Chronic Kidney Disease (CKD)

Anyone can develop CKD at any age. Some people have a higher risk because of other health conditions, family history, age, or a past kidney injury. For many people, CKD is not caused by only one thing. It may be linked to health, lifestyle, environment, and access to care.

Common risk factors for CKD

• Diabetes
• High blood pressure, also called hypertension
• Heart disease or heart failure
• Obesity
• Age over 60
• Family history of CKD or Kidney failure
• Personal history of acute kidney injury, also called AKI
• Smoking or use of tobacco products
• Heavy Alcohol use

Other causes of CKD

CKD can also be caused by other conditions or circumstances. Examples include:

• Glomerular (glow-MAIR-yoo-ler) diseases, such as glomerulonephritis (glow-MAIR-yoo-low-ne-FRY-tis), and  IgA nephropathy.
• Genetic or Inherited conditions, such as polycystic kidney disease
• Autoimmune diseases, such as lupus nephritis, can also cause CKD. Lupus nephritis, (LOO-pus ne-FRY-tis), happens when lupus damages the kidneys.
  • Autoimmune means the body’s defense system attacks healthy parts of the body by mistake. 
• Severe infections, such as sepsis and hemolytic uremic syndrome, also called HUS
• Kidney cancer
• Kidney stones
• Long-lasting urinary tract infections
• Hydronephrosis

Doctors describe CKD in different ways. This helps them understand your kidney health, choose the right care plan, and decide how often you need follow-up care.

CKD stage

CKD is divided into stages 1 through 5. Stages are based mostly on your estimated glomerular filtration rate, also called eGFR. Your CKD stage helps guide treatment decisions, how often you need testing, and when you may need to see a kidney doctor.

Albumin in the urine

Albumin is a protein that should usually stay in the blood. Albumin in the urine can be a sign of kidney damage. The urine albumin-creatinine ratio, also called uACR, helps show whether there is albumin in the urine and how high the level is.

Cause of CKD

Some people have CKD caused by diabetes, high blood pressure, glomerular disease, genetic conditions, autoimmune disease, or other health problems. Knowing the likely cause can help guide treatment.

As CKD worsens, the risk of complications can go up. Complications may include:

• Heart disease or stroke
• High blood pressure
• Anemia, or low levels of red blood cells
• Metabolic acidosis, Metabolic acidosis, which means acid builds up in the blood
• Mineral and bone disorder, when calcium and phosphorus levels are out of balance and may affect the bones or heart
• Hyperkalemia, Hyperkalemia, which means high potassium levels in the blood
• Kidney failure

Some conditions, such as heart disease and high blood pressure, can also cause CKD or make CKD worse.

Doctors diagnose CKD using blood and urine tests. These tests help show how well your kidneys are working and whether there is kidney damage.

Tests

Checking for CKD usually starts with two tests:

• A blood test called estimated glomerular filtration rate, or eGFR
• A urine test called urine albumin-creatinine ratio, or uACR

Both tests are needed to get a clear picture of your kidney health. An eGFR under 60 and/or a uACR over 30 for 3 months or more may be a sign of CKD.

eGFR blood test

The eGFR is an estimate of how well your kidneys are removing waste from the blood. It is calculated using a blood test result, using your age, and your sex. A higher eGFR number is usually better. Your eGFR helps determine your CKD stage.

uACR urine test

The uACR measures albumin and creatinine in your urine. Healthy kidneys keep albumin in the blood while filtering creatinine into the urine. A lower uACR number is usually better. A higher uACR can be a sign of kidney damage and a higher risk for complications.

Other tests

In some cases, your doctor may order other tests to learn more about your kidney health. These may include imaging tests, such as an ultrasound, CT scan, or MRI, or a kidney biopsy.

Treatment for CKD depends on your CKD stage, test results, and other health conditions. Treatment usually focuses on four goals:

• Managing the condition that is most likely causing CKD, such as diabetes, high blood pressure, or IgA nephropathy
• Taking steps to slow CKD progression
• Lowering the risk of heart disease and stroke
• Treating complications caused by CKD