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Overview

What Is Chronic Kidney Disease?

Chronic kidney disease (CKD) is lasting damage to the kidneys or reduced kidney function that continues over time. The kidneys normally filter waste and extra fluid from the blood, but damaged kidneys may not do this as well. Early chronic kidney disease may cause few or no noticeable symptoms. It can affect people of any age, although diabetes, high blood pressure, older age, and family history increase risk.

Symptoms

Chronic Kidney Disease Symptoms

Many people have no symptoms in the early stages of chronic kidney disease, so testing may find the condition before a person feels unwell. Symptoms usually become more noticeable as kidney function worsens and waste or extra fluid builds up. Kidney disease symptoms can also vary depending on the cause and other health problems.

  • Swelling in the ankles, legs, feet, hands, or around the eyes may result from extra fluid.
  • Changes in urination may include urinating more or less often, especially at night.
  • Foamy urine may indicate excess protein in the urine.
  • Fatigue or unusual weakness may occur when kidney disease affects the blood or waste removal.
  • Nausea or reduced appetite can develop as waste products build up.
  • Itchy skin may occur with advanced kidney problems.
  • Muscle cramps, especially in the legs, may result from fluid or mineral imbalances.
  • Shortness of breath may occur when fluid collects in the lungs or anemia develops.
  • Trouble concentrating or feeling mentally slowed may occur in more advanced disease.

SEEK URGENT CARE

Warning signs of serious kidney problems

Severe breathing difficulty, confusion, chest pain, or very little urine can indicate a serious problem and requires urgent medical assessment. Do not wait for symptoms to worsen, particularly if you already have kidney disease.

Causes

What Causes Chronic Kidney Disease?

Repeated or long-term injury to the kidneys’ filtering structures can cause scarring and reduce filtration. Over time, this may lead to a chronic loss of kidney function. The causes of kidney failure are often conditions that damage the kidneys gradually rather than a single sudden event.

  • Diabetes can damage the small blood vessels and filtering structures in the kidneys over time.
  • High blood pressure can place ongoing strain on kidney blood vessels and gradually reduce kidney function.
  • Glomerular diseases can inflame or damage the kidney filters that remove waste from blood.
  • Inherited kidney disorders, such as polycystic kidney disease, can interfere with kidney structure and function.
  • Repeated kidney infections or blockage of urine flow can cause lasting damage and scarring.
  • Some medicines, supplements, and toxins can injure the kidneys, especially with frequent or unsafe use.

Risk Factors

Risk Factors for Chronic Kidney Disease

Modifiable risk factors

  • Uncontrolled diabetes can damage kidney filters, so managing blood sugar may lower kidney risk.
  • Uncontrolled high blood pressure can injure kidney blood vessels, so regular treatment and monitoring may help protect the kidneys.
  • Smoking can worsen blood vessel damage, and quitting may reduce stress on the kidneys.
  • Overweight or obesity can increase the risk of diabetes and high blood pressure, so reaching a healthy weight may help.
  • Frequent use of kidney-harming medicines, including some pain relievers, may increase risk, so use them only as directed by a clinician.

Non-modifiable or less-modifiable risk factors

  • Older age is associated with a higher likelihood of reduced kidney function.
  • A family history of kidney disease may indicate inherited or shared risk.
  • Inherited kidney diseases can increase the chance of renal disease even when lifestyle factors are healthy.
  • A previous kidney injury may leave lasting damage or increase vulnerability to later disease.
  • Some racial and ethnic groups have higher population-level rates of kidney disease, although individual risk varies.

Complications

Chronic Kidney Disease Complications

  • Fluid retention can cause swelling, weight gain, high blood pressure, or shortness of breath.
  • High blood pressure can both result from kidney disease and contribute to further kidney damage.
  • Anemia can develop when damaged kidneys produce less of the hormone needed for red blood cell production.
  • Mineral and bone disorders can weaken bones and disturb calcium and phosphorus balance.
  • High potassium can affect muscles and the heart and may become dangerous if severe.
  • Cardiovascular disease risk increases because kidney disease affects blood pressure, blood vessels, and inflammation.
  • Uremia occurs when waste products build up in the blood and may cause nausea, confusion, itching, or severe weakness.

Diagnosis

How Chronic Kidney Disease Is Diagnosed

Clinicians diagnose chronic kidney disease when evidence of kidney damage or reduced kidney function lasts at least three months. This can be found through blood or urine testing even when a person feels well. Repeated results help distinguish ongoing disease from a temporary change.

  • An estimated glomerular filtration rate (eGFR) is calculated from a blood test to estimate how well the kidneys filter waste.
  • A urine albumin test checks for albumin, a protein that can leak through damaged kidney filters.
  • Urinalysis looks for blood, protein, infection, or other clues to kidney damage.
  • Blood pressure measurement identifies high blood pressure, which is both a cause and complication of kidney disease.
  • Imaging, such as an ultrasound, can show kidney size, structure, cysts, or urinary blockage.
  • Selected additional tests, including blood tests, genetic tests, or a kidney biopsy, may be used to identify the cause.
StageGeneral eGFR rangeWhat it means
Stage 190 or higher with evidence of kidney damageKidney filtration is relatively preserved, but testing shows kidney damage.
Stage 260–89 with evidence of kidney damageThere is mildly reduced filtration along with evidence of kidney damage.
Stage 330–59Moderately reduced kidney function; complications may become more likely.
Stage 415–29Severely reduced kidney function and a need for close specialist care.
Stage 5Below 15Kidney failure; dialysis or transplantation may be considered based on the person's condition.

Treatment & Management

Treatment and Management of Chronic Kidney Disease

  • Controlling blood pressure can reduce stress on the kidneys and help slow loss of kidney function.
  • Managing blood sugar can limit diabetes-related damage to the kidney filters.
  • Kidney-protective medicines may be prescribed when appropriate to reduce kidney damage and protein loss.
  • Managing cholesterol can lower cardiovascular risk associated with kidney disease.
  • Stopping smoking supports healthier blood vessels and may reduce further kidney injury.
  • Nutrition guidance can help manage sodium, protein, potassium, phosphorus, and fluid intake when needed.
  • Regular physical activity can support blood pressure, weight, blood sugar, and heart health.
  • Avoiding kidney-harming medicines or supplements can reduce preventable injury; discuss over-the-counter products with a clinician.

Managing complications and monitoring

Prevention

Can Chronic Kidney Disease Be Prevented?

  • Manage diabetes with a clinician’s guidance to reduce damage to the kidney filters.
  • Control blood pressure and take prescribed medicines consistently to protect kidney function.
  • Maintain a healthy weight through sustainable eating and activity habits.
  • Avoid tobacco because smoking can damage blood vessels and increase kidney risk.
  • Exercise regularly according to your health and physical abilities.
  • Limit excess sodium to support healthy blood pressure and reduce fluid strain.
  • Use medicines safely and ask a clinician or pharmacist before using frequent pain relievers or supplements.
  • Discuss kidney testing with a clinician if you have diabetes, high blood pressure, family history, or another elevated risk.

Outlook and Prognosis

Outlook and Prognosis for Chronic Kidney Disease

Chronic kidney disease is usually a long-term condition rather than something that can be completely reversed. Its rate of progression varies widely: some people remain stable for years, while others develop worsening kidney function. Appropriate treatment, risk-factor control, and regular monitoring may slow progression and reduce complications.

Disease courseGeneral outlookTypical care focus
Early CKDKidney function may remain stable, and symptoms may be absent.Identify the cause, control blood pressure and diabetes, and monitor blood and urine tests.
Moderate CKDComplications become more likely, but progression remains variable.Adjust treatment, review medicines, manage complications, and track eGFR and urine albumin.
Advanced CKDKidney function is substantially reduced and may continue to decline.Work closely with a kidney specialist and plan for complications and possible kidney replacement therapy.
Kidney failureThe kidneys cannot adequately maintain fluid and waste balance.Consider dialysis, transplantation, or an individualized supportive-care plan.

When Should You See a Doctor

When Should You See a Doctor?

  • Arrange a medical appointment for new or persistent swelling in the legs, feet, hands, or around the eyes.
  • Arrange an evaluation for persistent changes in urination, including blood, foam, or a major change in frequency.
  • Discuss unexplained fatigue or weakness with a clinician, especially if it continues.
  • Seek medical advice for ongoing kidney pain or pain in the side or back.
  • Have high blood pressure checked and treated because it can damage the kidneys.
  • Ask about kidney testing if you have diabetes, even without signs of kidney problems.
  • Discuss testing if a close family member has kidney disease.
  • Follow up with a clinician after a known abnormal kidney test or reduced kidney function result.

GET URGENT MEDICAL HELP

Serious kidney warning signs

Seek urgent care for severe shortness of breath, chest pain, confusion, fainting, severe weakness, repeated vomiting, or very little or no urine. These symptoms may signal a serious complication, including severe fluid or electrolyte problems.

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