If you’re one of the nearly 36 million adults in the U.S. who have been diagnosed with chronic kidney disease (CKD), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health provides an overview of what you should know for effective disease management.

Kidney function and chronic disease

The kidneys fulfill several important functions:

• Filter the blood of extra water and waste to make urine 
• Control salt and mineral levels in the blood, such as sodium and potassium (electrolytes) 
• Regulate blood pressure 
• Produce red blood cells production 
• Strengthen bones 

Chronic kidney disease means that the kidneys are damaged and can’t filter blood as they should. It’s considered chronic because the damage to the kidneys occurs gradually. Over time, wastes, toxins, and excess minerals and fluids can build up in your body, further damaging the kidney and leading to other health issues. 

Disease progression

In the early stages of CKD, you may notice few, if any, signs or symptoms. The disease may not become apparent until kidney function is significantly impaired.

Kidney disease typically progresses over the course of years. If your kidneys eventually fail—defined as functioning at less than 15% of their normal capacity—dialysis or a kidney transplant is needed to sustain life and health. Identifying kidney disease early enables you to make the necessary changes to protect your renal health. 

As long as you have one healthy kidney, it can continue to perform its job, with even greater efficiency. For this reason, you can still feel okay and not experience any noticeable symptoms, even if your other kidney has sustained damage. For many people, blood and urine tests are the only way to detect signs of early kidney disease. 

Symptoms

As the disease progresses and the kidneys lose the ability to excrete excess fluid and salt, a person may experience a variety of symptoms such as edema (swelling) in the legs, ankles, feet, and sometimes the hands and face. Symptoms of advanced CKD include:

• Chest pain 
• Dry, itchy skin 
• Numbness 
• Increased or decreased urination 
• Loss of appetite 

People can also become anemic and malnourished, as well as develop weak, brittle bones.  

Disease causes and risk factors

Some forms of CKD, such as polycystic kidney disease (ADPKD) are genetic, but these are rare. The primary causes of, and risk factors for, CKD are:

• Diabetes,
• Hypertension (high blood pressure), and
• Heart disease.

A family history of CKD and/or any of these medical issues create a higher risk for developing CKD yourself. Age can also be a factor, with those 65 years and older being more likely to be affected by kidney disease.

Treatment

If caught early enough, CKD can often be managed with diet and exercise, smoking cessation, and other lifestyle changes, along with any necessary medications to control blood sugar, blood pressure, and other underlying conditions. 

If you reach end-stage kidney disease (ESKD), also called end-stage renal disease (ESRD), treatment will also include dialysis or a kidney transplant. If you choose to forego treatment, you can still receive palliative care or hospice care.