification of CKD is necessary to improve patient communication and reduce unnecessary distress.
• Philosophical inquiry into disease concepts can inform more accurate and helpful clinical practice.