What Is Chronic Kidney Disease?
Chronic kidney disease (CKD) means your kidneys are damaged and can’t filter blood the way they should. The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time. This damage can cause wastes to build up in your body. CKD can also cause other health problems.
Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.
In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.
Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.
Who is more likely to develop CKD?
You are at risk for kidney disease if you have
- Diabetes. Diabetes is the leading cause of CKD. High blood glucose, also called blood sugar, from diabetes can damage the blood vessels in your kidneys. Almost 1 in 3 people with diabetes has CKD.1
- High blood pressure. High blood pressure is the second leading cause of CKD. Like high blood glucose, high blood pressure also can damage the blood vessels in your kidneys. Almost 1 in 5 adults with high blood pressure has CKD.1
- Heart disease. Research shows a link between kidney disease and heart disease. People with heart disease are at higher risk for kidney disease, and people with kidney disease are at higher risk for heart disease. Researchers are working to better understand the relationship between kidney disease and heart disease.
- Family history of kidney failure. If your mother, father, sister, or brother has kidney failure, you are at risk for CKD. Kidney disease tends to run in families. If you have kidney disease, encourage family members to get tested. Use tips from the family health reunion guide and speak with your family during special gatherings.
Your chances of having kidney disease increase with age.1 The longer you have had diabetes, high blood pressure, or heart disease, the more likely that you will have kidney disease.
Symptoms
Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred. Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include:
- Nausea
- Vomiting
- Loss of appetite
- Fatigue and weakness
- Sleep problems
- Changes in how much you urinate
- Decreased mental sharpness
- Muscle twitches and cramps
- Swelling of feet and ankles
- Persistent itching
- Chest pain, if fluid builds up around the lining of the heart
- Shortness of breath, if fluid builds up in the lungs
- High blood pressure (hypertension) that’s difficult to control
Does CKD cause other health problems?
Kidney disease can lead to other health problems, such as heart disease. If you have kidney disease, it increases your chances of having a stroke or heart attack.
High blood pressure can be both a cause and a result of kidney disease. High blood pressure damages your kidneys, and damaged kidneys don’t work as well to help control your blood pressure.
If you have CKD, you also have a higher chance of having a sudden change in kidney function caused by illness, injury, or certain medicines. This is called acute kidney injury.
Causes
Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years.
Diseases and conditions that cause chronic kidney disease include:
- Type 1 or type 2 diabetes
- High blood pressure
- Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis), an inflammation of the kidney’s filtering units (glomeruli)
- Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney’s tubules and surrounding structures
- Polycystic kidney disease
- Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
- Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back up into your kidneys
- Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis)
Risk factors
Factors that may increase your risk of chronic kidney disease include:
- Diabetes
- High blood pressure
- Heart and blood vessel (cardiovascular) disease
- Smoking
- Obesity
- Being African-American, Native American or Asian-American
- Family history of kidney disease
- Abnormal kidney structure
- Older age
Complications
Chronic kidney disease can affect almost every part of your body. Potential complications may include:
- Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
- A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart’s ability to function and may be life-threatening
- Heart and blood vessel (cardiovascular) disease
- Weak bones and an increased risk of bone fractures
- Anemia
- Decreased sex drive, erectile dysfunction or reduced fertility
- Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures
- Decreased immune response, which makes you more vulnerable to infection
- Pericarditis, an inflammation of the saclike membrane that envelops your heart (pericardium)
- Pregnancy complications that carry risks for the mother and the developing fetus
- Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival
Prevention
To reduce your risk of developing kidney disease:
- Follow instructions on over-the-counter medications. When using nonprescription pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), follow the instructions on the package. Taking too many pain relievers could lead to kidney damage and generally should be avoided if you have kidney disease. Ask your doctor whether these drugs are safe for you.
- Maintain a healthy weight. If you’re at a healthy weight, work to maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss. Often this involves increasing daily physical activity and reducing calories.
- Don’t smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you’re a smoker, talk to your doctor about strategies for quitting smoking. Support groups, counseling and medications can all help you to stop.
- Manage your medical conditions with your doctor’s help. If you have diseases or conditions that increase your risk of kidney disease, work with your doctor to control them. Ask your doctor about tests to look for signs of kidney damage.