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Disease

Chronic Kidney Disease

Learn about chronic kidney disease, including its symptoms, diagnosis, laboratory tests, treatment and prevention.

Last Reviewed 27 Jul 2026
Reading Time 9 min read

Overview

Fatigue that will not lift, ankles that seem to swell by evening, or urine that looks a little foamy, these are easy to dismiss as ordinary tiredness or a long day on your feet. Chronic kidney disease often builds quietly for years behind symptoms this vague, which is part of why it is so often only caught once a significant amount of kidney function is already gone.

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Key Fact

In parts of sub-Saharan Africa, only around half of people with kidney failure who need dialysis are able to access it, and many who start treatment are unable to continue it. This makes preventing and slowing kidney disease, largely by managing diabetes and high blood pressure, far more valuable than treating it after the kidneys have already failed.

Warning

Severe swelling, confusion, little or no urination, or shortness of breath can indicate the kidneys have stopped working properly and need emergency care. If you have diabetes or high blood pressure, ask your doctor about kidney function testing, even without symptoms.

AT A GLANCE

Disease Summary

Category Non-Communicable Disease
Cause Gradual, progressive loss of kidney function, most commonly caused by diabetes and hypertension
Transmission Not applicable; chronic kidney disease is a non-communicable condition and cannot be spread between people
Body System Kidneys
Preventable Yes
Curable No

Symptoms

Common Symptoms

Chronic kidney disease often causes no symptoms in its early stages. When symptoms do appear, they are often vague and easy to mistake for other things.

Fatigue

Persistent tiredness can occur as waste products build up in the blood.

Swelling in the Legs, Ankles, or Feet

Fluid retention is common as kidney function declines.

Changes in Urination

Foamy urine, or urinating more or less often than usual, particularly at night, can be an early sign.

Poor Appetite or Nausea

Can develop as waste products build up in the body.

Itching

Persistent itching can occur as the kidneys become less able to filter the blood.

Danger Signs

Seek emergency medical attention immediately if any of the following develop.

Little or No Urination

Can indicate the kidneys have significantly reduced function and needs urgent assessment.

Severe Shortness of Breath

Can indicate fluid has built up around the lungs, a serious complication.

Confusion or Extreme Drowsiness

Can indicate a dangerous buildup of waste products or fluid affecting the brain.

Irregular Heartbeat

Can indicate a dangerous imbalance of potassium or other minerals in the blood.

Diagnosis

Blood Test for Kidney Function (eGFR)

Estimates how well the kidneys are filtering waste from the blood, the primary measure used to diagnose and stage kidney disease.

Urine Test for Protein (Albumin-to-Creatinine Ratio)

Checks for protein in the urine, an early sign that the kidneys’ filtering units are damaged.

Kidney Imaging

An ultrasound or other scan can check the size and structure of the kidneys and look for blockages or other abnormalities.
Important
Chronic kidney disease is confirmed when reduced kidney function or damage is present for three months or longer, which is why repeat testing over time matters more than a single result.

Laboratory Tests

Estimated Glomerular Filtration Rate (eGFR)

Calculated from a blood creatinine test, this is the main measure used to diagnose and stage kidney disease. A result below 60 for three months or more indicates chronic kidney disease.

Sample Venous blood
Time 24–48 hours

Urine Albumin-to-Creatinine Ratio (ACR)

Detects protein leaking into the urine, often one of the earliest signs of kidney damage, sometimes appearing before eGFR declines.

Sample Urine
Time 24–48 hours

Serum Electrolytes

Checks for imbalances in potassium and other minerals that can become dangerous as kidney function declines.

Sample Venous blood
Time Same day

Kidney Ultrasound

Checks the size and structure of the kidneys and can identify blockages, cysts, or other structural causes.

Sample Imaging, no sample required
Time Same day

Laboratory Note

Because eGFR can vary slightly between tests, a diagnosis of chronic kidney disease is usually based on results confirmed over at least three months, not a single reading.

Treatment

Managing Underlying Causes

Controlling blood pressure and blood sugar, often the two leading causes of kidney disease, is the most effective way to slow its progression.

Route Oral
Duration Ongoing, lifelong

Dialysis or Kidney Transplant

Needed once the kidneys can no longer function well enough to sustain life, replacing the filtering role the kidneys can no longer perform.

Route Hospital or dialysis centre-based
Duration Ongoing, or a single transplant procedure

Treatment Note

There is no way to reverse existing kidney damage, so treatment focuses on slowing further loss of function. Access to dialysis and transplantation remains limited in many parts of the world, which makes early detection and prevention especially important.

Prevention

Control blood pressure

Keeping blood pressure well managed is one of the most effective ways to protect the kidneys.

Manage blood sugar if you have diabetes

Good blood sugar control significantly slows kidney damage in people with diabetes.

