Chronic Kidney Disease
Kidney disease, sometimes called chronic kidney disease or CKD, causes more deaths than breast cancer or prostate cancer. It is the under-recognized public health crisis. It affects 30 million people in the U.S. (15% of the adult population) and, approximately 90% of those with kidney disease don’t even know they have it. (For people at the earliest stages of kidney disease, 96% don’t know.) 1 in 3 Americans is at risk for CKD. Kidney disease is the 9th leading cause of death in the U.S. and is growing in prevalence. The National Kidney Foundation (NKF) has led the way in rallying action on this problem. Because of increasing rates of diabetes and high blood pressure, chronic kidney disease is on the rise and is an urgent issue.
What is Chronic Kidney Disease?
Chronic kidney disease (CKD) means your kidneys are damaged and losing their ability to keep you healthy. In the early stages, most people do not have symptoms. But as kidney disease gets worse, wastes can build up in your blood and make you feel sick. You may develop other problems like high blood pressure, anemia, weak bones, poor nutritional health, and nerve damage. Kidney disease also increases your risk of having heart and blood vessel disease. These problems may happen slowly and can lead to kidney failure. Once kidneys fail, dialysis or a kidney transplant is needed to stay alive.
What Causes CKD?
The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. Other conditions are: glomerulonephritis, diseases that damage the kidney's filtering units, which are the third most common type of kidney disease; inherited diseases, such as polycystic kidney disease; malformations at birth that occur as a baby develops; lupus and other immune diseases; obstructions such as kidney stones or an enlarged prostate; and repeated urinary tract infections.
Who is at Risk for CKD?
1 in 3 American adults is at risk for kidney disease. Anyone can get chronic kidney disease at any age. Some demographic groups are at higher risk.
Almost 10,000 children and adolescents have kidney failure or end-stage renal disease. They are 30 times more likely to die than healthy children. Young adults with ESRD since childhood have a life expectancy of 38 years if they are treated with dialysis, and 63 years if they receive a kidney transplant.
Risk factors for CKD: diabetes; high blood pressure; family history of kidney failure; age 60 or older; and minority populations that have high rates of diabetes or high blood pressure, such as African Americans, Hispanics, Asians, Pacific Islanders, and Native Americans. The prevalence among African Americans is roughly three times higher than whites, and nearly 1.5 times higher for Hispanics. Asians and Native Americans have a prevalence higher than whites.
How is CKD Treated?
The best treatment is early detection when chronic kidney disease can be slowed or stopped. Early treatment includes diet, exercise, and medications. However, once kidneys fail, treatment with dialysis or a kidney transplant is needed.
- Dialysis comes in two forms: hemodialysis or peritoneal dialysis. Hemodialysis is a treatment (usually 3–4 times a week) that removes wastes and extra fluid from your blood. It can be done at home or at a dialysis center. During hemodialysis, your blood is pumped through a dialysis machine, where it is cleaned and returned to your body. With peritoneal dialysis, your blood is cleaned inside your body through the lining of your abdomen using a special fluid that is periodically changed. Peritoneal dialysis can be done at home, at work, at school, or even during travel.
- A kidney transplant
places a healthy kidney into your body from a deceased donor or from a living donor, such as a close relative, spouse, friend, or generous stranger. A kidney transplant, however, is a treatment, not a cure. Antirejection and other medications are needed to maintain the transplant.
How Big is This Problem? How Many Lives are Affected?
30 million American adults (1 in 7) are estimated to have chronic kidney disease, but most don’t even know they have it. Approximately 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure may have chronic kidney disease. Nearly 680,000 Americans have irreversible kidney failure, or end-stage renal disease (ESRD), and need dialysis or a kidney transplant to survive. Over 475,000 ESRD patients receive dialysis at least 3 times per week to replace kidney function. 121,000 people started ESRD treatment in 2014, of which 118,000 started dialysis. Over 200,000 Americans live with a kidney transplant. 100,000 Americans are waiting on a kidney transplant right now. But only about 19,000 will receive one this year, one-third of which will come from living donors.
CKD shortens life expectancy by 5–11 years. Over 95,000 people with kidney failure died in 2014. The number of people who die prematurely from all stages of kidney disease and conditions related to kidney disease is much, much higher.
What are the Costs?
More than $100 billion in annual Medicare costs for all people with CKD. Each year, Medicare spends $87,000 per dialysis patient and $32,500 for a transplant patient. Early detection of chronic kidney disease could save a substantial percentage of these costs.
Early detection is the most effective way to combat this condition. There are two simple, quick, and inexpensive tests for chronic kidney disease: A urine test
, Albumin Creatinine Ratio (ACR), measures the amount of protein (albumin) in your urine. Damaged kidneys leak protein into your urine when it should be in your bloodstream. A blood test,
(creatinine) is used to measure your Glomerular Filtration Rate (GFR), which tells how well your kidneys are working to remove wastes from your blood. It is the best way to check kidney function.
What Does It Feel Like to Have Kidney Disease? Ask People Who Know.
"I was diagnosed with CKD in 2000. I had extreme fatigue; my world kept shrinking around me. I just didn’t have the energy to do my daily activities. I remember waking up in the morning feeling like I hadn’t slept at all. Also for the first time in my life, I had high blood pressure and migraine headaches. My lab reports confirmed that I was spilling a large amount of protein in my urine, and my creatinine kept rising. But after 18 months of following the prescriptions my doctor recommended, I changed my diet and started seeing real improvements in my health. Working closely with my doctor, I've been able to put my CKD into remission. As a chef, I enjoy food, so developing recipes that are good for people with kidney disease, no matter what stage of the disease they are in, has become my passion." —Duane, Spokane, WA
“Dialysis was and still is the most painful thing, physically and emotionally, I've had to endure. You are hooked to a machine that feels like a vacuum, occasionally pulling on your insides, pulling you apart. Once hooked up you cannot move or go anywhere beyond the tubing. It's not something you can do yourself either, you feel vulnerable…eventually you get used to constantly waking up every night because of the pain. I wouldn't wish it upon anyone to experience dialysis….” —Hannah (Age 16), Henrico, VA
“Since my kidney transplant, I feel like me again. I am currently three months post op. I’m back to working and back to being a full-time student in the Nursing program. At the beginning of every week, I organize my medications. I have a daily reminder on my phone to take those medications. Post-transplant my diet is a normal one, but I choose to eat foods that are going to fuel my body. I work out three to four times a week and I make sure to create time for just me—it's important to slow down and care for yourself. I feel so much freedom and gratitude. Life is simply incredible. I’ve even done a bit of traveling—it’s all such a blessing!”—Cindy, Queens, NYC