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Essential kidney information

Transforming the way we talk about chronic kidney disease

Learn about chronic kidney disease 

Learn about chronic kidney disease

Get the facts about chronic kidney disease

What is chronic kidney disease?

Chronic kidney disease

Chronic kidney disease

A condition caused by progressive damage to the kidneys, that prevents them from working as well as they should.1 The kidneys have an important function to filter the blood in order to convert waste products and excess fluid into urine.

Managing chronic kidney disease

Managing chronic kidney disease

For most people, kidney disease will remain stable once the cause of problem is identified and addressed.2 However, chronic kidney disease can get worse over time and can sometimes lead to kidney failure, so it’s important to address any concerns you may have with your healthcare team.2

What causes chronic kidney disease? 

Chronic kidney disease can be caused by a variety of factors, but some of the most common are:1

Type 2 diabetes

Type 2 diabetes

Over time, uncontrolled high blood sugar caused by diabetes can lead to significant damage to the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well as they should. Many people with diabetes also develop high blood pressure, which in turn can also affect your kidneys. Kidney disease caused by diabetes is called diabetic kidney disease.3 Proper management of diabetes is vital to your kidney health.

High blood pressure

High blood pressure

Over time, high blood pressure can put stress on the blood vessels in your kidneys, which can limit the ability of your kidneys to do their job.4

Autoimmune disorders

Autoimmune disorders

In these diseases, the body starts to fight against its own organs and cause the kidney to develop glomerulonephritis. This is where the tiny filters in the kidneys, called glomeruli, become inflamed. Severe or long-term inflammation associated with glomerulonephritis can damage your kidneys.5

Hereditary kidney diseases

Hereditary kidney diseases

Some kidney diseases can be inherited through your genes, such as autosomal dominant polycystic kidney disease (ADPDK) where clusters of cysts cause the kidneys to enlarge and lose function over time.6

Obstructions

Obstructions

Obstructions, such as an enlarged prostate, tumors or kidney stones, can cause a backup of urine within your kidneys.7

Long-term use of certain medicines

Long-term use of certain medicines 

Take extra care as long-term use of certain medicines may be toxic to the kidneys e.g., anti-inflammatory medication.8

What are some of the signs and symptoms of chronic kidney disease? 

The kidneys are quite resilient and are able to function correctly even when damaged, so in the early stages of chronic kidney disease it’s uncommon to experience symptoms.9

While for many people the condition remains stable once diagnosed, it can progress into more advanced stages where you might experience symptoms like:1,2,10 

  • Swelling in the hands, feet or ankles

  • Poor appetite

  • Difficulty sleeping

  • Breathlessness

  • Tiredness

  • Blood in your urine

  • Itchy skin

  • Muscle pain

  • Nausea

  • Headaches

While for many people the condition remains stable once diagnosed

If you or your loved one is experiencing any of these symptoms, talk to your doctor right away.

How is chronic kidney disease diagnosed?

Chronic kidney disease is often diagnosed through a routine blood or urine test for something unrelated – not usually because of symptoms related to chronic kidney disease.9

Occasionally, if there is blood in your urine, a doctor will refer you to the kidney specialist (sometimes called a nephrologist). They will run additional tests to determine if the kidney is the cause of the blood in the urine.

One of the routine blood tests that assesses how your kidneys are working is a test to check your estimated glomerular filtration rate (eGFR), which determines how well your kidneys are filtering your blood.11

Creatinine levels

Creatinine levels

Your doctor will check the level of creatinine in your blood – this is a waste product that can build up in your kidneys when you have kidney disease.12 The eGFR is calculated from your creatinine levels in the blood. 

Urine tests

Urine tests

Your doctor may also request another test to determine the levels of a protein called albumin in your urine. When kidneys are functioning well, they filter out the albumin before it gets into the urine. When albumin is detected, it indicates that your kidneys aren’t functioning as well as they should be. The less albumin you have in the urine, the better. The presence of albumin in urine is called albuminuria.13

A biopsy

A biopsy

There may be a need to run additional tests, including a biopsy (a procedure where a small amount of tissue is taken and examined), to try to determine the cause of your kidney disease. Sometimes the underlying cause can be treated, so these tests may help your doctor decide what is the best treatment option for you and how often your kidneys should be monitored.

