Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD) means your kidneys slowly get damaged and can’t do important jobs like removing waste and keeping blood pressure normal. Conditions like hypertension and diabetes can lead to kidney damage because they affect the blood vessels in the kidneys, reducing their ability to filter waste and excess fluids from the body. Learn more about CKD below.

About CKD
5 Stages of CKD
Signs and symptoms
Causes/Risk factors
Complications
Treatment

About chronic kidney disease (CKD)

Your kidneys do many important jobs. Some of the ways they keep your whole body in balance include:
– Removing natural waste products and extra water from your body
– Helping make red blood cells
– Balancing important minerals in your body
– Helping maintain your blood pressure
– Keeping your bones healthy

Chronic kidney disease (CKD) is when the kidneys have become damaged over time (for at least 3 months) and have a hard time doing all their important jobs. CKD also increases the risk of other health problems like heart disease and stroke. Developing CKD is usually a very slow process with very few symptoms at first. So, CKD is divided into 5 stages to help guide treatment decisions.

5 Stages of chronic kidney disease (CKD)

CKD is evaluated using two simple tests – a blood test known as the estimated glomerular filtration rate (eGFR) and a urine test known as the urine albumin-creatinine ratio (uACR). Both tests are needed to have a clear picture of your kidney health. When identifying your CKD stage, these tests usually need to be repeated to confirm long-term damage (lasting 3 months or more).

Stage 1 CKD – eGFR 90 or higher and kidney damage (e.g. uACR 30 or higher) for 3 months or more
Stage 2 CKD – eGFR 60-89 and kidney damage (e.g. uACR 30 or higher) for 3 months or more
Stage 3a CKD – Mild to moderate loss of kidney function (eGFR 45-59 for 3 months or more)
Stage 3b CKD – Moderate to severe loss of kidney function (eGFR 30-44 for 3 months or more)
Stage 4 CKD – Severe loss of kidney function (eGFR 15-29 for 3 months or more)
Stage 5 CKD – Kidney failure (eGFR less than 15 for 3 months or more) or you are on dialysis

Signs and symptoms

Many people living with CKD do not have any symptoms until the more advanced stages and/or complications develop. If symptoms do happen, they may include:

  • Foamy urine
  • Urinating (peeing) more often or less often than usual
  • Itchy and/or dry skin
  • Feeling tired
  • Nausea
  • Loss of appetite
  • Weight loss without trying to lose weight
  • People who have more advanced stages of CKD may also notice:
    • Trouble concentrating
    • Numbness or swelling in your arms, legs, ankles, or feet
    • Achy muscles or cramping
    • Shortness of breath
    • Vomiting
    • Trouble sleeping
    • Breath smells like ammonia (also described as urine-like or “fishy”)

Causes/Risk factors

Anyone can develop CKD – at any age. However, some people are at a higher risk than others. The most common CKD risk factors are:

Complications

As CKD worsens, the risk of getting complications goes up. Some examples include:

Treatment for CKD

  1. Lifestyle Changes
    – Diet:
    Low-sodium (salt) diet
    Moderate protein intake
    Low potassium and phosphorus
    Fluid management
    – Exercise:
    Regular physical activity helps control blood pressure and blood sugar.
    – Smoking cessation:
    Smoking worsens kidney damage and increases cardiovascular risk.
    – Limit alcohol intake

  2. Medications
    – Blood pressure control
    – Diabetes management
    If diabetic: Blood sugar control with medications
    – Anemia management
    Iron supplements
    Erythropoiesis-stimulating agents (ESAs) if needed
    – Phosphate binders
    In later stages to reduce phosphate levels
    – Vitamin D supplements
    To manage bone health
    – Diuretics
    For fluid retention and high blood pressure

  3. Monitoring & Support
    Regular blood tests (creatinine, eGFR, electrolytes)
    Urine tests (protein, albumin)
    BP checks

  4. Advanced CKD (Stage 4 or 5)
    Dialysis: Hemodialysis or peritoneal dialysis
    Kidney transplant: Best option for eligible patients

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