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Chronic Kidney Disease
Key Points
- More than 1 in 7 American adults has chronic kidney disease (CKD).
- CKD is common among adults in the United
States. More than 35.5 million American
adults may have CKD.
- As many as 9 in 10 don't
know they have it.
- Specific blood and urine tests are needed to check for CKD.
- CKD can be treated (the earlier treatment starts the better).
- Kidney diseases are a
leading cause of death in the
United States.
- About 360 people begin
treatment for kidney failure
(dialysis or kidney transplant)
every day.
National Kidney Month
March is National Kidney Month, a time when communities
across the country raise awareness about kidney disease.
This year’s focus is on taking charge of your health and the
many factors that go into managing your kidney disease.
Chronic kidney disease (CKD) is a serious condition
affecting around 35.5 million people. Often overlooked until
symptoms appear, CKD is progressive and can put you at risk
for serious health complications including heart attack,
stroke, and kidney failure. Adopting a healthy lifestyle can
help you manage CKD and its complications from progressing.
About your Kidneys and CKD
Your hard-working kidneys
Your kidneys, each just the size of a computer mouse, filter all the
blood in your body every 30 minutes. They work hard to remove wastes,
toxins, and excess fluid. They also:
- Help control blood pressure.
- Signal the body to make red blood cells.
- Help keep your bones healthy.
- Regulate blood chemicals that are essential to life.
Kidneys that function properly are critical for maintaining good health.
CKD
CKD is a condition in which the kidneys are damaged and can't filter
blood as well as they should. Because of this, excess fluid and waste
remain in the body and may cause health problems such as heart disease.
Other health problems related to CKD include:
- Anemia or low number of red blood cells.
- Increased occurrence of infections.
- Low calcium levels, high potassium levels, and high phosphorus
levels in the blood.
- Loss of appetite or eating less.
- Depression or lower quality of life.
CKD has varying levels of seriousness. It usually gets worse over time,
though treatment has been shown to slow progression. CKD can progress to
kidney failure and early cardiovascular disease.
When the kidneys stop working, dialysis or kidney transplant is needed
for survival. Kidney failure treated with dialysis or kidney transplant
is called end-stage kidney disease. Not all people with kidney disease
progress to kidney failure.
Types of Kidney Disease
CKD is a condition where your kidneys can't filter toxins or extra fluid
from your blood as well as they should. While the condition can vary in
how serious it is, CKD usually gets worse over time. Treatment can slow
the progression of the disease.
If left untreated, CKD may lead to kidney failure. At this stage,
called end-stage renal disease (ESRD),
the condition must be treated by dialysis or kidney transplant. Diabetes
and high blood pressure are the leading causes of CKD.
It's estimated that 1 in 7 adult Americans have the condition. But 40%
of those with serious chronic
kidney disease aren't aware they have the condition.
Other common forms of kidney disease include:
-
Polycystic
kidney disease. This genetic disorder causes cysts
(fluid-filled sacs) to grow on your kidneys, limiting their ability
to filter waste from your blood.
-
Lupus
nephritis. Lupus is an autoimmune disease, meaning your
immune system attacks healthy cells. Lupus nephritis is when your immune
system attacks your kidneys.
-
Interstitial nephritis. This condition happens when you
have a bad reaction to a medicine that limits your kidneys' ability
to filter toxins. If you stop the medicine, your kidney health
should improve.
-
Glomerulonephritis (glomerular disease). Glomeruli are the
thousands of tiny filters that remove waste from your blood in your
kidneys. This condition damages them, and your kidneys can't
function as well. Inflammation in the glomeruli can happen
after a strep infection, as well.
-
APOL1-mediated kidney disease. Normally, the APOL1 gene
helps make an immune system protein, but if you inherit a mutated
version of the gene from both parents, you may be more at risk for
kidney disease. You may be more likely to have this gene mutation if
you identify as Black, African American, Afro-Caribbean, or
Latina/Latino.
-
Long-lasting viral illnesses. HIV
and AIDS, hepatitis B, and hepatitis C may
cause kidney disease.
-
Pyelonephritis. This
is a urinary tract infection within the kidneys, which can result in
scarring as the infection heals. It can lead to kidney damage if it
happens several times.
Stages of CKD
There are five stages of chronic kidney disease. The stages
are based on how well your kidneys are able to filter out
waste from your blood. Blood and urine tests determine which
stage of CKD you’re in. The stages range from very mild (stage 1) to kidney failure
(stage 5). Healthcare providers determine the stage of your
kidney function according to the glomerular filtration rate
(eGFR). Your eGFR is a number based on the amount of
creatinine, a waste product, found in your blood.
Stage |
eGFR
(mL/min) |
What It Means |
Symptoms |
Stage 1 |
90 and higher |
Your kidneys are working well but you have signs of mild
kidney damage. |
Typically asymptomatic |
Stage 2 |
60 to 89 |
Your kidneys are working well but you have more signs of
mild kidney damage. |
Typically asymptomatic |
Stage 3a |
45 to 59 |
Your kidneys aren’t working as well as they should and
show mild to moderate damage. This is the most common
stage. You may notice symptoms at this stage. |
Fatigue Weakness |
Stage 3b |
30 to 44 |
Your kidneys show moderate damage and don’t work as well
as they should. With the right treatment, many people
can stay in this stage and never advance to stage 4. |
Kidney pain
Foamy urine
Restless legs
Muscle cramps
Itchy skin
Swelling of hands or feet
Sleep problems |
Stage 4 |
15 to 29 |
You have very poor kidney function; your kidneys are
severely damaged and close to not working. |
Headache
Urinating more or less often
Loss of appetite
Blood in your urine
Inability to concentrate
Swelling around eyes and ankles
Easy bruising |
Stage 5 |
Less than 15 |
Your kidneys are very close to failing or have stopped
working. You may need kidney dialysis or a kidney
transplant at this stage. |
Shortness of breath
Chest pain or pressure
Nausea or vomiting
Bone pain
Weight loss
Skin and nail changes
Irregular heartbeats
Little or no urination |
Symptoms
You may wonder how you can have CKD and feel fine. Our
kidneys have a greater capacity to do their job than is
needed to keep us healthy. For example, you can donate one
kidney and remain healthy. You can also have kidney damage
without any symptoms because, despite the damage, your
kidneys are still doing enough work to keep you feeling
well. For many people, the only way to know if you have
kidney disease is to get your kidneys checked with blood and
urine tests.
As kidney disease gets worse, a person may have swelling,
called edema. Edema happens when the kidneys can’t get rid
of extra fluid and salt. Edema can occur in the legs, feet,
or ankles, and less often in the hands or face.
As the disease worsens, symptoms
may include:
- A need to pee more often.
- Tiredness, weakness, low energy level.
- Loss of appetite.
- Swelling of your hands, feet and ankles.
- Shortness of breath.
- Foamy or bubbly pee.
- Puffy eyes.
- Dry and itchy skin.
- Trouble concentrating.
- Trouble sleeping.
- Numbness.
- Nausea or vomiting.
- Muscle cramps.
-
High blood pressure.
- Darkening of your skin.
Keep in mind that it can take years for waste to build up in
your blood and cause symptoms.
Reducing Risk
- Keep your blood pressure below 140/90 mm Hg (or the target your
doctor sets for you).
- If you have diabetes, stay in your target blood sugar range as
much as possible.
- Get active. Physical activity helps control blood pressure and
blood sugar levels.
- Lose weight if needed.
- Get tested for CKD regularly if you're at risk.
- If you have CKD, meet with a dietician to create a
kidney-healthy eating plan. The plan may need to change as you
get older or if your health status changes.
- Take medicines as instructed and ask your doctor about blood
pressure medicines called angiotensin-converting enzyme
inhibitors and angiotensin II receptor blockers, which may
protect your kidneys in addition to lowering blood pressure.
- If you smoke, make a plan to quit.
Smoking can worsen kidney disease and interfere with medication
that lowers blood pressure.
- Include a kidney doctor (nephrologist) on your health care team.
CKD by the numbers
- Kidney diseases are a leading
cause of
death in the United States.
- CKD is most common among people ages 65 or older (34%),
followed by people ages 45 to 64 (12%), and people ages
18 to 44 (6%).
- CKD is slightly more common in women (14%) than in men
(12%).
- About 35.5
million US adults are estimated to have CKD, and most
are undiagnosed.
- About 20% of non-Hispanic Black adults have CKD.
-
Approximately 12% of non-Hispanic White adults have CKD.
-
About 14% of non-Hispanic Asian adults have CKD.
-
40% of
people with severely reduced kidney function (not on dialysis)
are not aware of having CKD.
- Every 24 hours, 360 people
begin dialysis treatment for kidney failure.
- In the United States, diabetes and high blood pressure are the
leading causes of kidney failure, accounting for 2
out of 3 new cases.
- In 2019, treating Medicare beneficiaries with CKD cost $87.2
billion, and treating people with end-stage kidney
disease cost an additional $37.3
billion.
- Medicare spending for beneficiaries with CKD (not
including ESKD) ages 66 or older was nearly $77 billion
in 2021, representing 24.1% of Medicare spending in this
age group.
- Medicare-related spending for beneficiaries with ESKD
totaled $52.3 billion in 2021.
- In 2021, annual per-person spending attributable to
Medicare Parts A, B, and D was more than double for
beneficiaries ages 66 or older with CKD ($28,162)
compared with those without CKD ($13,604).
CKD and Kidney Testing
CKD happens when your kidneys become damaged over time
and can't filter your blood as well. Diabetes is a
leading cause of CKD, and there are often no symptoms
until your kidneys are badly damaged.
If you find and treat kidney disease early, you may be
able to manage CKD and prevent other health
complications. But the only way to know how well your
kidneys are working is to get tested. Urine Tests
One of the earliest signs of kidney disease is when
protein leaks into your urine (proteinuria). Urine
testing can check for this. There are two types of urine
tests that can check your protein levels.
Dipstick urine test.
A dipstick — a thin, plastic stick with strips of chemicals
on it — is placed in the urine. The chemical strips change
color if certain substances are present or if their levels
are above typical levels. A dipstick test checks for:
-
Acidity (pH). The pH level
indicates the amount of acid in urine. The pH level
might indicate a kidney or urinary tract disorder.
-
Concentration. A measure of concentration shows
how concentrated the particles are in your urine. A
higher than normal concentration often is a result of
not drinking enough fluids.
-
Protein. Low levels of protein in urine are
typical. Small increases in protein in urine usually
aren't a cause for concern, but larger amounts might
indicate a kidney problem.
-
Sugar. The amount of sugar (glucose) in urine
is typically too low to be detected. Any detection of
sugar on this test usually calls for follow-up testing
for diabetes.
-
Ketones. As with sugar, any amount of ketones
detected in your urine could be a sign of diabetes and
requires follow-up testing.
-
Bilirubin. Bilirubin is a product of red blood
cell breakdown. Usually, bilirubin is carried in the
blood and passes into your liver, where it's removed and
becomes part of bile. Bilirubin in your urine might
indicate liver damage or disease.
-
Evidence of infection. Either nitrites or
leukocyte esterase — a product of white blood cells — in
your urine might indicate a urinary tract infection.
-
Blood. Blood in your urine requires additional
testing. It may be a sign of kidney damage, infection,
kidney or bladder stones, kidney or bladder cancer, or
blood disorders.
Urine albumin-to-creatinine ratio (UACR). This
test measures the amount of albumin and compares it to
the amount of creatinine (a normal waste product from
your muscles) in your urine. A UACR test lets the doctor
know how much albumin passes into your urine over a
24-hour period.
The results of the UACR test are expressed in milligrams of
albumin per gram of creatinine (mg/g). Interpretation of
these results can vary based on individual risk factors and
health conditions.
-
Normal Range: A ratio of less than 30 mg/g
indicates normal kidney function, with no significant
albumin in the urine.
-
Microalbuminuria: A ratio between 30-300 mg/g
suggests early kidney damage. This condition is often
reversible with proper treatment.
-
Macroalbuminuria: A ratio above 300 mg/g is a
sign of more advanced kidney damage and is typically
associated with chronic kidney disease (CKD).
Your healthcare provider may recommend follow-up testing to
confirm the diagnosis and assess kidney function over time.
Serum Creatinine
Because your kidneys remove waste, toxins, and extra
fluid from the blood, blood tests can check your kidney
function. They will show how well and how quickly your
kidneys are doing their job to remove waste.
A serum
creatinine blood test measures the amount of
creatinine in your blood. If your kidneys aren't working
well, your creatinine level goes up. Normal levels for
you will depend on your sex, age, and muscle mass.
The typical range for serum creatinine is:
- For adult men, 0.74 to 1.35 mg/dL (65.4 to 119.3 mmol/L).
- For adult women, 0.59 to 1.04 mg/dL (52.2 to 91.9 mmol/L).
Estimated
Glomerular Filtration Rate (eGFR)
The eGFR is
a blood test that measures how well your kidneys remove
waste, toxins, and extra fluid from your blood. Your
serum creatinine level, age, and sex are used to
calculate your eGFR number. Like other kidney tests, a
normal eGFR number for you will depend on your age and
sex.
If your
eGFR is low, your kidneys are likely not working
as they should. As kidney disease progresses, your eGFR
goes down. The results of your test can mean the
following:
If your
eGFR is 60
or more together with a normal urine albumin
test, you are in the normal range. But you'll still want
to talk to your doctor about when you should be checked
again.
If your
eGFR is less
than 60, it may mean you have kidney disease.
You'll want to talk to your doctor about treatment
options that are best for you.
If your
eGFR is less
than 15, it may mean your kidneys are failing.
If your results show kidney failure, you'll likely need
dialysis or a kidney transplant. If your eGFR level is
less than 20 over 6 to 12 months, your doctor may
consider a kidney transplant. Blood Urea Nitrogen (BUN)
A BUN is
a blood test that measures the amount of urea nitrogen
in your blood. Urea nitrogen is a waste product your
body makes from the breakdown of protein in the foods
you eat. Healthy kidneys filter urea nitrogen out of
your blood, which leaves your body through your urine.
This process helps keep your BUN level within a normal
range.
A normal BUN level depends on your age and other health
conditions, but usually ranges from 7 to 20. If your BUN
level is higher than normal, this may be a sign that
your kidneys aren't working well. As kidney disease
progresses, your BUN level goes up.
If your BUN levels are in the normal
range, it means your kidneys are working well. They’re
doing a good job of filtering waste from your blood. But, if
your BUN levels are not normal, it could mean your kidney
function is not good or there’s another health issue.
BUN Level |
Interpretation |
7-20 mg/dL |
Normal range, indicating healthy kidney
function |
Above 20 mg/dL |
Elevated levels, suggesting impaired kidney
function or other factors |
Below 7 mg/dL |
Low levels, potentially indicating liver
disease, malnutrition, or over hydration |
High BUN levels might mean your kidney
function is not good, you’re dehydrated, have heart
failure, or eat too much protein. Low BUN levels could point
to liver disease, not enough nutrients, or too much water.
It’s vital to talk to your doctor about your BUN
test results to figure out what’s going on and what to
do next.
Your doctor will look at your BUN
test results and other things like your medical
history, symptoms, and other test results. This helps them
understand your kidney
function and health better. Checking BUN levels
regularly can help see how your kidney
function changes over time and guide treatment.
Other Tests
Your doctor may also perform other tests to
check your kidneys. These could include
monitoring your blood pressure, running
imaging tests, or performing a kidney
biopsy. Kidney testing helps you and your
doctor determine the best treatment plan for
you.
Complications Associated with Chronic Kidney Disease
Chronic kidney disease can lead to serious complications as it
progresses. These issues affect many parts of the body. It’s important
to manage the disease well and watch for any signs of these problems.
