Chronic Kidney Disease

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KEY POINTS

• Chronic kidney disease is a slow loss of kidney function over time.
• Treatment may include medicine, changing your diet, dialysis, or a kidney transplant. Chronic kidney disease cannot be cured. You will have it for the rest of your life unless you have a kidney transplant.
• Follow the full course of treatment prescribed by your healthcare provider. Ask your provider what medicines you need to avoid because they could damage your kidneys.

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What is chronic kidney disease?

Chronic kidney disease is a slow loss of kidney function over time.

The kidneys are inside your belly, on either side of your spine just above your waist. They make urine by removing waste products, extra salt and other minerals, and water from the blood. As long as you have at least one kidney that is working, your body can filter enough blood and make enough urine to keep you healthy.

As kidney disease gets worse, you may develop kidney failure, which means:

• Your body cannot get rid of wastes.
• Your body cannot keep a healthy balance of water and minerals.
• Your kidneys may make less urine, or no urine.

If not treated, kidney failure will cause death within a few days or weeks.

Chronic kidney disease can affect your health in other ways. For example, it can cause or worsen high blood pressure. You are also more likely to have blood vessel or heart disease, bone disease, anemia, and nutrition problems.

What is the cause?

Chronic kidney disease is more common in middle-aged and older people. It is caused by damage to the kidneys over the years by diseases such as:

• High blood pressure
• Diabetes
• Heart or lung disease
• Autoimmune disease, which is a disease that causes your body to mistakenly attack your own tissue such as with lupus
• Injury to the kidneys, kidney infection, and other kidney problems

Using nonprescription painkillers, such as acetaminophen, aspirin, or ibuprofen, for a long time can also cause chronic kidney failure. A family history of chronic kidney disease is also a risk factor.

What are the symptoms?

Chronic kidney disease gets worse over time. In the early stages, you may not have any symptoms. If you do have symptoms, they may come on gradually over several months. Symptoms may include:

• Feeling tired or weak
• Trouble staying alert during the day
• Trouble sleeping at night
• Itchy, dry skin
• Headaches
• Loss of appetite, often with weight loss

As your kidneys get worse, other parts of your body may be damaged by excess waste and changes in the balance of water, salt, and other minerals. Some of the common symptoms of kidney failure include:

• Changes in urine, such as urinating more often, less often, or not at all
• Swelling, especially in your legs, feet, or ankles
• Muscle cramps or weakness
• Bruising or bleeding
• Skin that is yellow or a darker color than is usual for you
• Unusual pain in one or both sides of your back
• Nausea and vomiting
• Shortness of breath
• Confusion or seizures

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood and urine tests
• Ultrasound scan, which uses sound waves to show pictures of the kidneys
• CT scan, which uses X-rays and a computer to show detailed pictures of the kidneys
• Needle biopsy, which is the removal of a small piece of tissue from your kidney with a needle

How is it treated?

Your healthcare provider may prescribe medicine to:

• Treat health conditions that cause kidney disease such as diabetes, heart or lung disease, infection, or other kidney problems
• Keep your blood pressure normal
• Keep the balance of liquids and minerals in your body normal

You may need to change your diet. With the right diet, you can help keep kidney disease from getting worse and help prevent other problems. Follow your healthcare provider's advice carefully about what foods you should eat and how much fluid you can drink. Your provider may recommend working with a dietitian to help you plan meals that include the right foods.

If you develop kidney failure, you will need dialysis or a kidney transplant. Dialysis uses a machine to do the work of your kidneys. It removes waste products and extra water from your blood and can be life saving. Dialysis may help you live longer and improve your quality of life. Dialysis can be done in a hospital, dialysis center, or you may be able to do dialysis in your own home. Dialysis usually needs to be done several times a week. Dialysis can be done by filtering the blood or with a tube that filters fluid from the abdomen.

Whether dialysis is a good option for you depends on the cause of your kidney disease, how well your kidneys are working, and your overall health.

If your health is good except for kidney failure, a kidney transplant may be an option. Talk with your healthcare provider about whether a transplant is an option for you.

Chronic kidney disease cannot be cured. You will have it for the rest of your life unless you have a kidney transplant. There are many choices to make about your care. Talk about the choices with your healthcare provider so that you can get all of your questions answered.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Take all medicines exactly as directed by your provider. Ask your provider what medicines you need to avoid because they could damage your kidneys.

Other things you can do that may help include:

• Eat a healthy diet. Ask your provider and dietitian what you need to eat, and what you should avoid.
• Try to keep a healthy weight. If you are overweight, lose weight.
• Stay fit with the right kind of exercise for you.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
• Try to get at least 7 to 9 hours of sleep each night.
• Keep up to date with recommended shots (immunizations). Get a flu shot every year and ask your healthcare provider about any other vaccinations you may need

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

You can get more information from:

• The National Kidney Foundation
  800-622-9010
  https://www.kidney.org/