Chronic kidney disease

Overview

Your kidneys clean waste and extra fluid from your blood and make urine. They also help control blood pressure, make red blood cells, and keep bones healthy.

In CKD, damage builds slowly. Waste and fluid can build up, and other problems like anemia and bone disease can follow. Treatment slows the damage. If kidneys fail, dialysis or a transplant is needed.

Symptoms

Early CKD usually has no symptoms. These show up as it gets worse:

• Foamy or bubbly urine
• Swollen ankles, feet, or legs
• Feeling tired
• Getting up at night to pee

Less common

• Itchy skin
• Muscle cramps
• Poor appetite, nausea, or vomiting
• Trouble sleeping or concentrating
• Peeing much less than usual

When to get medical care

Causes

Diabetes and high blood pressure cause most CKD. Other causes include kidney inflammation, polycystic kidney disease, repeated kidney infections, and blockages.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.
• It can run in families. Tell your doctor if a parent, brother, or sister has it.

Who is more likely to get it

• Diabetes
• High blood pressure
• Heart disease
• Family history of kidney failure
• Older age
• Being African American, Hispanic, American Indian, or Native Hawaiian or Pacific Islander

Possible complications

• Anemia: Low red blood cells
• Heart attack: Higher risk
• Stroke: Higher risk
• Sudden kidney injury: From illness, dehydration, or some medicines

Diagnosis

Kidney disease is found with blood and urine tests. Testing is the only way to know early.

Questions you may be asked

• Whether you have diabetes, high blood pressure, or heart disease
• Family history of kidney failure
• Which pain medicines you take, like ibuprofen

The exam

They'll check your blood pressure and look for swelling in your legs.

Tests

Common tests:

• eGFR blood test: Estimates how well your kidneys filter. Below 60 for 3 months means CKD.
• Urine albumin test: Checks for protein leaking into your urine, an early sign of damage.
• Ultrasound: Looks at the size and shape of the kidneys.

Treatment

Treatment slows kidney damage and treats problems it causes.

Self-care

• Keep your blood pressure in range (often below 130/80)
• Keep your blood sugar in range if you have diabetes
• Eat less salt and work with a dietitian on protein, potassium, and phosphorus
• Avoid NSAID pain relievers like ibuprofen and naproxen unless your doctor says OK
• Don't smoke

Medicines

These medicines can slow CKD:

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Some medicines, like ACE inhibitors, ARBs, and SGLT2 medicines, protect the kidneys. If kidneys fail, options are dialysis, a kidney transplant, or comfort care.

Prevention

You can protect your kidneys:

• Control blood pressure and blood sugar
• Get kidney tests each year if you're at risk
• Limit NSAID pain relievers
• Eat less salt
• Stay active and don't smoke

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a nephrologist (kidney doctor).

Living with it

• Ask a dietitian about salt, protein, and potassium.
• Avoid NSAIDs like ibuprofen unless your doctor says OK.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• National Kidney Foundation: Help line, peer mentors, and education about kidney health.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

• Older adults: Kidney function drops a little with age. Medicine doses may need to change.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• This condition needs closer checkups during pregnancy. Plan ahead with your doctor.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Most people with CKD don't need dialysis, especially when it's found early and blood pressure and blood sugar are controlled.

Getting ready for your visit

Know your numbers.

What to bring

• Your latest eGFR and urine albumin results
• A list of all medicines and supplements

Questions to ask

• What stage is my kidney disease?
• How can I slow it down?
• Which medicines should I avoid?
• Should I see a kidney specialist or dietitian?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Chronic kidney disease