What is Chronic Kidney Disease (CKD)?

‍Chronic Kidney Disease (CKD) is a condition in which your kidneys have become damaged over time and they no longer function as they did to filter the blood effectively.  The kidneys main job is to filter the blood, removing fluid and waste products and making urine. The extra fluid and waste is then passed from our bodies in urine. To keep your body working and keep you healthy the kidneys also balance salts and minerals, such as calcium, phosphorus, sodium, and potassium; these circulate in your blood.  Kidneys also make hormones that help to control blood pressure, make red blood cells, and help in keeping your bones strong.  However, damaged kidneys are not able to perform their jobs properly.   Because the damage happens slowly, often the person remains unaware of what is happening until the damage to the kidneys has progressed to an advanced stage.  When kidney disease continues to grow worse over time, waste may build up in your blood to high levels. This can make you feel sick, and can cause some serious complications such as: high blood pressure, weak bones, anemia (low blood count),  poor nutritional health, nerve damage.  These problems can happen slowly, over a long period of time. You might not even realize you have kidney disease until it has progressed to an advanced stage of the disease.  In the early stages of CKD, noticeable signs and symptoms can easily be mistaken for some other illness, or brushed aside as not too worrisome or bothersome.  Often, you may not develop noticeable signs until irreversible damage has already been done.  

Treatment of CKD is focused on slowing down the damage to your kidneys.  This can be done primarily by controlling what caused the kidney damage to happen, such as diabetes.  However, even controlling the cause might not be able to keep the kidney damage from getting worse.  This is why early detection and treatment are so important. If treated in early stages, you may keep CDK from getting worse or greatly slow the progression of the disease.  Chronic kidney disease may progress to end stage kidney failure.  This is fatal without dialysis (artificial filtering of the blood), or a kidney transplant. Because early detection is so important, let's take a look at what some signs and symptoms of kidney disease may be.  Keep in mind that symptoms can develop over time if kidney damage progresses slowly. 

Symptoms of CKD.  Depending on the severity, loss of kidney function can cause the following symptoms: 

1)  nausea 

2)  vomiting 

3) loss of appetite 

4) fatigue and weakness 

5)  sleep problems 

6)  urinating, more, or less. 

7)  decreased mental sharpness 

8)  muscle cramps 

9)  swelling of feet and ankles 

10)  Dry itchy skin 

11)  High blood pressure (hypertension) 

12)  shortness of breath (if fluid builds up in the lungs) 

13)  chest pain (if fluid builds up around the lining of the heart. 

Further signs of CKD can be found here.

Because early detection of chronic kidney disease may prevent the disease progressing to end stage kidney failure, it is important that you see your healthcare provider if you do think you are developing symptoms.  If you are at a higher risk of developing CKD due to an existing medical condition such as diabetes, your doctor may want to monitor your blood pressure and kidney function by testing your blood and urine. You play the most important role in your healthcare and staying healthy. You can do this by communicating concerns to your healthcare professional, keep all your appointments, follow your provider's instructions for any existing medical condition to help to keep it controlled, (such as blood sugar level), exercise and follow a healthy eating plan.  

CKD occurs when a disease or condition impairs kidney function causing kidney damage to worsen over several months or years.  I will list below the diseases and medical conditions that can cause chronic kidney disease, having one of these puts you at a higher risk of developing CKD in your lifetime. 

Causes of Chronic Kidney Disease:

1. Diabetes is the leading cause of CDK.  High blood sugar can damage the blood vessels in your kidneys.  Almost 1 in 3 people with diabetes has CKD.
2. High blood pressure.  This is the second leading cause of CDK.  It also can damage the blood vessels in the kidneys.  Approximately 1 in 5 adults with high blood pressure also has CKD.
3. Heart disease.  Research has shown a link between kidney disease and heart disease.  People with heart disease are at greater risk of kidney disease. Likewise, people with kidney disease are at greater risk of heart disease.  Researchers are working to better understand the relationship between the two.  
4. Family history.  Family history of kidney failure. Polycystic Kidney Disease (or other inherited kidney diseases).
5. Recurrent kidney infection
6. Prolonged urinary tract obstruction. Obstruction of the urinary tract caused by conditions such as enlarged prostate, kidney stones, and some cancers

I think it is important to also list here the things that put you at higher risk of developing chronic kidney disease, some are things you may be able to help to control, such as smoking. While some things you are unable to change, such as your ethnicity.  However, knowing your risk you are able to be aware of symptoms and follow your provider's advice in lowering your own risk to avoid kidney damage. You will see several of the listed “causes” also repeated here under “risk factors”. This is because while we know for example Diabetes can cause CDK, it does not mean every person who is diabetic will develop kidney disease. However, having diabetes puts you at a much higher risk than a person without diabetes, so it is both a cause and a risk factor. 

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Risk Factors: The following things increase your risk of developing CDK.

