What Is Chronic Kidney Disease (CKD)?

Chronic kidney disease (CKD) happens when your kidneys gradually lose their ability to filter waste products and excess fluid from the blood. CKD typically causes no symptoms at first, but as your kidney function deteriorates and waste products build up in your blood, you may begin to feel sick.e60dc2a1-f33c-4a05-9b50-8e3e8e59762927153b2e-0d9f-4a2f-862f-1babef5ce8e2 Your kidneys may become damaged and lose function over time due to several different factors, including high blood pressure and diabetes. You’re more likely to develop chronic kidney disease the longer you have underlying conditions that contribute to it, and your risk also grows with age.e60dc2a1-f33c-4a05-9b50-8e3e8e59762997699df1-9698-4653-b309-83fd9c5bb6f6 CKD is often managed successfully with lifestyle changes, but it can lead to irreversible damage that will require dialysis or a kidney transplant.
Stages of CKD Stages Chronic kidney disease is grouped into five stages, from less severe to more advanced disease. These stages are determined by how well your kidneys are able to filter your blood. A blood test known as an estimated glomerular filtration rate (eGFR) estimates how well your kidneys are filtering waste from your blood.e60dc2a1-f33c-4a05-9b50-8e3e8e59762917f0b58a-2bd7-4f2f-b8d9-dc3d8ab265be Stage 1 You have mild kidney damage, but your kidneys are working well. Stage 2 You have more kidney damage, but your kidneys are still working well. Stage 3 You have moderately decreased kidney function, and you may show some symptoms of CKD. Stage 4 You have poor kidney function with moderate to severe kidney damage. You almost certainly have symptoms of CKD. Stage 5 You have, or nearly have, kidney failure. You need dialysis or a kidney transplant to stay alive.
What stage of CKD you have will determine what treatments or lifestyle modifications your healthcare provider recommends. The most commonly diagnosed stage of CKD is stage 3.
Signs and Symptoms of CKD Symptoms Chronic kidney disease may not cause symptoms until severe damage has occurred. Early CKD symptoms can also be nonspecific and may appear to be symptoms of another health condition. Symptoms of CKD are caused by the buildup of waste products in your blood, excess fluid buildup in your body, and other consequences of poor kidney function.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296aac28f7-c9cc-4f12-b28d-b9c8d01bd90f Fatigue or loss of energy Difficulty concentrating Loss of appetite Muscle cramps (especially at night) Swelling in your feet and ankles Dry or itchy skin More or less frequent urination Nausea or vomiting Chest pain Shortness of breath
Causes and Risk Factors of CKD Causes Chronic kidney disease develops due to damage that occurs in the kidneys over time. This damage can be related to different health conditions. You’re also more likely to develop CKD if you have a family history of kidney failure.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299d5d35af-c84c-492b-b69c-42c5735dff62 The following diseases or conditions may cause or contribute to CKD:e60dc2a1-f33c-4a05-9b50-8e3e8e597629914b8696-6b55-4707-9468-353d08d882dd Diabetes (type 1 or type 2) High blood pressure Heart disease Glomerulonephritis, which involves damage to the kidney’s filtering units Polycystic kidney disease, a genetic disorder that causes cysts to form in the kidneys Lupus Urinary tract obstruction, potentially due to an enlarged prostate, kidney stones, or cancer Vesicoureteral reflux, a backup of urine in your kidneys Recurrent kidney infections
How Is CKD Diagnosed? Diagnosis Your doctor will diagnose chronic kidney disease based on your health history, blood tests, and probably at least one urine test. Based on these results, your doctor may order imaging tests or a kidney biopsy to get a better picture of what is going wrong in your kidneys.e60dc2a1-f33c-4a05-9b50-8e3e8e59762961c55577-4c44-47a1-ad4f-def5d6a8f259 Blood and Urine Tests The most commonly used tests to diagnose CKD include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629d0be3169-699c-46ef-b5f7-85201a38dbbd Glomerular Filtration Rate (GFR) This blood test estimates how efficiently your kidneys are filtering your blood. Urine Albumin Test This test looks at how much protein and blood are in your urine, which can indicate kidney damage. Imaging Tests If blood and urine tests indicate that you might have CKD, your doctor may order any of the following imaging tests to look at the structure and size of your kidneys, the blood flow to those organs, and signs of injury or damage:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a81bba57-1b90-4782-a973-d5003b8af699 Ultrasound, which uses sound waves to make picture of the kidneys Magnetic resonance imaging (MRI), which uses magnets and radio waves to make 3D pictures Computerized tomography (CT), which uses X-rays and computer technology to create detailed images Kidney Biopsy Taking a small sample of kidney tissue can help determine the health of your kidneys. To do this, your doctor will typically numb the area and insert a long, thin needle through your skin into one of your kidneys. The tissue sample will be sent to a lab for analysis.e60dc2a1-f33c-4a05-9b50-8e3e8e59762953a3156b-df41-49e7-8305-ecd80439d6b1
