If you have high blood pressure or diabetes, it's essential to get regular testing for chronic kidney disease
- With chronic kidney disease, your kidneys are so damaged they can't filter waste from your blood.
- This common but serious health condition can lead to kidney failure, stroke, and heart disease.
According to the American Kidney Fund, more than one in seven people in the United States — about 37 million folks total — live with chronic kidney disease.
This serious health condition goes by many names, including chronic renal disease, chronic renal insufficiency, or chronic renal failure.
Chronic kidney disease develops when your kidneys become so damaged they can no longer effectively perform their main function: filtering out waste from your blood. This level of damage is most commonly caused by high blood pressure and diabetes.
Left untreated, this condition can rapidly lead to end-stage kidney disease, a condition that requires ongoing dialysis or a transplant, says Dr. Dapo Afolabi, co-founder and CEO of Fort Worth Renal Group.
What's more, chronic kidney disease also raises your risk of stroke, heart attack, and heart disease.
Read on to learn the main signs of this condition, what causes it, and how to get a diagnosis and treatment.
Symptoms
Early damage to your kidneys might not cause any symptoms, Afolabi says.
But over time, as the damage progresses, chronic kidney disease may cause swelling in your extremities — aka arms and legs — and sometimes your face.
Other possible symptoms of advanced chronic kidney disease include:
- Fatigue
- Itchy or dry skin
- More or less of a need to urinate
- Appetite loss
- Muscle cramping
- Chest pain
- Headaches
- Nausea
- Problems sleeping
- Weight loss
- Issues with concentration
Additionally, high blood pressure — aka hypertension — can show up as a symptom of chronic kidney disease — but it's also a leading cause. Here's why:
- You may have high blood pressure as a symptom because your kidneys play a major role in the hormonal processes that regulate blood pressure, and kidney damage keeps them from functioning properly. Waste that builds up in your bloodstream due to poor kidney function may also raise your blood pressure.
- High blood pressure can be a cause because hypertension damages blood vessels, including the ones in your kidneys. Over time, this can lead to chronic kidney disease.
Causes
Almost a third of US adults with diabetes and one in five with high blood pressure have chronic kidney disease.
But other conditions can also lead to kidney damage, including:
- Autoimmune conditions like lupus nephritis
- Inherited physical abnormalities of the kidney and urinary tract
- Genetic disorders like polycystic kidney disease
- Acute or chronic glomerulonephritis. These diseases damage the glomeruli, the part of the kidney that filters blood
- Tumors or other obstructions affecting the kidneys
- Chronic urinary tract infections (UTIs)
Since most people don't have symptoms early on, it's essential to be aware of your individual risk factors, Afolabi says. These include:
- Your age — after you turn 40, your kidney function decreases by 1% each year.
- Having high blood pressure
- Having a family history of kidney disease or kidney failure
- Having any type of diabetes
Additionally, Afolabi says people of color are disproportionately affected by chronic kidney disease.
Hispanic people are almost 1.3 times more likely to be diagnosed with chronic kidney disease than non-Hispanic people, and American Indians experience 1.2 times the risk of white people, says Dr. Shree Mulay, nephrologist and CEO of The Kidney Experts.
And according to the CDC, non-Hispanic Black people represent 16.3% of people with chronic kidney disease in the US — though they only make up only 13% of the population.
Social determinants of health (SDoH) are partly to blame for these statistics, Mulay says. SDoHs are non-medical factors, like lack of insurance or access to medical care, that can have an impact on health.
"Oftentimes, the kidney specialist provides a detailed care plan for their patients, but we know that once they walk out of that office, many of our patients lack the resources they need to adhere to this plan on a daily basis," Afolabi says.
For example:
- Lack of transportation access might make it difficult to get to important medical appointments.
- Food insecurity can make it challenging to eat a balanced diet and control risk factors like high blood pressure.
Diagnosis
If you have risk factors for chronic kidney disease, it's important to have regular checkups with your doctor. Early diagnosis is crucial in preventing further damage to your kidneys, Afolabi says.
Your care team will typically order a combination of blood and urine tests to find out how your kidneys function. These tests check your:
- Creatinine levels: High creatinine levels in your blood may mean your kidneys aren't filtering waste properly.
- Estimated glomerular filtration rate (eGFR): Doctors calculate eGFR using several variables, including creatinine levels, age, and sex, to get a rough estimate of kidney function. A result between 15 and 29 means you likely have advanced kidney disease, Mulay says. A result of 60 may point to stage 3 chronic kidney disease, or mild to moderate damage.
- Urine albumin creatinine ratio (uACR): Albumin, a protein in your blood, shouldn't show up in your urine. If it does, this often signals a problem with your kidneys. "Levels over 30 milligrams per gram indicate an increased risk for severe kidney disease," Mulay says.
Note: Imaging tests like CT scans can also help your care team identify potential health issues that may contribute to chronic kidney disease, including congenital abnormalities or tumors.
Treatment
Your treatment options generally depend on the underlying cause of kidney disease and the severity of the damage to your kidneys.
For instance:
- If you have kidney damage due to high blood pressure, your treatment may involve taking blood pressure-lowering medications.
- Treatment for kidney disease caused by diabetes will involve controlling your blood sugar with medications like insulin.
In the later stages of chronic kidney disease, when your kidneys stop working and can no longer filter your blood, treatment involves tri-weekly dialysis or a kidney transplant, Afolabi says. You may also need nightly dialysis while you sleep.
Ultimately, it's not always possible to reverse kidney damage, but you can slow disease progression and limit the strain on your kidneys by trying the following:
- Get regular physical activity, which can help lower blood pressure
- Eat a diabetes-friendly diet to lower your blood pressure and control blood sugar
- Limit your salt intake
- Monitor your blood pressure
- Quit smoking
Afolabi says education is a key factor in curbing the progression of a condition like chronic kidney disease. That's because most people don't know they have this condition until the damage has become so severe that their kidneys are shutting down.
Education doesn't just mean increasing awareness of the disease itself — but also informing people with the condition of the resources available to them.
For example, many people qualify for a free blood pressure cuff through their health insurance benefits but don't know it, Afolabi says. Being able to take your own blood pressure at home can make a big difference, when it comes to tracking your overall health status and treatment progress.
Insider's takeaway
Chronic kidney disease is an umbrella term for kidney damage.
You may not realize you have kidney damage in the early stages, since it often doesn't cause symptoms until the damage becomes severe.
That's why it's so important to get your kidney function tested regularly if you have risk factors for chronic kidney disease, including diabetes, high blood pressure, or a family history of the condition.
Catching and treating kidney disease early won't necessarily reverse existing damage, but it can prevent the condition from getting worse and becoming kidney failure.