Chronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body.
Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure
Chronic kidney disease (CKD) slowly gets worse over months or years. You may not notice any symptoms for some time. The loss of function may be so slow that you do not have symptoms until your kidneys have almost stopped working.
The final stage of CKD is called end-stage renal disease (ESRD). At this stage, the kidneys are no longer able to remove enough wastes and excess fluids from the body. At this point, you would need dialysis or a kidney transplant.
Diabetes and high blood pressure are the 2 most common causes and account for most cases.
Many other diseases and conditions can damage the kidneys, including:
CKD leads to a buildup of fluid and waste products in the body. This condition affects most body systems and functions, including:
The early symptoms of CKD are the same as for many other illnesses. These symptoms may be the only sign of a problem in the early stages.
Symptoms may include:
Symptoms that may occur when kidney function has gotten worse include:
Blood pressure control will slow further kidney damage.
Making lifestyle changes can help protect the kidneys, and prevent heart disease and stroke, such as:
Always talk to your kidney specialist before taking any over-the-counter medicine. This includes vitamins, herbs and supplements. Make sure all of the providers you visit know you have CKD. Other treatments may include:
Your provider may have you follow a special diet for CKD.
All people with CKD should be up-to-date on the following vaccinations:
Some people benefit from taking part in a kidney disease support group.
Many people are not diagnosed with CKD until they have lost most of their kidney function.
There is no cure for CKD. If it worsens to ESRD, and how quickly, depends on:
Kidney failure is the last stage of CKD. This is when your kidneys can no longer support our body's needs.
Your provider will discuss dialysis with you before you need it. Dialysis removes waste from your blood when your kidneys can no longer do their job.
In most cases, you will go to dialysis when you have only 10 to 15% of your kidney function left.
Even people who are waiting for a kidney transplant may need dialysis while waiting.
Complications may include:
Treating the condition that is causing the problem may help prevent or delay CKD. People who have diabetes should control their blood sugar and blood pressure levels and should not smoke.
Christov M, Sprague SM. Chronic kidney disease - mineral bone disorder. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 53.
Grams ME, McDonald SP. Epidemiology of chronic kidney disease and dialysis. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 77.
Taal MW. Classification and management of chronic kidney disease. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 59.