1. Diabetes 
2. High Blood Pressure 
3. Heart Disease
4. Smoking
5. Obesity 
6. Ethnicity: Black, Native American, Asian American 
7. Family History 
8. Abnormal kidney structure. 
9. Older age
10. Medications  (Frequent use of medications that can damage the kidneys).

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Chronic Kidney Disease is divided into five stages. The stages are based on the amount of damage to your kidneys and how well they are functioning. Healthcare providers use a blood test combined with other factors such as age and gender to calculate your eGFR, and this tells them how well your kidneys work, and what stage of kidney disease you are in.  (eGFR stands for the estimated glomerular filtration rate).  

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The Five Stages of Kidney Disease

Stage 1:  Damage to your kidneys is mild. Your kidneys are working well, but may have signs of kidney damage. You have a normal eGFR of 90 or greater. 

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Stage 2:  Damage to your kidneys is still mild at this stage and they are still working well, but you will have signs of kidney damage. Your eGFR is between 60 and 89.

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Stage 3:  Your kidneys now have damage that affects how well they work, and you may now notice symptoms. The damage in this stage is not normally reversible. However, you can do things to slow further damage.  Your eGFR is between 30 and 59.

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Stage 4:  Your kidneys are moderately to severely damaged at this stage and are not working well to filter waste from your blood. Waste products may begin to build up. Your eGFR is between 15 and 29. This is the last stage before kidney failure.

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Stage 5:  You have an eGFR of less than 15.  Your kidneys are getting very close to failure or have already failed.  If kidneys fail you will need to start dialysis or have a kidney transplant in order to continue life. 

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Chronic kidney disease can affect nearly every part of your body. You can develop complications that may be life threatening depending upon the stage of your kidney disease. These complications may include the following.

Complications:  

1. Fluid Retention which may lead to swelling of arms and legs, high blood pressure and fluid in your lungs. 
2. Hyperkalemia is caused by a sudden rise in potassium levels in your blood.  It can be life threatening because it causes the heart to not function as well as it should.
3. Anemia is caused by a lack of red blood cells in the body which leads to reduced oxygen flow to the body's organs. 
4. Heart Disease
5. Weak bones with an increased risk of fractures.
6. Decreased sex drive erectile dysfunction and reduced fertility.
7. Central nervous system damage may lead to trouble concentrating, personality changes and seizures. 
8. Decreased immune response which can make you more vulnerable to infections.
9. Pericarditis which is inflammation of the pericardium; the membrane around your heart. 
10.  Complications in pregnancy for both mother and fetus.
11.  Irreversible kidney damage leading to end stage kidney disease that requires dialysis or transplant in order to sustain life.

There are some things you can do in the way of prevention in order to reduce your risk of developing kidney disease. Always follow dosage instructions on over the counter medications. Taking higher than recommended doses of over the counter pain relievers for long periods of time can damage your kidneys. Maintain a healthy weight with good nutrition and exercise. Do not smoke, if you do make a plan with your healthcare providers help to quit now. Manage medical conditions such as diabetes that put you in a higher risk category for developing CKD by working with your healthcare providers. 

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Video

This video created by Alliant Health Solutions explains what Chronic Kidney Disease is. The transcript of the video is below.

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Video Transcript

During this conversation you will hear the term CKD mentioned various times.  CKD is an abbreviation of Chronic Kidney Disease.

Before we continue let's define the term chronic condition it is a condition that is present for more than three months.  Although chronic conditions cannot be cured, they can be managed.

Chronic Kidney Disease, CKD, happens when the kidneys slowly stop working overtime.  Tiny filters in the kidneys that clean the blood are damaged and are not able to clean blood well enough to keep the body healthy.

Chronic Kidney Disease is caused by many factors including other chronic conditions like diabetes and high blood pressure.

This is important to recognize because diabetes and high blood pressure are the two main causes of Chronic Kidney Disease (CKD).

Another important fact, according to the Center for Disease Control (CDC), is that one in seven adults is estimated to have Chronic Kidney Disease and most of them are not aware that they have it because the disease progresses very slowly; showing symptoms when it is advanced.

People often ask if there is a cure for chronic kidney disease. Unfortunately, Chronic Kidney Disease does not go away but although there's no cure for Chronic Kidney Disease, we can take steps to prevent further complications. The good news is that there are things we can do to keep our kidneys healthy and prevent further damage to our kidneys.

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Related Articles

What Do Your Kidney Do?

Signs that You Have Chronic Kidney Disease

What Causes Chronic Kidney Disease?

Treatment Options for Chronic Kidney Disease

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References

‍National Kidney Foundation

‍American Kidney Fund

Mayo Clinic

Alliant Health Solutions

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About the Author

Monica McCarthy has bachelors in Political Science and Criminal Justice from Central Washington University.  A majority of her career was spent as a political consultant.   She currently works at KidneyLuv as a staff writer.

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Patient Education Disclaimer

This material is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional. KidneyLuv makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.

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