Treatment and Medication Options for CKD Treatment With the right treatment, it’s possible to slow or even halt the progression of CKD. Your doctor may prescribe medications and recommend certain lifestyle changes. If your CKD progresses to the point of kidney failure, you’ll need to start dialysis or undergo a kidney transplant.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c4684826-dc99-4118-b216-69fc7206d3e4 Medications Depending on the specific causes and stage of your CKD, your doctor may prescribe one or more of the following medications to help preserve kidney function and lower your risk of developing heart disease: Angiotensin-Converting Enzymes (ACE) Inhibitors or Angiotensin II Receptor Blockers (ARB) These drugs help lower your blood pressure and may help delay CKD progression.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298f2a927a-4ffa-4286-a7aa-e24fae1d3551 GLP-1 Receptor Agonists These drugs, more commonly known as diabetes or weight loss meds, help slow CKD and lower heart disease risk for those who have type 2 diabetes or obesity.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298bfde7f6-1765-4fa6-b5a7-1aa6ce2cb031 SGLT2 Inhibitors Originally developed to treat type 2 diabetes, these drugs have also been found to help slow CKD progression. You don’t need to have diabetes to take these drugs for CKD.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290384de56-669d-4598-a72d-a368a95003e3 Statins These medications help lower cholesterol levels, which reduces the risk of heart disease, a common complication of CKD.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d4c9db08-b11f-4313-b2b7-1699837d1103 You may also benefit from taking certain medications to help control symptoms of CKD:e60dc2a1-f33c-4a05-9b50-8e3e8e5976293708c490-4790-451f-ae1a-574db8d39b32 Diuretics to reduce swelling and remove excess fluid Erythropoietin to treat anemia Calcium and vitamin D supplements to help prevent bone loss A phosphate binder to help protect your blood vessels from calcium deposits Dialysis Dialysis is the process of filtering waste products and excess fluid from your blood when your kidneys can no longer do it. If your CKD progresses to the point of kidney failure, you’ll need to start dialysis — unless an immediate kidney transplant is an option. This may require treatment three to seven days a week, and sessions can last from three to eight hours.e60dc2a1-f33c-4a05-9b50-8e3e8e59762921da5dc1-7014-4ee1-a3d2-afd7f6daf19c There are two main types of dialysis:e60dc2a1-f33c-4a05-9b50-8e3e8e59762951b61e15-977d-49cd-8f9e-56a66251d616 Hemodialysis In this process, your blood is sent through an artificial kidney machine (hemodialyzer) and returned to your body. Typically, each treatment lasts about four hours and takes place three times a week. Peritoneal Dialysis This process, which may be done at home, takes place inside your body, and involves filling your abdominal cavity with a solution (dialysate) that draws extra waste products and fluid from your blood. It can be done either manually or using a machine that pumps the solution in and out of your body. Dialysis does not improve your kidney function, and you’ll need to continue with it for the rest of your life unless you receive a kidney transplant. While the average life expectancy for people on dialysis is 5 to 10 years, many people live much longer. Kidney Transplantation A kidney transplant may help you live longer and sustain a better quality of life, but it involves major surgery that carries risks. You’ll need to take anti-rejection medication for as long as your new kidney is working — which raises your risk of infection and some types of cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296ab4c71c-0819-4056-a468-697d7f365a3a On average, kidney transplants last for 10 to 20 years, and eating healthy, staying active, and avoiding infections can help you stay well. Most people feel better and live longer after a transplant, but there’s a higher risk of getting these health conditions:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e50090c5-8e60-408b-9961-53893d668741 Diabetes High blood pressure Gout Lupus Skin cancer A transplanted kidney can come from either a deceased or living donor. You may decide, with your doctor, to get a transplant before you need dialysis or soon after starting on dialysis.
Prevention of CKD Prevention A healthy lifestyle may be the best way to prevent CKD. Research suggests that getting more physical activity, minimizing salt intake, and eating more vegetables and potassium may all help decrease someone’s risk for CKD.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b791496c-b27a-4b26-a16c-3e4579d8b3fb If you are older than 65, have diabetes, or have high blood pressure, you may need to get tested for CKD, so if it’s detected, it can be managed right away.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295dcdc379-33c4-4ec5-a7a1-721428932f4d People with diabetes may need yearly screenings for CKD in order to catch it early.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290867a6e7-57bf-4287-9a27-c7de18c84af3 Meeting your treatment goals for your preexisting conditions, such as achieving the blood sugar or blood pressure targets set by your clinician, can help lower your risk of kidney damage.
Lifestyle Changes for CKD Lifestyle Changes Your doctor or a dietitian may recommend certain lifestyle measures to help reduce damage to your kidneys. Recommended lifestyle changes may include dietary changes and other new healthy habits that can support better metabolic health. Dietary Changes Dietary strategies can have a positive impact on CKD outcomes. Knowing which nutrients to include — and avoid — in your diet may help slow the progression of the disease.e60dc2a1-f33c-4a05-9b50-8e3e8e59762965e64284-b7f9-4729-967a-b5b336ae4381 Minimize protein intake. This could help with CKD progression, since protein increases the workload of the kidneys.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c8b8ac-c0df-4b5e-9775-57f6fca0467c Decrease intake of sodium. This can lower blood pressure and lessen the strain on the kidneys to filter out excess sodium.e60dc2a1-f33c-4a05-9b50-8e3e8e59762981176114-55e4-43be-88b9-7790a6f6b163 Watch potassium intake. Monitor this if advised to do so by your doctor. When kidney function falls below a certain level, there’s a risk of potassium levels getting too high.e60dc2a1-f33c-4a05-9b50-8e3e8e59762981176114-55e4-43be-88b9-7790a6f6b163 Minimize phosphorus intake. Do this in the later stages of CKD, since the kidneys can’t remove this mineral very well.e60dc2a1-f33c-4a05-9b50-8e3e8e59762919fa9d9c-bfb2-4bfb-a803-4ced2060ad4c It’s important to note that these recommendations will differ depending on your kidney health and treatment. People on dialysis, for example, may be asked to increase their protein intake and to limit how much fluid they drink.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b87c961f-7249-4630-8c68-18b9191583dd Experts also recommend that patients with CKD should follow healthy and diverse diets that focus on plant-based foods and minimize ultraprocessed foods.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298fe7bd80-2d8e-4397-b1c0-f80382c0733b Other Lifestyle Changes The general lifestyle recommendations for people with CKD are similar to anyone who’s seeking to follow a healthy lifestyle. Get a regular amount of physical activity. However, there is mixed data on whether this helps slow down CKD progression.e60dc2a1-f33c-4a05-9b50-8e3e8e59762932702d57-4d09-42cc-b2e5-34d0d413bdc8 Exercise might need to be modified depending on factors like fatigue.e60dc2a1-f33c-4a05-9b50-8e3e8e59762928b9f539-3e32-4a0d-b862-25e8ce8f58fd Stop smoking if you still do. Cigarettes may make CKD worsen faster, while quitting may help slow disease progression down.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c8b8ac-c0df-4b5e-9775-57f6fca0467c Get to and maintain a healthy weight. Obesity may contribute to CKD progressing faster.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c8b8ac-c0df-4b5e-9775-57f6fca0467c People in earlier stages of CKD may have different goals for weight than people in end-stage kidney disease when there is more risk for malnutrition.e60dc2a1-f33c-4a05-9b50-8e3e8e59762932702d57-4d09-42cc-b2e5-34d0d413bdc8 Avoid excessive alcohol consumption. The relationship between alcohol and CKD is complicated, but binge drinking may increase the odds of CKD getting worse.e60dc2a1-f33c-4a05-9b50-8e3e8e59762932702d57-4d09-42cc-b2e5-34d0d413bdc8
Prognosis and Outlook for CKD Prognosis and Outlook The prognosis for CKD can vary wildly. It can depend on factors such as your age, overall health, the type of treatment you receive, and how well you follow your treatment plan. The precise life expectancy is not clear cut, and it can depend on age. Younger patients (50 or under) can lose 10 or more years of life expectancy, older patients much less.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bcc2a710-fca3-4a81-9e80-1eba043d5c4c CKD is not curable, but many people with CKD can live long lives. Most people who seek treatment for this disease won’t die from it.e60dc2a1-f33c-4a05-9b50-8e3e8e597629356ded18-b02c-4422-b8bc-25eed9cff3a5 However, people with higher blood pressure and more protein in their urine are more likely to have their kidney function worsen more quickly.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f1d4b564-658e-426e-a758-34a5c3fb4945 Left undiagnosed or untreated, CKD can progress to fatal kidney failure, as well as a deadly heart attack or stroke.e60dc2a1-f33c-4a05-9b50-8e3e8e597629844a6130-7718-4e68-a926-2e8ebce3d914 Many people experience cardiovascular-related death before CKD progresses to end-stage kidney disease, also known as kidney failure.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d4c04d22-80b1-4512-9375-76b7f6ed07d5 Kidney failure, meaning one or both of your kidneys no longer function well without assistance, is not reversible. Mortality rates are lower for people who choose to get a kidney transplant than those who get dialysis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ab331018-bdb7-4cd0-8d44-1b5511a70673
Complications of Chronic Kidney Disease Complications CKD can lead to complications all over the body. These complications may be caused by a buildup of waste products in your blood, excess fluid in your body, or other factors.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295b50e064-af03-4e5b-9b6e-ef7c0f06f9f0 Pulmonary edema , or fluid in the lungs Hyperkalemia, or high blood potassium levels Anemia Hyperphosphatemia, a high blood phosphorus level Low bone mineral density, known as osteopenia High blood pressure Heart disease Insulin resistance
Research and Statistics: Who Has CKD? Research and Statistics More than 1 in 7 adults in the United States, about 35.5 million people or 14 percent, are thought to have CKD. It’s possible that 90 percent of them are unaware that they have the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293786e4fb-7ec4-4dfe-8830-e9d5f3cd5303 Some groups of people are more likely to experience CKD than others, and some are more likely to experience worse outcomes. Americans who are Black and Hispanic have a higher incidence of CKD.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293786e4fb-7ec4-4dfe-8830-e9d5f3cd5303 In the United States, research suggests that compared with white individuals, Black individuals are 3.4 times more likely to experience end-stage kidney disease, and Hispanic individuals are 1.3 times more likely to experience it. This could be related to struggles to access treatment before kidney disease advances to a higher stage.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b1a97c28-750d-41b5-ac0b-745f02d35357 CKD is also more common in people older than 65 and slightly more common in women.
Support for CKD Support National Kidney Foundation This group advocates for improving treatment for kidney disease and addressing health disparities. They also foster community connection and provide online information about kidney disease treatment and living with kidney disease. They do fundraising events, like the Kidney Walk , which involves events throughout the country to raise money for kidney disease research. American Kidney Fund This group advocates for kidney patients at various stages of diagnosis. They help fund over 130 monthly kidney transplants and support nephrology research. The group is passionate about health equity and also seeks to advocate for governmental policy for people with kidney disease.
The Takeaway Chronic kidney disease (CKD) occurs when the kidneys gradually lose their ability to filter waste. It is most common in people with diabetes and high blood pressure, and may have no symptoms in its early stages. CKD is classified into five stages based on kidney function. Symptoms like fatigue, swelling, nausea, and urinary changes may emerge in more advanced stages. CKD can be diagnosed with blood, urine, and imaging tests, and treatment may involve medications or lifestyle changes. There is no cure for this condition. Following healthy habits like reducing salt and protein intake, staying active, and managing blood pressure and weight can slow the progression of CKD.
Resources We Trust Cleveland Clinic: Chronic Kidney Disease: Know Your Options National Institute of Diabetes and Digestive and Kidney Diseases: Healthy Eating for Adults with Chronic Kidney Disease American Kidney Fund: Physical Activity and Kidney Health NYU Langone Health: Lifestyle Changes for Kidney Disease National Kidney Foundation: Kidney Transplant