Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.
In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.
Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.
Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include:
Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.
Make an appointment with your doctor if you have any signs or symptoms of kidney disease.
If you have a medical condition that increases your risk of kidney disease, your doctor is likely to monitor your blood pressure and kidney function with urine and blood tests during regular office visits. Ask your doctor whether these tests are necessary for you.
Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years.
Diseases and conditions that cause chronic kidney disease include:
A normal kidney has about 1 million filtering units. Each unit, called a glomerulus, connects to a tubule, which collects urine. Conditions such as high blood pressure and diabetes take a toll on kidney function by damaging these filtering units and collecting tubules and causing scarring.
A healthy kidney (left) eliminates waste from the blood and maintains the body's normal chemical balance. Fluid-filled sacs (right), called cysts, characterize polycystic kidney disease.
Factors that may increase your risk of chronic kidney disease include:
Chronic kidney disease can affect almost every part of your body. Potential complications may include:
To reduce your risk of developing kidney disease:
As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you've been diagnosed with high blood pressure, if you've taken a medication that might affect kidney function, if you've noticed changes in your urinary habits, and whether you have any family members who have kidney disease.
Next, your doctor performs a physical exam, also checking for signs of problems with your heart or blood vessels, and conducts a neurological exam.
For kidney disease diagnosis, you may also need certain tests and procedures, such as:
During a kidney biopsy, your doctor uses a needle to remove a small sample of kidney tissue for lab testing. The biopsy needle is inserted through your skin and is often directed using the guidance of an imaging device, such as ultrasound.
Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure.
Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of the disease. If your kidneys become severely damaged, you may need treatment for end-stage kidney disease.
Your doctor will work to slow or control the cause of your kidney disease. Treatment options vary, depending on the cause. But kidney damage can continue to worsen even when an underlying condition, such as high blood pressure, has been controlled.
Kidney disease complications can be controlled to make you more comfortable. Treatments may include:
Your doctor may recommend follow-up testing at regular intervals to see whether your kidney disease remains stable or progresses.
If your kidneys can't keep up with waste and fluid clearance on their own and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant.
For some who choose not to have dialysis or a kidney transplant, a third option is to treat kidney failure with conservative measures. However, once you have complete kidney failure, your life expectancy generally would be only a few months.
Regenerative medicine holds the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair.
Regenerative medicine approaches include:
For people with chronic kidney disease, regenerative medicine approaches may be developed in the future to help slow progression of the disease.
During kidney transplant surgery, the donor kidney is placed in your lower abdomen. Blood vessels of the new kidney are attached to blood vessels in the lower part of your abdomen, just above one of your legs. The new kidney's urine tube (ureter) is connected to your bladder. Unless they are causing complications, your own kidneys are left in place.
As part of your treatment for chronic kidney disease, your doctor may recommend a special diet to help support your kidneys and limit the work they must do. Ask your doctor for a referral to a dietitian who can analyze your current diet and suggest ways to make your diet easier on your kidneys.
Depending on your situation, kidney function and overall health, your dietitian may recommend that you:
Receiving a diagnosis of chronic kidney disease can be worrisome. You may be concerned about what your diagnosis means for your future health. To help you cope with your feelings, consider trying to:
You'll likely start by seeing your primary care doctor if you have signs or symptoms of kidney disease. If lab tests reveal you have kidney damage, you may be referred to a doctor who specializes in kidney problems (nephrologist).
To get ready for your appointment, ask if there's anything you need to do ahead of time, such as limit your diet. Then make a list of:
Take a family member or friend along, if possible. Sometimes it can be hard to remember everything you talked about with your doctor, and a relative or friend may hear something that you missed or forgot.
For chronic kidney disease, some basic questions to ask your doctor include:
Don't hesitate to ask any other questions during your appointment as they occur to you.
Your doctor may ask you questions, such as: