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Chronic kidney disease (CKD)

Chronic kidney disease, also known as chronic renal disease or CKD, is a condition characterized by a gradual loss of kidney function over time. To read more about kidney function, see How Your Kidneys Work.

What is chronic kidney disease?

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by filtering wastes from your blood. If kidney disease worsens, wastes can build to high levels in your blood and make you feel sick. You may develop complications like:

  • high blood pressure
  • anemia (low blood count)
  • weak bones
  • poor nutritional health
  • nerve damage

Kidney disease also increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long time. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

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Kidney disease facts

  • 37 million American adults have CKD, and millions of others are at increased risk
  • Early detection can help prevent the progression of kidney disease to kidney failure
  • Heart disease is the primary cause of death for all people with CKD

What are the main causes of chronic kidney disease?

Diabetes and high blood pressure, or hypertension, are responsible for two-thirds of chronic kidney disease cases. 

Diabetes: Diabetes occurs when your blood sugar remains too high. Over time, unmanaged blood sugar can cause damage to many organs in your body, including the kidneys and heart and blood vessels, nerves, and eyes. 

High blood pressure: High blood pressure occurs when your blood pressure against the walls of your blood vessels increases. If uncontrolled or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes, and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.

What are other conditions that affect the kidney?

There are a few other conditions or circumstances that can cause kidney disease. 

Glomerulonephritis: Glomerulonephritis is a group of diseases that cause inflammation and damage the kidney's filtering units. These disorders are the third most common type of kidney disease.

Inherited diseases: Polycystic kidney disease, or PKD, is a common inherited disease that causes large cysts to form in the kidneys and damage the surrounding tissue.

Kidney and urinary tract abnormalities before birth: Malformations that occur as a baby develops in its mother's womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.

Autoimmune diseases: When the body's defense system, the immune system, turns against the body, it's called an autoimmune disease. Lupus nephritis is one such autoimmune disease that results in inflammation (swelling or scarring) of the small blood vessels that filter wastes in your kidney.

Other causes: Obstructions caused by kidney stones or tumors can cause kidney damage. An enlarged prostate gland in men or repeated urinary infections can also cause kidney damage.

What are the risk factors of chronic kidney disease?

Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:

  • have diabetes
  • have high blood pressure
  • have a family history of kidney failure
  • are older
  • belong to a population group with a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians

What are the symptoms?

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:

  • feel more tired and have less energy
  • have trouble concentrating
  • have a poor appetite
  • have trouble sleeping
  • have muscle cramping at night
  • have swollen feet and ankles
  • have puffiness around your eyes, especially in the morning
  • have dry, itchy skin
  • need to urinate more often, especially at night

What will happen if my doctor suspects chronic kidney disease?

Your doctor will want to pinpoint your diagnosis and check your kidney function to help plan your treatment. The doctor will perform these blood and urine tests:

Albumin to creatine ratio urine test: Albumin is a protein that shouldn't be found in urine and indicates kidney function problems. 

Blood test for creatinine: This determines if there is too much creatinine, a waste product, in the blood.

Learn about lab values.

Glomerular Filtration Rate (GFR): The doctor will calculate your Glomerular Filtration Rate (GFR) using the results from the tests and other factors like age and gender. The result of the GFR is the best way to measure your level of kidney function and determine your stage of kidney disease.

Learn more about GFR.

Kidney Numbers and the CKD Heat Map

Click here to download a printable resource that describes the kidney numbers that everyone should know and how your doctor uses them to diagnose chronic kidney disease (CKD).  You will also learn how the kidney numbers fit onto the CKD Heat Map, which helps to guide your treatment plan.

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Kidney Numbers and CKD Heat Map

Watch a series of short, animated videos that will help you learn about the importance of knowing your kidney numbers, how the heat map works for identifying where you are in terms of kidney health and along with some tips for improving your kidney numbers and moving in the right direction on the heat map.

Additional tests

Your doctor may perform a CT scan to get a picture of your kidneys and urinary tract to spot any kidney or urinary tract structure problems. Using this test, they can determine if your kidneys are too large or small or have issues like a kidney stone or tumor. 

They may also choose to biopsy the kidney to check for a specific type of kidney disease, see how much kidney damage has occurred, and help plan treatment. During this procedure, the doctor removes small pieces of kidney tissue and looks at them under a microscope.

Learn more about the diagnosis process.