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Chronic Kidney Disease

What is Chronic Kidney Disease?

Your kidneys have a vital role in filtering your blood to remove waste and extra fluid from your body. They also help make red blood cells, vitamin D, and hormones that control your blood pressure.

Chronic kidney disease (CKD) damages your kidneys and can impact many aspects of your health. It's a chronic illness, which means it gets worse over time and can be a life-long condition.

About 37 million American adults have CKD.

Causes of chronic kidney disease

One cause of CKD is other illnesses. Diabetes and uncontrolled high blood pressure cause two-thirds of cases.

Sometimes, it's the result of an injury to the kidneys.

The following conditions are common causes of kidney damage:

  • Glomuleronephritis — swelling of the filtering part of your kidneys.
  • Systemic lupus erythematosus, an immune system disease that can attack the kidneys, or drugs that damage the kidneys.
  • Malformed kidneys, or a genetic condition called polycystic kidney disease, which causes cysts to grow in the kidneys.
  • Kidney stones or chronic urinary tract infections.
  • An enlarged prostate gland in men.

Chronic kidney disease risk factors and complications

While CKD can affect anyone, the risk is higher for:

  • People with diabetes or high blood pressure.
  • Anyone with a family history of kidney failure.
  • Older adults.

If you catch the disease early, you can manage it with lifestyle changes — like a new diet — and medicine, if needed.

As the disease progresses, CKD can:

  • Cause other health problems, like anemia or bone disease.
  • Further increase your blood pressure, leading to heart disease or stroke.
  • Lead to end-stage kidney disease.

How to prevent chronic kidney disease

The best way to prevent CKD is to take care of your health.

Maintain a healthy weight and manage any health conditions that can increase your risk for the disease

To protect the overall health of your kidneys:

  • Eat a healthy diet with lots of fruits and veggies. They're high in potassium, which promotes healthy blood pressure. Limiting salt from both the shaker and processed foods also helps reduce your blood pressure.
  • Aim for at least 30 minutes of moderate-intensity physical activity most days of the week.
  • Limit alcohol to one drink a day for women and two drinks per day for men.
  • Take steps to manage stress and get at least 7 to 8 hours of sleep each night.
  • Quit smoking if you smoke cigarettes or marijuana.
  • Get your blood pressure and blood sugar (glucose) checked routinely.
  • See a doctor for regular care if you have diabetes or high blood pressure.
  • Inform your doctor if you routinely take over the counter drugs or herbal supplements.
  • Avoid NSAIDs (e.g. ibuprofen, naproxen).

Why choose UPMC for chronic kidney disease care?

At the UPMC Kidney Disease Center:

  • Our experts treat the full spectrum of kidney diseases, including world-recognized experts in CKD.
  • We'll work with you to slow the progression of your disease as much as possible and improve your quality of life.
  • We partner with special dialysis clinics, experts in supportive care, and the surgeons at the Thomas E. Starzl Transplantation Institute.

Chronic Kidney Disease Symptoms and Diagnosis

Early stage CKD often has no symptoms.

As it gets worse, you may start to notice that you:

  • Feel extremely tired.
  • Lose your appetite or feel nauseous.
  • Have headaches or problems concentrating.
  • Have trouble sleeping.
  • Have to pee frequently.
  • Have swollen feet or ankles.
  • Have dry, itchy skin.
  • Have severe weight loss.

If you have any or all of these symptoms, speak with your PCP. They may order tests or refer you to a kidney specialist.

Diagnosing chronic kidney disease

To diagnose CKD and check your kidney function, your doctor will have to take a few tests.

These may include blood tests to measure:

  • Glomerular filtration rate (GFR). The amount of blood your kidneys can filter.
  • Blood urea nitrogen (BUN). Urea nitrogen is a waste product that increases in your blood when your kidneys aren't working properly.
  • Creatinine. Your kidneys filter waste products like creatinine out of your blood. When your kidneys aren't working well, it tends to build up in your body.

Your doctor may also:

  • Check your urine for albumin, a protein that spills into the urine when the kidneys aren't working right.
  • Order a CT scan, ultrasound, or biopsy to rule out other types of kidney diseases.

Stages of chronic kidney disease

The results of your GFR blood test helps your doctor learn the stage of your disease and make plans for treatment.

The normal GFR for healthy kidneys is at least 90 milliliters per minute. It's sometimes lower for older adults.

As your CKD gets worse, it will move through five stages:

Stage GFR Kidney function
1 90 ml/min Normal.
2 60 to 89 ml/min Mild loss.
3a 45 to 59 ml/min Mild to moderate loss.
3b 30 to 44 ml/min Moderate to severe loss.
4 15 to 29 ml/min Severe loss.
5 15 ml/min or less End-stage kidney disease.

Chronic Kidney Disease Treatment

There's no cure for CKD.

But at the UPMC Kidney Disease Center, the goals of treatment are to:

  • Protect your kidneys.
  • Slow the progression of the disease.
  • Help you find comfort despite your symptoms.

Your treatments may change over time if your CKD gets worse, but treatments will be lifelong. No matter the stage of your disease, you have hope at the UPMC Kidney Disease Center.

Lifestyle changes

Lifestyle changes may help slow the progress of CKD.

Your doctor may ask you to:

  • Quit smoking, limit alcohol use, and reduce stress.
  • Improving your diet and exercise will help you achieve a healthier weight, reduce your blood pressure, and lower your blood sugar. A low-sodium diet is essential.
  • Restrict certain nutrients, like protein, phosphorus, or potassium. That's because your kidneys may be unable to filter excess amounts of those nutrients from your blood. Without proper filtering, they can build up to dangerous levels.

At the UPMC Kidney Disease Center, we'll provide you with detailed guidance to help you make changes to your diet and lifestyle.

Medicine to treat CKD

You might need medicine if you have high blood pressure, high blood sugar, or albumin in your urine.

For instance:

  • Diabetes drugs can lower your blood sugar.
  • Blood pressure drugs can reduce your risk of kidney failure.

Our experts in supportive care can also prescribe medicine to ease other painful symptoms.

Dialysis

End-stage kidney disease — having less than 15 percent of your normal function — can cause toxic waste to build up in your body. You may need to have dialysis, also called renal replacement therapy.

During dialysis, a machine cleans waste from your blood and helps control your blood pressure.

There are two common types of dialysis:

  • Hemodialysis — done at a dialysis clinic or at home 3 times a week for about 3 hours. The UPMC Kidney Disease Center partners with many local dialysis clinics to provide you with specialized care.
  • Peritoneal dialysis — done nightly from the comfort of your home. The UPMC Kidney Disease Center can help you set up a home dialysis routine.

For most people, dialysis is only a short-term treatment. In time, you may need a kidney transplant.

Supportive care without dialysis

Although dialysis treatments are lifesaving for many people, they can be hard and sometimes painful for others.

For people with advanced kidney disease who want to avoid dialysis treatment, renal supportive care can offer hope and comfort.

Supportive care aims to:

  • Treat the symptoms of kidney disease.
  • Raise your quality of life.
  • Provide short-term treatment as you get ready for kidney transplant.

At the UPMC Kidney Disease Center, you have access to world-recognized experts through the Renal Supportive Care Clinic.

Kidney transplant to treat CKD

If you have CKD, a kidney transplant may be the key to getting you back to your healthy life.

We partner with the kidney transplant experts at UPMC Transplant Services to provide care before, during, and after transplant.

Chronic kidney disease prognosis

Living with CKD can be tough, but you have hope at the UPMC Kidney Disease Center.

Some people with CKD respond well to medical treatments and may never enter end-stage kidney disease.

Your age, overall health, and treatment outcomes all play a role in your prognosis. Early diagnosis and treatment can keep you informed and prepared.

Contact the UPMC Kidney Disease Center

To learn more about kidney disease: