Chronic Kidney Disease

(CKD; Chronic Renal Disease)

Definition

Chronic kidney disease (CKD) is a decrease in kidney function for more than 3 months. Kidneys clean waste from the blood. The waste then passes out of the body in urine. If they do not work well it can cause a number of symptoms.

There are different levels of kidney disease. If more than 90% of the kidney is damaged and not working, it is considered kidney failure.

Anatomy of the Kidney

Glomerulonephritis
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Causes    TOP

CKD is caused by damaged to the kidney. It is often caused by conditions such as:

Risk Factors    TOP

Factors that may increase your chance of CKD include:

Symptoms    TOP

CKD may cause:

  • Fatigue
  • Weakness
  • Sleeping problems
  • Loss of appetite
  • Nausea
  • Itching
  • Shortness of breath
  • Change in taste
  • Change in mental state

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done.

The doctor will look at the results of blood and urine tests. The tests will show if kidneys are not working as expected. It can also show how severe the kidney failure is.

To learn more about what is causing the failure, the doctor may also use:

  • Ultrasound—to show images of the kidney
  • Kidney biopsy—tissue sample sent to lab for testing, rarely done

You may be referred to a doctor who specializes in kidney disorders.

Treatment    TOP

Chronic renal disease cannot be cured. It is possible to slow further damage.

Treatment may include:

  • Managing related conditions:
    • Lowering high blood pressure
    • If you have diabetes—controlling blood sugar and lipid levels
    • Controlling protein in the urine by changes to diet or medication
    • Specific type of blood pressure medications such as ACE inhibitors or angiotensin II receptor antagonists
    • Reducing the use of and the dosages of drugs that may be harming the kidneys
  • Managing the complications of chronic renal disease such as:
    • Fluid overload
    • High blood phosphate or potassium levels
    • Low blood level of calcium
    • Anemia—low number of red blood cells
  • Lifestyle habits such as:
    • Staying hydrated
    • Controlling salt in the diet
    • Participating in an exercise training program to keep you physically fit and reduce the chance of depression
    • Quitting smoking
  • Support for kidneys with severe failure which may include:
    • Undergoing dialysis—a mechanical process that cleans the blood
    • Having a kidney transplant—not an option for everyone

Prevention    TOP

To help reduce your chance of chronic renal failure:

  • Get a physical exam every year. It should include a urine test to check the health of your kidneys.
  • If you smoke, talk to your doctor about options to help you quit.
  • Maintain a healthy weight.
  • Drink water and other fluids to stay hydrated.

Regular screening may help find problems early. Early changes may help stop or slow change to kidney disease. Screening should be considered in people with:

  • Diabetes
  • Previous kidney disease
  • High blood pressure
  • Age over 60 years
  • Family history of kidney disease

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
https//www.niddk.nih.gov
National Kidney Foundation
https://www.kidney.org

CANADIAN RESOURCES:

The Kidney Foundation of Canada
https://www.kidney.ca

References:

Chronic kidney disease. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/chronic-kidney-disease/chronic-kidney-disease. Updated March 2017. Accessed June 1, 2018.
Chronic kidney disease (CKD) in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated March 27, 2018. Accessed June 1, 2018.
Gaitonde DY, Cook DL, Rivera IM. Chronic kidney disease: detection and evaluation. Am Fam Physician. 2017;96(12):776-783.
8/26/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Heiwe S, Jacobson SH. Exercise training in adults with CKD: A systematic review and meta-analysis. Am J Kidney Dis. 2014;64(3):383-393.
4/6/2016 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Park H, Adeyemi A, et al. A meta-analytic assessment of the risk of chronic kidney disease in patients with chronic hepatitis C virus. J Viral Hepat. 2015;22(11):897-905.
Last reviewed June 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/1/2018

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