Living with chronic kidney disease

Spring is the perfect time to take charge of your health and a good place to start is by learning more about your kidneys. Get to know what they do, risk factors and consequences of kidney disease, and the tests and screening that are key for early detection of kidney disorders.

Your kidneys are two bean-shaped organs, about the size of a fist located on either side of your spine right behind your abdomen.^1,2 The job of the kidneys is to eliminate extra water and waste from your body, and the kidneys achieve this by producing urine. Kidneys also make hormones that help control the production of red blood cells and regulate blood pressure.

Kidney disease refers to a state in which your kidneys are damaged and not functioning normally. An estimated 37 million (15%) U.S. adults have chronic kidney disease (CKD).^3,4 People with high blood pressure and diabetes are at greatest risk as these are the leading causes of kidney failure.^1,2,5

What are the symptoms and causes of CKD?

CKD typically has a silent course with few or no symptoms until very late in the disease.^2,3 As a result, it may be overlooked until symptoms appear, and the kidneys are significantly damaged — making it more important for at-risk individuals to take actions as early as possible to slow the loss of kidney function. Some symptoms of CKD to watch for include:

• Dry, itchy skin^2,5
• Poor appetite^2,5
• Nausea or vomiting^2,5
• Trouble concentrating^2,5
• Swollen feet and ankles^2,5
• Tiredness^2,5
• Muscle cramps^2,5

The main causes are diabetes and high blood pressure.⁴ Other conditions that can lead to CKD include:

• Glomerulonephritis (third most common cause) — inflammation and damage to the kidney’s filtering system⁵
• Obstruction of the kidneys due to kidney stones^2,5
• Genetic conditions such as polycystic kidney disease⁵
• Atherosclerosis of the blood vessels that perfuse the kidneys⁵
• Abnormalities in the kidneys or urinary tract before birth⁵
• Autoimmune diseases such as Lupus nephritis^2,5
• Enlarged prostate gland (in men) or repeated urinary tract infections⁵

How is CKD screened/tested?

If you are at risk, you should ensure your primary care doctor is regularly screening your kidneys.⁶ Your doctor may run a series of tests including:

Urine

An abnormal amount of protein leakage in the urine is often one of the earliest signs of kidney disease and provides prognostic information into the likelihood of your kidney disease worsening over time.⁷ There are two types of tests that can detect protein in the urine:

• Urine albumin-to-creatinine ratio (UACR): compares protein levels found in the urine to creatine levels (waste found in the urine from normal wear and tear of the muscles).⁷
• Urine dipstick: As a part of urinalysis, this test measures the albumin (protein) levels of your in your urine, comparing it to normal levels.⁷

Blood

Your doctor will test your blood to ensure that the kidneys are filtering waste and fluid from your blood.⁷ These tests include:

• Blood urea nitrogen (BUN): This test measures the urea nitrogen levels in your blood.7, When urea nitrogen urea (waste from the breakdown of protein in food) enters your bloodstream, your kidneys filter it and allow it pass through the urine.^7,8
• Glomerular filtration rate (GFR): This test provides a measure of how much blood your kidneys are filtering. This test looks at the level of a blood chemical called creatinine, which is filtered by the kidneys and estimates your GFR with the inclusion of other factors such as age, body size and gender. If your GFR is low, this is an indication that your kidneys are not working as well as they should and provides a numerical valuation of the extent of your kidney disease.^7,8
• Serum creatinine: This test measures the creatinine in your blood. Depending on several factors such as age, sex and muscle, your normal levels may differ from person-to-person.^7,8

Your doctor may also check your blood pressure, order imaging or take a biopsy to further test for kidney problems, including CKD.^7,8

How to manage CKD

If kidney disease is detected, actions can be taken that may slow the loss of kidney function.⁹ Individuals with CKD often will continue to lose kidney function over time, eventually causing waste products to build up and cause multiple effects on the body, such as weak bones, fluid retention, high blood pressure and problems with the heart and vascular system.⁵

A healthy lifestyle is critical for managing CKD and slowing its progression and complications. Take charge of your kidney health by meeting regularly with your health care team, ensuring your blood pressure and your blood glucose are at optimal levels. It is also critical to maintain a healthy lifestyle such as managing your body weight, keeping physically active, quitting smoking, and eating more fruits and vegetables.⁹

A few small changes today can go a long way to keeping your kidneys healthier!

Disclaimer:

The information featured in this site is general in nature. The site provides health information designed to complement your personal health management. It does not provide medical advice or health services and is not meant to replace professional advice or imply coverage of specific clinical services or products. The inclusion of links to other web sites does not imply any endorsement of the material on such websites.

1. Kidneys. https://my.clevelandclinic.org/health/body/21824-kidney. Last reviewed May 17, 2022. Accessed May 12, 2023.
2. Chronic kidney disease. https://medlineplus.gov/ency/article/000471.htm. Last reviewed July 27, 2021. Accessed June 2, 2023.
3. Chronic Kidney Disease Basics. https://www.cdc.gov/kidneydisease/basics.html. Revised February 28, 2022. Accessed May 1, 2023.
4. Kidney Disease Statistics for the United States. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease. Last reviewed September 2021. Accessed May 2, 2023.
5. Chronic kidney disease (CKD). https://www.kidney.org/atoz/content/about-chronic-kidney-disease. Accessed June 2, 2023.
6. Get Tested for Chronic Kidney Disease. https://www.cdc.gov/kidneydisease/publications-resources/get-tested.html. Last reviewed May 27, 2022. Accessed June 2, 2023.
7. Kidney Testing: Everything You Need to Know. https://www.cdc.gov/kidneydisease/publications-resources/kidney-tests.html. Last reviewed March 24, 2022. Accessed June 2, 2023.
8. Tests to Measure Kidney Function, Damage and Detect Abnormalities. https://www.kidney.org/atoz/content/kidneytests#blood-tests. Accessed June 2, 2023.
9. Prevention and Risk Management. https://www.cdc.gov/kidneydisease/prevention-risk.html. Last reviewed July 12, 2022. Accessed June 2, 2023.