Chronic Kidney Disease: Slow Loss of Kidney Function, Risks and Ongoing Care

What it involves

MedlinePlus explains that chronic kidney disease, or CKD, means the kidneys are damaged and cannot filter blood as they should, so wastes and extra water build up. It develops slowly, over months or years, and the final stage is called end-stage renal disease.

Who this is for

• Patients with diabetes or high blood pressure who want to protect their kidneys
• Patients told that a kidney blood test or urine test was abnormal
• Patients with swelling in the feet, itching, or tiredness and no clear cause
• Patients who take medicines that can affect the kidneys and want them reviewed

What to expect

• Questions about your health history, family history, and medicines, including anything bought over the counter
• A blood pressure check and a review of your recent kidney blood tests and urine tests
• A look at swelling, skin changes, and other signs that kidney function is affected
• A plan that may include blood pressure and blood sugar control, repeat testing, and a referral to a kidney specialist

The two biggest causes

MedlinePlus says diabetes and high blood pressure are the two most common causes of CKD and account for most cases. Both damage the small filtering vessels inside the kidneys over many years. Other causes include autoimmune disorders, birth defects such as polycystic kidney disease, kidney stones and infection, problems with the arteries feeding the kidneys, and some medicines. The diabetes management page and the hypertension page explain the day-to-day care that protects the kidneys.

Why it is easy to miss

MedlinePlus says many people have no symptoms until the disease is far along, and that many are not diagnosed until most of their kidney function is gone. When symptoms do appear, they resemble other illnesses:

• Appetite loss, fatigue, and a general ill feeling
• Headaches, nausea, itching, and dry skin
• Weight loss without trying
• Later, swelling in the hands and feet, muscle cramps, numbness, shortness of breath, and trouble sleeping

How it is found

MedlinePlus says blood and urine tests are the only way to know whether you have kidney disease. A urinalysis may show protein months to years before symptoms appear, and blood tests such as creatinine and blood urea nitrogen measure how well the kidneys are working. The kidney function tests guide, the urinalysis guide, and the basic metabolic panel guide walk through those results.

What slows it down

MedlinePlus says treatment cannot cure CKD but can slow it. Controlling blood pressure is central, often with ACE inhibitors or ARBs, with a goal at or below 130/80 mm Hg for many people, though a provider sets your own target. Keeping blood sugar under control, lowering cholesterol if needed, not smoking, exercising, and limiting salt all help. The blood pressure readings guide explains the numbers, and the high cholesterol page covers lipids.

Be careful with over-the-counter products

MedlinePlus advises talking to your provider before taking any over-the-counter medicine, including vitamins, herbs, and supplements, and making sure every provider you see knows you have CKD. Some pain relievers and supplements can strain the kidneys. A provider can help you build a list of what is safe for you.

Later stages and vaccinations

As kidney function falls, MedlinePlus says other treatments may be needed for anemia, phosphorus, and calcium balance, and a special diet may be advised. It lists hepatitis A, hepatitis B, flu, pneumococcal, and COVID-19 vaccines as ones people with CKD should keep current. Kidney failure, the last stage, may require dialysis or a transplant, and a kidney specialist guides those decisions. Persistent tiredness is covered in the fatigue guide, and puffy ankles in the leg swelling guide.

Sources

• MedlinePlus — Chronic kidney disease
• MedlinePlus — Chronic Kidney Disease health topic