Chronic kidney disease (CKD) is the progressive and irreversible loss of kidney function. Your kidneys are essential parts of your body.
Your kidneys have several functions, including:
- helping maintain the balance of minerals and electrolytes in your body, such as calcium, sodium, and potassium
- playing an essential role in the production of red blood cells
- maintaining the delicate acid-base (pH) balance of your blood
- excreting water-soluble wastes from your body
Damaged kidneys lose their ability to perform these functions.
CKD doesn’t cause any symptoms until your kidneys have lost most of their function. Once your kidneys are severely damaged, the symptoms of CKD can include:
- swelling around your eyes (periorbital edema)
- swelling of your legs (pedal edema)
- shortness of breath
- weight loss
- nausea or vomiting, especially in the morning and after eating
- a urine-like odor to your breath
- decreased urine output
- numbness in your hands and feet
- easy bruising and bleeding
- bone pain
- skin, hair, or nail changes
- drowsiness or mental cloudiness
- erectile dysfunction
- muscle twitching and cramps
- blood in your stools
- excessive thirst
- decreased interest in sex
- sleep apnea
You may also experience symptoms of any health conditions that are contributing to your kidney problems.
Each kidney contains about
High blood pressure can also damage the blood vessels of your kidneys, heart, and brain. Your kidneys are highly vascularized, meaning they contain lots of blood vessels. So, blood vessel diseases are generally dangerous to your kidneys.
Autoimmune diseases such as lupus can damage blood vessels and produce antibodies against kidney tissue.
According to the Centers for Disease Control and Prevention (CDC), CKD is more common in people older than
It’s more likely to occur in African Americans, Hispanic Americans, and Asian Americans.
Other risk factors for CKD include:
- cigarette smoking
- high cholesterol
- diabetes (types 1 and 2)
- autoimmune diseases
- obstructive kidney disease, including bladder obstruction caused by benign prostatic hyperplasia
- cirrhosis and liver failure
- narrowing of the artery that supplies your kidney
- kidney cancer
- bladder cancer
- kidney stones
- kidney infection
- systemic lupus erythematosus
- vesicoureteral reflux (when urine flows back into your kidney)
To diagnose CKD, a doctor will start by taking a medical history. A family history of kidney failure, high blood pressure, or diabetes may indicate to your doctor that you might have CKD. But other tests, including those below, are necessary to confirm the diagnosis.
Complete blood count
A complete blood count can show anemia. Your kidneys make a hormone called erythropoietin, which stimulates your bone marrow to make red blood cells. When your kidneys are severely damaged, your ability to make erythropoietin decreases. This causes a decrease in red blood cells, or anemia.
Electrolyte level test
CKD can affect your electrolyte levels. Your potassium may be high and your bicarbonate levels may be low if you have CKD. There may also be an increase in acid in your blood.
Blood urea nitrogen test
Blood urea nitrogen can become elevated when your kidneys start to fail. Typically, your kidneys clear the products of protein breakdown from your blood. But when you have kidney damage, these byproducts build up. Urea is a byproduct of protein breakdown that gives urine its odor. Your doctor may check for urea buildup.
Creatinine is a protein related to muscle mass. As your kidney function declines, your creatinine level increases.
Parathyroid hormone (PTH) test
The kidneys and your parathyroid glands interact through the regulation of calcium and phosphorus. A change in kidney function affects the release of PTH, which affects calcium levels throughout your body.
When your kidneys progress to end stage renal disease (ESRD), they no longer release enough phosphorus, and this impairs the creation of vitamin D in your body. Your bones may also release calcium and become weak over time.
Renal flow and scan
A renal scan is an imaging study of your kidney function.
This noninvasive test provides images to help your doctor see whether there’s an obstruction.
Additional tests for CKD include:
CKD is chronic and irreversible. Treatment focuses on improving the underlying disease. Treatment can also help prevent and manage CKD complications such as:
- fluid overload
- congestive heart failure
- brittle bones
- weight loss
- electrolyte imbalance
Managing underlying health conditions such as high blood pressure and diabetes can slow the progression of kidney damage.
The treatment for CKD and ESRD includes the following strategies.
You should decrease the fat, salt, protein, and potassium in your diet. Reducing salt and fluid intake can help manage your blood pressure and prevent fluid overload. But be sure to consume enough calories to maintain your weight. If you have diabetes, you may need to restrict your carbohydrate intake.
Be sure to discuss any dietary changes with a doctor or a registered dietitian who is familiar with CKD.
Make an effort to get enough exercise. If you smoke, quitting smoking can also help.
Supplements and medication
Your treatment may involve:
- iron and vitamin supplements to manage anemia
- calcium and vitamin D supplements
- erythropoietin injections to stimulate the production of red blood cells
- phosphate binders
- stool softeners to help with constipation
- antihistamines for itching
If you have CKD associated with type 2 diabetes, taking the prescription drug Kerendia (finerenone) may reduce your risk of:
- sustained decline in glomerular filtration rate
- cardiovascular death
- nonfatal heart attack
- hospitalization for heart failure
You should take Kerendia only if your doctor recommends it.
You may need dialysis to filter your blood when your kidneys can no longer do so. In some cases, you may need a kidney transplant. You should also talk with your doctor about managing your blood sugar and managing diabetes, if you have it.
You may be more susceptible to infections if you have CKD or ESRD. Doctors are likely to recommend that you get the following vaccinations:
- pneumococcal vaccine
- hepatitis B vaccine
- influenza (flu) vaccine
You can’t always prevent CKD, but managing any other health conditions you have, such as high blood pressure and diabetes, can help. You should get regular screenings for CKD if you have a high risk of developing it. Getting an early diagnosis of CKD can help slow its progression.
What are the first warning signs of kidney disease?
Early stage CKD does not always show clear symptoms, but there are some to watch for.
Among the first symptoms of kidney disease are fatigue and dizziness. These symptoms have many possible causes but could indicate toxins in your blood. Other potential signs and symptoms include high blood pressure, swelling in your hands and feet, urinary tract infections, and protein or blood in your urine.
What are the 4 types of kidney disease?
There are many forms of kidney disease — far more than four, in fact. Here are some examples of kidney disorders aside from CKD:
- polycystic kidney disease, in which small fluid-filled cysts grow inside your kidneys and can interfere with their function and cause them to fail
- glomerulonephritis, an inflammation of blood vessels within your kidneys, which can also lead to kidney failure
- kidney stones, which are small deposits of minerals that can grow in your kidneys and pass out of your body in your urine, often painfully
- IgA nephropathy, an autoimmune disease in which antibodies grow in your kidneys and attack them
Can kidney disease be cured?
There is currently no cure for CKD, but treatment can help manage its symptoms and slow its progression. Early diagnosis is crucial to maintaining your quality of life while living with CKD.