Avoid overusing certain painkillers

Frequent or long-term use of some over-the-counter pain medications can damage the kidneys over time.

Get regular kidney function checks

Especially important for people with diabetes, high blood pressure, or a family history of kidney disease, since early kidney disease often causes no symptoms.

Prevention Note

Diabetes and hypertension together cause the majority of chronic kidney disease cases worldwide. Managing these two conditions well is one of the most effective ways to protect long-term kidney health.

Risk Factors

Higher Risk

These conditions are the leading causes of chronic kidney disease worldwide.

  • Diabetes
  • High blood pressure
  • A family history of kidney disease

Additional Risk Factors

These factors are linked to a higher risk of developing kidney disease.

  • Age over 60
  • Obesity
  • Recurrent kidney infections or long-term use of certain medications

Related Conditions in the Region

Some infections and conditions common in the region can also affect the kidneys.

  • Untreated schistosomiasis
  • Certain viral infections, including hepatitis B

Risk Note

Because diabetes and hypertension are responsible for most cases of chronic kidney disease, anyone managing either condition should have their kidney function checked regularly, even without symptoms.

Complications

Kidney Failure

Advanced kidney disease can progress to the point where dialysis or a transplant is needed to survive.

Cardiovascular Disease

Chronic kidney disease significantly increases the risk of heart attack and stroke. More people with kidney disease die from cardiovascular causes than ever reach kidney failure.

Anaemia and Bone Problems

Declining kidney function can affect red blood cell production and the balance of minerals needed for healthy bones.

Complication Note

Cardiovascular disease, not kidney failure, is the most common cause of death in people with chronic kidney disease, which is why managing heart health is just as important as managing the kidneys themselves.

When to Seek Medical Care

Little or No Urination

Needs urgent medical assessment.

Severe Swelling or Shortness of Breath

Can indicate significant fluid buildup and needs prompt attention.

Confusion or Extreme Fatigue

Can indicate a dangerous buildup of waste products and needs urgent evaluation.

Known Diabetes or Hypertension Without Recent Kidney Testing

Should prompt a conversation with a healthcare provider about kidney function screening.

Emergency Advice

Because chronic kidney disease often causes no symptoms until it is advanced, regular testing for people with diabetes or hypertension matters as much as responding to the warning signs above.

Prognosis

Progression Can Often Be Slowed

Managing blood pressure and blood sugar well can significantly slow the loss of kidney function.

Generally Not Reversible

Once kidney function is lost, it does not typically return, which is why prevention and early management matter so much.

Outcomes Depend Heavily on Access to Treatment

In parts of sub-Saharan Africa, only around half of people who need dialysis for kidney failure are able to access it.

Prognosis Note

Chronic kidney disease is estimated to contribute to one death every 20 seconds worldwide. Because advanced treatment is not available everywhere, slowing the disease before it reaches this stage is often the most realistic and effective form of care.

Differential Diagnosis

Acute Kidney Injury

A sudden, often reversible drop in kidney function, distinguished from chronic kidney disease by its rapid onset and, in many cases, recovery with treatment.

Urinary Tract Infection

Can cause changes in urination but is generally short-lived and resolves with antibiotics, unlike the persistent decline seen in chronic kidney disease.

Nephrotic Syndrome

Causes significant protein loss in the urine and swelling, and can occur alongside or independently of chronic kidney disease.

Clinical Note

Repeated blood and urine testing over time, rather than a single result, helps distinguish chronic kidney disease from other causes of changes in kidney function.

References

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Statistics and clinical information on chronic kidney disease prevalence, causes, and diagnosis.

Centers for Disease Control and Prevention (CDC)

Data and public health guidance on chronic kidney disease prevalence and risk factors.

Bedside Rationing and Moral Distress in Nephrologists in Sub-Saharan Africa

Peer-reviewed research on access to dialysis and kidney failure treatment in sub-Saharan Africa.

Frequently Asked Questions

Can chronic kidney disease be cured?
No. Kidney function that has already been lost generally does not come back. Treatment focuses on slowing further loss of function, most often by managing diabetes and blood pressure well.
How would I know if I have kidney disease?
Often you would not, at least not early on, since early kidney disease usually causes no symptoms. Blood and urine tests are the main way it is detected, which is why regular testing matters for anyone with diabetes, high blood pressure, or a family history of kidney disease.
What happens if kidney disease is not treated?
It can progress to kidney failure, where the kidneys can no longer function well enough to sustain life without dialysis or a transplant. Along the way, it also significantly increases the risk of heart attack and stroke.
Can kidney disease be prevented?
To a significant extent, yes. Since diabetes and high blood pressure cause most cases, managing both conditions well is one of the most effective ways to protect the kidneys over a lifetime.