Chronic kidney disease (CKD) means your kidneys are damaged or are not filtering blood as well as they should, and the change has lasted three months or longer. CKD is common. It often develops slowly, and many people do not feel sick until the disease is advanced. That is why testing and early care matter.
What your kidneys do
- Filter waste and extra fluid out of your blood and into your urine
- Keep the right balance of sodium, potassium, calcium, phosphorus, and acid in your body
- Help control blood pressure
- Make hormones that help produce red blood cells and keep bones strong
Common causes and risk factors
The two most common causes of CKD are diabetes and high blood pressure. Other causes include glomerulonephritis (inflammation of the kidney filters), polycystic kidney disease, repeated kidney infections or blockages, and long-term use of some medicines.
You may be at higher risk if you:
- Have diabetes, high blood pressure, or heart disease
- Have a family member with kidney disease or kidney failure
- Are age 60 or older
- Have had a sudden kidney injury in the past
- Are Black, Hispanic or Latino, American Indian, Alaska Native, Asian American, or Pacific Islander, groups with higher rates of kidney disease
Symptoms
Early CKD usually has no symptoms. As kidney function falls, some people notice:
- Tiredness or trouble concentrating
- Swelling in the feet, ankles, or around the eyes
- Foamy urine, or urinating more or less than usual
- Itchy or dry skin, poor appetite, nausea, or muscle cramps
Many of these symptoms have other causes too, so the only way to know is with blood and urine tests.
The stages of CKD
CKD is staged using your eGFR, a number calculated from a blood test that estimates how well your kidneys filter. Your stage helps guide your care.
| Stage | eGFR | What it means |
|---|---|---|
| 1 | 90 or higher | Normal filtering, with other signs of kidney damage such as protein in the urine |
| 2 | 60 to 89 | Mild loss of kidney function |
| 3a | 45 to 59 | Mild to moderate loss of kidney function |
| 3b | 30 to 44 | Moderate to severe loss of kidney function |
| 4 | 15 to 29 | Severe loss of kidney function; time to plan for future treatment |
| 5 | Less than 15 | Kidney failure; dialysis or a transplant may be needed |
Your doctor will also look at the amount of albumin (a protein) in your urine. More albumin in the urine means a higher risk that CKD will get worse, even when eGFR looks good.
How to protect your kidneys
- Control blood pressure and check it at home if your doctor asks you to.
- Manage blood sugar if you have diabetes.
- Take kidney-protective medicines as prescribed. Several medicines can slow CKD; ask whether they are right for you.
- Avoid NSAID pain relievers such as ibuprofen and naproxen unless your doctor says they are safe for you.
- Eat less sodium and follow the eating plan your care team recommends.
- Do not smoke, stay active, and keep a healthy weight.
- Keep your lab appointments so changes are caught early.
Questions to ask at your visit
- What is my eGFR, and what stage of CKD do I have?
- How much albumin is in my urine?
- What is causing my kidney disease?
- Which of my medicines should I change or avoid?
- How often should my kidney function be checked?
This guide is general education and is not a substitute for medical advice. Talk with Dr. Salim or your care team about your own situation. Informed by patient materials from the National Kidney Foundation; learn more at kidney.org.