Chronic Kidney Disease (CKD)

Overview

The kidneys are two organs in your body that filter waste and excess fluids from your body. These waste materials then leave your body in your urine. With chronic kidney disease – or CKD – the kidneys gradually stop performing their normal function and fluids, electrolytes and waste can build up in your body. Advanced stage CKD is very serious and can be fatal if not effectively quickly. CKD is also known as chronic kidney failure.

Chronic kidney disease causes 

CKD can be caused by the following health conditions that impair kidney function:

• Certain types of cancer
• Enlarged prostate
• Glomerulonephritis (swelling of the lining of the kidneys)
• Hypertension (high blood pressure)
• Interstitial nephritis (inflammation of the kidney’s tubules)
• Kidney stones
• Polycystic kidney disease
• Pyelonephritis (recurrent kidney infection)
• Type 1 or type 2 diabetes
• Vesicoureteral reflux (condition that causes urine to pool in the kidneys)

Chronic kidney disease risk factors

Factors that put you at an increased risk for developing CKD include:

• Being a smoker
• Being African-American, Native American or Asian-American
• Being obese
• Being older
• Having a family history of kidney disease
• Having an abnormal kidney structure
• Having diabetes type 1 or type 2
• Having heart disease
• Having hypertension

Chronic kidney disease symptoms

In its early stages, CKD usually does not cause any symptoms. In later stages, signs and symptoms of CKD may include:

• Changes in cognitive (thinking) abilities
• Changes in how much you urinate
• Chest pain
• Fatigue
• Hypertension that can’t be controlled
• Itching that won’t go away
• Loss of appetite
• Muscle twitches or cramping
• Nausea
• Shortness of breath
• Swelling in your feet or ankles
• Trouble sleeping
• Vomiting
• Weakness

Chronic kidney disease diagnosis

Your specialist will use one or more of the following diagnostic tools to diagnose CKD:

• Physical exam. Your specialist will complete a physical exam and ask you about your symptoms and history related to your kidney function and symptoms.
• Blood tests. Your specialist will obtain a sample of your blood for close analysis in the lab. If your blood contains elevated levels of certain waste products – such as creatinine or urea – you may have CKD.
• Imaging tests. Your specialist may order imaging tests – such as ultrasound – to check your kidneys’ size and structure.
• Kidney biopsy. In this test, your specialist inserts a thin needle into your abdomen near your kidney to obtain a small tissue sample. Lab technicians analyze the sample and can help determine the underlying cause of your kidney failure.
• Urine tests. Your specialist will obtain a sample of your urine for close analysis in the lab. Lab technicians can determine if your urine contains certain abnormalities that can point to CKD. These tests can also help your kidney specialist determine the cause of your kidney failure.

Chronic kidney disease treatment

Your kidney specialist may recommend one or more of the following treatments for CKD:

• Diet modifications. Your specialist may recommend reducing the amount of protein in your diet, which can help reduce the work of your kidneys. You may work with a dietitian to make changes to your diet that will work for you.
• Managing the underlying condition. If your CKD has been caused by an underlying health condition, such as diabetes or heart disease, your treatment will focus on effectively managing that condition and minimizing the future impact on your kidneys.
• Medications. Your kidney specialist may prescribe one or more medications to treat the symptoms of CKD and help slow progression. These medications may include high blood pressure medications, cholesterol medications, anemia medications, diuretics (water pills) or medications to protect your bones from damage.
• Dialysis. In this treatment for end-stage kidney disease, when your kidneys are no longer functioning, a machine performs the work of filtering your blood that your kidneys normally do. Often, people awaiting a kidney transplant will be on dialysis until they receive a transplant. There are multiple types of dialysis, and your kidney specialist will advise which option would be best for your situation.
• Kidney transplant. In this treatment for end-stage kidney disease, when your kidneys are no longer functioning, your kidney specialist surgically removes your diseased kidneys and replaces them with a kidney from a live or deceased donor. After undergoing a transplant, you will be on anti-rejection medication for the rest of your life and will need to be seen regularly by your kidney transplant.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a kidney specialist – or nephrologist – for more specialized treatment.