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.
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.
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.
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.
Serum Electrolytes
Checks for imbalances in potassium and other minerals that can become dangerous as kidney function declines.
Kidney Ultrasound
Checks the size and structure of the kidneys and can identify blockages, cysts, or other structural causes.
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.
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.
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.
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
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.
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.
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.
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.
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.