Understanding Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD) is the gradual loss of the kidneys' ability to filter waste from the blood. It is often a result of a kidney disease. But did you know CKD could also be a result of other diseases and illnesses? Diabetes and high blood pressure are the leading causes of CKD. Because CKD usually occurs over time, you may not have any symptoms until it's time to start dialysis.

What is chronic kidney disease ?

Chronic kidney disease (CKD) is the slow break down of the kidneys' ability to filter waste and fluid from the bloodstream.

Kidneys are made up of nephrons, tiny structures that filter waste out of the blood. When a person is diagnosed with a kidney disease or another disease that affects the kidneys (such as diabetes or high blood pressure), the nephrons will become damaged over time and lose their filtering ability.

Because there are millions of nephrons in each kidney, a person may not notice when a few nephrons become damaged. The remaining healthy nephrons are able to take up the slack. But as more and more nephrons become damaged, the remaining healthy nephrons must work harder. Eventually, the healthy nephrons become damaged as well.

Kidneys can become scarred or even shrink in size.

What causes chronic kidney disease?

If you have been diagnosed with chronic kidney disease, that didn't happen suddenly. And, CKD will not get better. There are two common diseases that can lead to CKD: diabetes and high blood pressure.

Diabetes is a disease where the body is not producing enough insulin to break down the sugar from the food we eat. The excess sugar (also known as glucose) remains in the bloodstream. High levels of glucose can damage the nephrons in your kidneys. This could lead to a condition called diabetic nephropathy.

High blood pressure can also cause CKD. Over time, high blood pressure damages blood vessels throughout the body. The high pressure and stress from the blood vessels in the kidneys can damage the nephrons.

What are the symptoms of chronic kidney disease?

Chronic kidney disease is a slow process. Because CKD occurs over a long period of time (often years), you may not notice any symptoms until there is a significant loss of kidney function. This is why CKD is a silent, but devastating disease.

Since your kidneys will be unable to filter fluid and waste from your blood efficiently, you will have a build up of toxins in your blood stream. A build up of nitrogen waste in your bloodstream is called azotemia. Although, some patients with azotemia may not feel ill.

When patients finally feel the effects of their damaged kidneys, they will experience an overall ill feeling. This is called uremia. Too much fluid and waste are in the bloodstream. You may feel tired, have frequent hiccups and feel nauseated. You may vomit, your skin may itch and you may have headaches.

Other symptoms that may appear in the later stages of CKD are easy bruising or bleeding, increased or decreased urine output, a need to urinate at night, seizures, uremic frost (deposits of white crystals in and on the skin) and decreased sensation in the hands, feet and other areas.

Can I be tested for CKD?

Your doctor can order a urine and blood sample for analysis. These tests can help determine whether or not your kidneys are working properly. Your doctor would look for creatinine and urea nitrogen in your blood. Both are waste products produced by the body. If your blood test indicates either of these two waste products are high, this may be a sign your kidneys are not doing their job.

Your doctor may also test to see if your erythropoietin levels are normal by ordering a hemoglobin or hematocrit test. Erythropoietin is a hormone produced by your kidneys. If you have high levels of potassium, phosphorous, magnesium and calcium, this could also indicate your kidneys are not functioning well. Your doctor may order an MRI or an ultrasound to see if your kidneys have shrunk in size.

If the cause for CKD is not clear, your doctor may decide to do a kidney biopsy. This is done under local anesthesia.

How is CKD treated?

CKD is treated by taking care of the underlying cause of the disease. This may slow the disease's progression. If you have been diagnosed with a kidney disease, high blood pressure or diabetes, your doctor may have you on medication to help control your illness. Your dietitian may have also placed you on a special diet that restricts sugar, sodium (salt), protein, phosphorus and potassium.

As CKD progresses to the point where you have less than 15% of your kidney function, dialysis or a kidney transplant will be needed.

What can I do to prevent chronic kidney disease?

It is important to have any illness diagnosed in its early stages. If you have been diagnosed with chronic kidney disease, the condition is irreversible. However, you may be able to slow the progress of the disease through a proper diet, medication (if needed) and exercise.

Ask your doctor to monitor your glucose levels and blood pressure. An early diagnosis of diabetes or hypertension can lead to appropriate treatment before any harm is done to the kidneys. If you have already been diagnosed with diabetes or high blood pressure, you should follow your doctor's instructions regarding medication, diet and exercise. Keeping your blood sugar level and blood pressure low is important in preventing more damage not only to your kidneys, but your entire body.

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a kidney doctor tool to locate a nephrologist in your area.

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