Which condition is a leading causative factor for chronic kidney disease?

• A. Hypertension
• B. Diabetes mellitus
• C. Polycystic kidney disease
• D. Sleep apnea

Answer: (B)

Diabetes mellitus is the leading causative factor for chronic kidney disease because prolonged high blood sugar damages the kidneys’ delicate filtering units (glomeruli). This damage, known as diabetic nephropathy, involves changes such as thickening of the glomerular basement membrane, mesangial expansion, and nodular glomerulosclerosis, which together reduce filtration efficiency and lead to albumin loss in the urine and a progressive decline in glomerular filtration rate. Since diabetes is very common, especially type 2, its cumulative impact on the kidneys makes it the most frequent cause of CKD worldwide.

Hypertension is also a major contributor and often coexists with kidney disease, accelerating damage, but the question asks for the leading factor, and diabetes currently accounts for the largest share of CKD cases. Polycystic kidney disease is a significant genetic cause but much less common overall, and sleep apnea is associated with CKD progression but does not serve as a primary driver of CKD evident in most patients.