CKD & Kidney HealthChronic Kidney Disease (CKD): Symptoms, Causes, Diagnosis and Treatment
Chronic kidney disease is a long-term condition in which the kidneys are damaged or do not work as well as they should. CKD often develops gradually, and many people have few or no symptoms early on.
Why early awareness matters
CKD can be present without obvious symptoms. Kidney function and kidney damage are assessed with blood and urine testing, so people with relevant risk factors should discuss appropriate testing with a healthcare professional.
What do the kidneys do?
The kidneys help remove waste and extra water, support red-blood-cell production, keep minerals in balance, help regulate blood pressure, and support bone health. When kidney function stays impaired for three months or more, it may meet the definition of CKD.
Signs and symptoms
Early CKD may cause no noticeable symptoms. When symptoms appear, they can include:
- Foamy urine
- Urination that becomes more or less frequent than usual
- Dry or itchy skin
- Tiredness or low energy
- Nausea or reduced appetite
- Unintentional weight loss
More advanced disease can be associated with difficulty concentrating, swelling of the limbs or feet, muscle aches or cramps, shortness of breath, vomiting, and sleep problems. Symptoms alone cannot confirm CKD; testing is required.
Common risk factors and causes
Common risk factors
- Diabetes
- High blood pressure
- Heart disease or heart failure
- Obesity
- Older age
- Family history of CKD or kidney failure
- Previous acute kidney injury
- Smoking or tobacco use
- Heavy alcohol use
Other causes
- Glomerular diseases
- Inherited conditions such as polycystic kidney disease
- Autoimmune disease such as lupus nephritis
- Severe infections such as sepsis or HUS
- Kidney cancer
- Kidney stones
- Long-lasting urinary tract infections
- Hydronephrosis
How doctors describe CKD
Doctors generally consider three parts of kidney status: the CKD stage based mainly on eGFR, the amount of albumin in the urine measured with uACR, and the likely cause of CKD. Together, these help guide care and follow-up.
Possible complications
As CKD progresses, the risk of complications can increase. Examples include heart disease or stroke, high blood pressure, anemia, metabolic acidosis, mineral and bone disorders, high potassium, and kidney failure.
How CKD is diagnosed
Evaluation usually starts with two tests:
- eGFR: a blood-test-based estimate of how well the kidneys filter waste.
- uACR: a urine test that measures albumin relative to creatinine and helps identify kidney damage.
An eGFR below 60 and/or a uACR above 30, persisting for three months or longer, may indicate CKD. Depending on the situation, doctors may also use ultrasound, CT, MRI, urinalysis, or kidney biopsy.
Treatment and long-term management
CKD treatment depends on the stage, test results, underlying cause, and other health conditions. The goals include managing the cause, slowing further loss of kidney function, reducing cardiovascular risk, and treating complications.
- Medications may be used for blood pressure, kidney protection, cardiovascular risk, or CKD complications, depending on individual needs.
- Some pain medicines, especially NSAIDs, can be harmful to the kidneys and should be discussed with a clinician.
- Nutrition needs may change according to CKD stage, blood pressure, diabetes, lab results, and complications.
- A kidney dietitian can help decide whether sodium, potassium, phosphorus, calcium, protein, or fluid intake needs adjustment.
- Regular physical activity can support kidney and cardiovascular health when it is safe for the individual.
Preparing for a kidney-care appointment
Bring recent laboratory reports, a current list of medicines and supplements, and questions about kidney function. Useful questions include your eGFR and uACR values, CKD stage, likely cause, how kidney function has changed over time, testing frequency, medication safety, diet and drink changes, and whether a kidney specialist is needed.
