Is “chronic kidney disease” a disease?

Journal article

Several philosophers of medicine have attempted to answer the question “what is disease?” In current clinical practice, an umbrella term “chronic kidney disease” (CKD) encompasses a wide range of kidney health states from commonly prevalent subclinical, asymptomatic disease to rare end‐stage renal disease requiring transplant or dialysis to support life. Differences in severity are currently expressed using a “stage” system, whereby stage 1 is the least severe, and stage 5 the most. Early stage CKD in older patients is normal, of little concern, and does not require treatment. However, studies have shown that many patients find being informed of their CKD distressing, even in its early stages. Using existing analyses of disease in the philosophy literature, we argue that the most prevalent diagnoses of CKD are not, in fact, diseases. We conclude that, in many diagnosed cases of CKD, diagnosing a patient with a “disease” is not only redundant, but unhelpful.

Authors: Smart, B; Stevens, R; Verbakel, J

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Wiley
• Journal: Journal of Evaluation in Clinical Practice
• Volume: 24
• Issue: 5
• Pages: 1033-1040
• Publication date: 2018-08-24
• Acceptance date: 2018-07-17
• DOI: 10.1111/jep.13018
• EISSN: 1365-2753
• ISSN: 1356-1294
• Pmid: 30144250
• Language: English
• Keywords: overmedicalization; chronic kidney disease; biostatistical model; concepts of disease; Boorse; naturalism; harmful dysfunction