Last updated: Nov 25, 2025Published on: Nov 25, 2025
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Table of Contents
Introduction
Our kidneys play a significant role in filtering waste and excess fluids from the body. But when their function is affected for a long period of time, it results in a condition known as Chronic Kidney Disease (CKD)1.
CKD is found to affect about 13.4% of individuals across the world. What makes these statistics even more alarming is the fact that most of these people are unaware of this condition until later stages, with around 4-7 million people requiring kidney replacement therapy2. CKD is a silent killer, with no obvious symptoms until there is significant damage. This is the reason why awareness and early detection is crucial. If left unnoticed CKD can progress into kidney failure, heart disease or even death.
What is Chronic Kidney Disease (CKD)?
CKD is a condition where the kidneys get damaged over time, leading to poor blood filtration. Due to kidney damage, there is an accumulation of toxic waste and extra fluids, which may result in high blood pressure, heart disease, stroke, and early death. People who have CKD or are at risk of developing it can work with their health care providers to take measures that help safeguard kidney health1.
What Causes Chronic Kidney Disease?
CKD can develop in anyone regardless of age. It develops when an underlying illness or condition reduces kidney function, leading to progressive damage over months or years.
Chronic kidney disease causes:
Major causes
Diabetes (caused due to high blood sugar)
High Blood Pressure
Secondary causes
Acute Kidney Disease (sudden but usually reversible decline in kidney function)
Kidney stones with complications
Autoimmune Disorders (body’s immune system attacks its own cells)
Lupus (body’s immune system attacks its own tissues)
Good pasture’s disease/ anti-glomerular basement membrane disease (body’s immune system makes antibodies that attack the kidneys)
Glomerular disease
Membranous nephropathy (protein loss due to immune attacks on glomerulus)
Focal segmental glomerulosclerosis (scarring of glomerulus)
IgA nephropathy (kidney inflammation due to IgA deposits)
IgA vasculitis (blood vessel inflammation due to IgA deposits)
Hepatorenal syndrome (kidney damage due to liver disease)
Cardiorenal syndrome (kidney damage due to heart disease)
Metabolic syndrome (a group of conditions like obesity, high blood pressure etc that increase the probability of kidney disease)
Polycystic kidney disease (genetic disorder causing fluid-filled cysts to grow in the kidneys)
Rare genetic conditions
Alport syndrome (genetic disorder affecting the glomerulus)
Uromodulin associated kidney disease (abnormal protein made in kidneys that stress and damage the kidney cells)
Renal artery stenosis (narrowing of kidney blood supply)
Severe obesity (excess weight straining the kidneys)
Signs and symptoms appear gradually when kidney damage advances slowly. Declining kidney function may lead to fluid retention, accumulation of waste in the body, or disturbances in electrolyte balance5.
Early-stage symptoms: The initial symptoms are very subtle and very similar to several other conditions. Possible early symptoms include:
Reduced appetite
Fatigue
Headache
Dry, itchy skin
Nausea
Weight loss
Late-stage symptoms: As the kidney function gradually declines, further several symptoms appear such as:
Trouble focusing, drowsiness, or confusion
Easy bruising or bloody stool
Shortness of breath
Unusually dark/pale skin
Bone pain
Numb feeling in hands and feet
Frequent hiccups
Amenorrhea (absence of menstrual cycle)
Difficulty sleeping
Vomiting
Sleep problems
Swelling in the limbs
Excessive thirst
Odour in breath
Diagnosis of Chronic Kidney Disease
Chronic kidney disease (CKD) happens when the kidneys are damaged and can’t clean the blood properly.
Doctors usually use two main tests to check kidney health:
Blood test: Kidney function tests are used to assess how well the kidneys are working. These include parameters like6:
Renal Angiography: shows vasculature of kidneys, helps in detecting blockages1.
Renal scan: A small quantity of radioactive material is used to see kidney anatomy and function1.
To confirm CKD, these tests are repeated to show that kidney damage is long-term, lasting at least three months.
Stages of Chronic Kidney Disease
CKD is classified into five stages based on estimated glomerular filtration rate (eGFR) by CKD EPI formula, and into three stages based on the level of albuminuria7. Table 1 explains the stages of CKD based on eGFR and table 2 explains the stages of CKD based on albuminuria levels.
Stage of CKD
eGFR result
Interpretation
Stage 1
90 or higher
Mild kidney damage; kidneys function normally
Stage 2
60-89
Mild damage; kidneys still function normally.
Stage 3a
45-59
Mild to moderate damage; kidney function is reduced.
Stage 3b
30-44
Moderate to severe damage; the kidneys function below normal.
Stage 4
15-29
Severe damage; kidneys are nearly nonfunctional.
Stage 5
Less than 15
Most severe damage; the kidneys are very close to failing or have stopped functioning.
Table 1: Chronic Kidney Disease stages based on eGFR value6
Category
Albuminuria level
Interpretation
A1
<30 mg/g or <3 mg/mmol
Kidneys are functioning well or only slightly affected.
