Chronic kidney disease
Also called: CKD, Chronic renal failure
Long-term loss of kidney function over months or years, usually from diabetes or high blood pressure. Often silent until advanced, it greatly increases cardiovascular risk.
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About 1 in 10 adults worldwide.
Causes
- Diabetes
- High blood pressure
- Glomerulonephritis
- Polycystic kidney disease
- Recurrent infections or obstruction
- Medicines (long-term NSAIDs, lithium)
Risk factors
- Diabetes
- Hypertension
- Cardiovascular disease
- Family history
- Older age
- Obesity
- Smoking
Symptoms
- Usually none in early stages
- Tiredness
- Swollen ankles
- Foamy urine
- Itching, nausea and breathlessness in advanced disease
Diagnosis — tests and examinations
- eGFR (blood creatinine)
- Urine albumin–creatinine ratio
- Kidney ultrasound
- Staging (G1–G5, A1–A3)
Treatment
Medicines and medical treatment
- ACE inhibitor or ARB
- SGLT2 inhibitors (dapagliflozin, empagliflozin) slow decline
- Finerenone in diabetic kidney disease
- Control blood pressure and glucose; statins
- Treat anaemia, bone and acid problems
Operations and procedures
- Dialysis (haemodialysis or peritoneal)
- Kidney transplantation
Self-care, home remedies and lifestyle
- Avoid NSAIDs
- Limit salt
- Stop smoking
- Dietary advice on potassium, phosphate and protein in later stages
Possible complications
- Cardiovascular disease
- Kidney failure
- Anaemia
- Bone disease
- High potassium
Prevention
- Control blood pressure and diabetes; avoid unnecessary NSAIDs
Outlook
Progression can often be slowed dramatically with modern treatment.
When to see a doctor
Ask for kidney checks if you have diabetes or high blood pressure.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
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