Your test results

Your test results

These will help your doctor to estimate how damaged your kidneys are – known as the stage of chronic kidney disease. Your eGFR results determine whether you have stage 1-5 kidney disease.14

stage-1

Normal kidney function

Kidneys filter 90 ml or more per minute but other tests have detected signs of kidney damage e.g. albumin in the urine.

Stage-2

Mildly reduced kidney function 

Kidneys filter between 60 to 89 ml of blood per minute but there are other signs of kidney damage e.g. albumin in the urine.

Moderately reduced kidney function

Moderately reduced kidney function 

Kidneys filter between 30 to 59 ml of blood per minute. Albuminuria, the presence of albumin in the urine, may also accompany this stage.

Severely reduced kidney function

Severely reduced kidney function  

Kidneys filter between 15 to 29 ml of blood per minute. Albuminuria, the presence of albumin in the urine, may also accompany this stage.

End-stage kidney failure

End-stage kidney failure 

Kidneys filter below 15 ml of blood per minute. Albuminuria, the presence of albumin in the urine, may also accompany this stage. Based on the symptoms and findings from laboratory tests, a replacement therapy such as dialysis might be needed to prevent your body from being poisoned by the buildup of waste products the kidney can no longer remove.14 

References

  1. Webster AC, et al. Chronic Kidney Disease. The Lancet. 2017;389:1238–1252.

  2. Kidney Care UK. Chronic Kidney Disease (CKD). Available at: https://www.kidneycareuk.org/about-kidney-health/conditions/ckd/ (Last accessed: October 2021).

  3. Lai S. Chronic Kidney Disease and Diabetes – A Potential Causal Link. EBioMedicine. 2016;6:10-11. 

  4. National Kidney Foundation. High Blood Pressure and Chronic Kidney Disease. Available at: https://www.kidney.org/sites/default/files/docs/hbpandckd.pdf (Last accessed: October 2021).

  5. Sethi S and Fervenza FC. Standardized classification and reporting of glomerulonephritis. Nephrol Dial Transplant. 2019;34:193–199.

  6. National Institute of Diabetes and Digestive and Kidney Diseases. Autosomal Dominant Polycystic Kidney Disease. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/polycystic-kidney-disease/autosomal-dominant-pkd (Last accessed: October 2021).

  7. Bindroo S., et al. Renal Failure. Stat Pearls Publishing. 2021. 

  8. Lefebvre C., et al.  Non-steroidal anti-inflammatory drugs in chronic kidney disease: a systematic review of prescription practices and use in primary care. Clinical Kidney Journal. 2020;13(1):63-71.

  9. NHS website. Chronic kidney disease.  Available at: https://www.nhs.uk/conditions/kidney-disease/ (Last accessed: October 2021).

  10. National Institute of Diabetes and Digestive and Kidney Diseases. What Is Chronic Kidney Disease? Available at: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease#symptoms (Last accessed: October 2021).

  11. National Institute of Diabetes and Digestive and Kidney Diseases. Explaining Your Kidney Test Results: A Tool for Clinical Use. Available at: https://www.niddk.nih.gov/health-information/professionals/advanced-search/explain-kidney-test-results (Last accessed: October 2021). 

  12. Steubl D & Inker LA. How best to estimate glomerular filtration rate? Novel filtration markers and their application. Curr Opin Nephrol Hypertens. 2018;27:398-405.

  13. National Institute of Diabetes and Digestive and Kidney Diseases. Albuminuria: Albumin in the Urine. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis/albuminuria-albumin-urine (Last accessed: October 2021).

  14. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International Supplements. 2020;98:1-115.

Job code: PC-CRP-102667

Date of preparation: November 2021