A2
30–300 mg/g or 3–30 mg/mmol
Indicates kidney damage; requires closer monitoring and management.
A3
>300 mg/g or >30 mg/mmol
Significant kidney damage; high risk of kidney failure and heart disease.
Table 2: Chronic Kidney Disease stages based on Albuminuria6
Knowing the CKD stage helps to:
Estimate how quickly the disease might progress
Understand the risk of complications, such as heart disease
Plan the most suitable treatment options
Complications
When kidneys fail to function correctly, they cause problems throughout the body, including8:
Hypertension: Usually poorly maintained. Speeds up the CKD progression
Salt and fluid imbalance: very common in stages 3 to 5. Causes oedema, hypertension, and thickening of heart valves.
Hyperkalaemia (excess potassium in blood)
Metabolic acidosis: acid buildup as a result of reduced excretion.
Hyperphosphatemia (excess phosphorus in blood)
Anaemia: Due to low erythropoietin/ iron
Cardiovascular disease: can lead to thickened heart muscles, valve problems, and calcium deposit in blood vessels.
Uremic symptoms: loss of appetite, fatigue, muscle degradation, itching, nausea, restlessness (in legs), poor sleep and sexual problems.
Chronic Kidney Disease Treatment
Although CKD has no cure, the symptoms can be managed through treatments and slow the progression. The approach depends on the disease stage.
Blood pressure: Drugs like ACE inhibitors, ARBs (angiotensin receptor blockers), Beta-blockers, Calcium channel blockers are used to keep blood pressure under control1,8.
Diabetes: Oral antidiabetic drugs (like biguanides or sulfonylureas) and insulin help lower blood sugar levels1,8
Cholesterol: Statins is the most common type of medication used to lower cholesterol1,8
Hyperkalaemia: Calcium salts, Potassium binders, and Diuretics are used to control/ lower high potassium levels1,8.
Swelling: Diuretics such as thiazides are used to remove extra fluid from body1,8.
Anaemia: Iron supplements, and Erythropoiesis-stimulating agents (trigger red blood cell production) like ferrous sulphate or shots1,8
Weak bones: Calcium supplements and vitamin D analogues and Phosphate binders to strengthen bones1,8
Inflammation: NSAIDs (pain relievers) like ibuprofen reduce swelling in heart lining/lungs (must be used responsibly, only with a prescription. As NSAIDs are often avoided in CKD1,8.)
3. Advanced treatments
Dialysis: Filters blood artificially (haemodialysis or peritoneal dialysis)1.
Kidney transplant: Best long-term option but requires lifelong immunosuppressants1.
Supportive (palliative) care: For those who choose not to pursue dialysis/transplant, focusing on symptom relief and quality of life1.
Vaccinations: When diagnosed with CKD the patient must be up-to-date on the following vaccinations8:
Early management through lifestyle changes and medications can delay CKD progression, while dialysis or transplant becomes vital in the later stages. Regular monitoring and doctor consultations are crucial for more efficient treatment.
Symptom Management and Prevention Strategies
Some steps can protect the kidneys from further damage when diagnosed with CKD. The earlier the detection, the better the outcome. Protecting the kidneys can also prevent heart disease and improve overall health9.
Control Blood Pressure: High blood pressure accelerates kidney damage by straining blood vessels. Maintaining blood pressure below 140/90 mmHg (or as a doctor advises) is crucial. This can be achieved through a low-sodium diet, regular exercise, stress management, and medications like ACE inhibitors or ARBs, which also protect kidney function.
Manage Blood Sugar (If diabetic): Uncontrolled diabetes harms the kidneys by damaging their filtering system. Consistently checking blood glucose levels and maintaining an A1C below 7% helps prevent further kidney decline. Adjusting diet, staying physically fit, and taking diabetes medications as prescribed are essential to keep blood sugar in check.
Monitor Kidney Function with Regular Tests: Tracking eGFR (kidney filtration rate) and urine albumin helps assess kidney function over time. Declining GFR or rising albumin levels signal worsening disease. Discussing test results with a doctor ensures timely treatment adjustments to slow kidney damage.
Prepare for Doctor Visits Effectively: Writing down questions about test results, medications, diet, and symptoms before appointments ensure no concerns are missed. Bringing a family member or friend helps remember advice and provides support. Keeping a health journal can also help track progress.
Work Closely with Your Healthcare Team: A nephrologist (kidney specialist), dietitian, pharmacist, and primary care doctor all play roles in managing kidney disease. Dietitians create kidney-friendly meal plans, pharmacists check for safe medications, and social workers assist with treatment logistics like dialysis planning.
Take Medications Safely: Some drugs, like ACE inhibitors and ARBs, protect the kidneys, while others (e.g., NSAIDs like ibuprofen) can cause harm. Always consult a doctor before taking new medications. Keeping an updated medicine list helps avoid dangerous interactions.
Follow a Kidney-Friendly Diet: A diet low in sodium, processed foods, and excess protein reduces kidney strain. A dietician can tailor meal plans to individual needs, balancing nutrition while managing blood pressure, diabetes, and waste buildup in the blood.
Adopt a Healthy Lifestyle: Regular exercise, avoiding smoking, getting enough sleep, and maintaining a healthy weight all support kidney health. Managing stress with relaxation techniques or counselling also helps, since ongoing stress raises blood pressure and harms overall well-being.
Living with CKD
Chronic kidney disease (CKD) requires careful management, but not everyone with the condition progresses toward kidney failure. With the right strategies in place, further harm to the kidneys can be prevented.
Many people with CKD can maintain a good quality of life through self-management. Critical components of self-care are the following10:
Fostering social connections
Sustaining an active lifestyle
Following prescribed medications
Consuming appropriate kidney dietary meals
Quit smoking
Limit alcohol consumption
Keep blood pressure below 140/90 mm Hg
Monitor and manage blood sugar range
Get annual flu shot
Patients play a central role in achieving good health outcomes through self-management. At each process step, health care providers are available to support and guide the patient.
When to See a Doctor?
Knowing the risk factors and paying attention to the warning signs of kidney problems is very important. Things like swelling in legs or face, fatigue, changes in urination without any definitive reason shouldn’t be ignored. People with risk factors (diabetes, high blood pressure or family history of CKD) also need to be extra careful. Spotting these signs early and getting a consultation will help catch problems in early stages, slows down kidney damage and prevents complications5. The patient must be referred to a nephrologist under the following circumstances7:
GFR < 60mL/min/1.73 m²
GFR drops ≥ 25% or > 5 mL/min per year
Significant albuminuria (protein in urine)
Persistent unexplained blood in urine
Secondary hyperparathyroidism, metabolic acidosis, or anaemia from low EPO
High BP not controlled with 4+ drugs
Ongoing potassium imbalance
Recurrent/severe kidney stones
Hereditary or unknown cause of CKD
Conclusion
CKD is when the kidneys are damaged and fail to filter blood effectively. CKD leads to a gradual decline in kidney function, causing kidney failure. Conditions like diabetes and high blood pressure can lead to CKD. Even though there is no cure, several steps can be taken to prevent this condition. In individuals with CKD, working in collaboration with the healthcare provider for proper treatment and adapting to a healthier lifestyle can help preserve kidney function and lead a normal life.
Frequently Asked Questions (FAQs)
What are other conditions that mimic chronic kidney disease but are reversible if treated early?
-Acute kidney injury -Renal artery stenosis (narrowing of kidney blood supply) or thrombosis (blood clots in kidney vessels) -Multiple myeloma (cancer of the plasma cells) -Obstruction to kidney tract by kidney stones or other causes. -Rapidly progressive Glomerulonephritis (rapid decline in kidney function) -Severe hypertension1.
How is my diabetes related to my kidney function?
Elevated blood sugar levels tent to damage blood vessels in the kidneys and nephrons (filtration units of the kidneys). This results in the decline of kidney function. Therefore, regularly checking blood glucose levels and adjusting your lifestyle based on the results can help your kidney’s function and may prevent CKD8. Earliest manifestation is leakage of protein albumin in urine.
Are there medications I should avoid with CKD?
Painkillers like ibuprofen, diclofenac, aceclofenac and indomethacin can lead to kidney damage. Taking more than the advised amount of medication can be harmful. It is essential to follow the prescribed dose carefully. Since the kidneys are responsible for filtering medicines, using them correctly helps avoid extra stress on these organs. If pain relief is needed often, doctors can suggest safer options11.
Can I prevent kidney disease and how?
Yes, CKD can be prevented. All patients with risk factors like diabetes, hypertension, obesity, recurrent Urine infections, kidney stones should be tested to detect early kidney damage by urine albumin creatinine ratio and serum creatinine test. Good control of diabetes, hypertension, control of weight can help prevent kidney damage and CKD12.
Ammirati AL. Chronic Kidney Disease. Rev Assoc Med Bras (1992). 2020;66Suppl 1(Suppl 1):s03-s09. Published 2020 Jan 13. doi:10.1590/1806-9282.66.S1.3. Available at: https://pubmed.ncbi.nlm.nih.gov/31939529/
Bello AK, Alrukhaimi M, Ashuntantang GE, et al. Complications of chronic kidney disease: current state, knowledge gaps, and strategy for action. Kidney Int Suppl (2011). 2017;7(2):122-129. doi:10.1016/j.kisu.2017.07.007. Available at: https://pubmed.ncbi.nlm.nih.gov/30675426/
Baker M, Perazella MA. NSAIDs in CKD: Are They Safe?. Am J Kidney Dis. 2020;76(4):546-557. doi:10.1053/j.ajkd.2020.03.023. Available at: https://pubmed.ncbi.nlm.nih.gov/32479922/
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