Anemia and Bone Disease
Chronic kidney disease can cause anemia, where the body doesn’t have
enough red blood cells. This is because the kidneys make a hormone that
helps make red blood cells. When kidney function drops, anemia happens.
Symptoms include feeling tired, weak, and short of breath.
Bone disease is also common in chronic kidney disease. The kidneys
help keep bones healthy by controlling calcium and phosphorus and
activating Vitamin D. When kidney function is bad, bones can weaken,
leading to fractures and pain. This is called chronic kidney
disease-mineral and bone disorder (CKD-MBD).
Cardiovascular Disease and Fluid Retention
Cardiovascular disease is a big risk with chronic kidney disease. As
kidney function gets worse, heart disease risk goes up. This is because
of high blood pressure, fluid buildup, and inflammation. People with
chronic kidney disease are more likely to have heart attacks and
strokes.
Fluid buildup is another problem in chronic kidney disease. When kidneys
can’t remove extra fluid, it builds up in legs, ankles, and lungs. This
causes swelling and breathing trouble. It also raises blood pressure and
strains the heart.
Managing these complications is key to improving health and well-being
in chronic kidney disease patients. Treatment may include
medicines, lifestyle changes, and regular check-ups by doctors. This
helps prevent more damage and keeps quality
of life high.
CKD Treatment
The treatment of CKD varies by the stage of the disease, the
underlying causes, and other factors.
Lifestyle
Lifestyle changes are recommended at every stage of CKD to
keep you healthy and slow the progression of the disease.
These include:
-
Limiting salt intake: People with CKD and
hypertension should consume no more than 2,400
milligrams (mg) of sodium from all sources daily.
-
Limiting protein intake: Talk to your
healthcare provider about the appropriate amount of
protein for your stage of CKD and how to balance your
diet.
-
Quitting cigarettes: Cigarette smoking causes
the narrowing of arteries and veins, further restricting
blood flow to the kidneys. Smokers with diabetes also
have a harder time controlling their blood sugar, even
with insulin injections.
-
Maintaining a healthy weight: This includes
eating a balanced diet and exercising at least 150
minutes weekly. Shedding excess pounds helps lower blood
pressure and blood sugar.
Medications
Different medications may be prescribed to manage the
underlying causes and complications of CKD, including:
-
ACE (angiotensin-converting enzyme) inhibitors like
Altace (ramipril) and Vasotec (enalapril) that reduce
blood pressure
- Antidiabetic drugs like Farxiga (dapagliflozin) that
reduce blood sugar
-
Loop diuretics like Lasix (furosemide) that
treat fluid overload
-
Statin drugs like Lipitor (atorvastatin) and Zocor
(simvastatin) that lower cholesterol
-
Potassium binders like Lokelma (sodium
zirconium cyclosilicate) that treat high potassium
-
Iron supplements or erythropoietin
infections that treat anemia
-
Calcium supplements that replace lost calcium
and protect bones
Dialysis
For the small proportion of people who progress to ESRD, dialysis may
be needed to remove waste from your body when the kidneys
can no longer do so.
There are two types commonly used:
-
Hemodialysis involves a machine that removes
wastes and fluids from your blood. It is performed in a
center three times weekly, with each treatment lasting
four hours. There are also home units you can connect
yourself to four to five times weekly.
-
Peritoneal dialysis is a procedure performed at
home using the lining of the abdomen as a filter. Fluids
are manually pumped into and suctioned out of the
abdomen several times a day to remove waste. Newer
continuous cycling machines allow you to do so while you
are asleep.
Kidney Transplant
A kidney transplant is another treatment option for ESRD.
Typically, when a person with CKD has an eGFR of 20, they
are assessed to determine if they are a candidate for a
transplant and placed on a waiting list.
The kidney may come from a deceased or living donor. The
donor is "matched" so that their blood and tissue types are
compatible, minimizing the risk of organ rejection.
A transplant can be performed without dialysis if the kidney
failure is progressing slowly and the symptoms can be
controlled with diet and medications. If not, a person may
be placed on dialysis until a donor kidney is received.
Daily CKD Management
Managing CKD requires a commitment to good health. In
addition to making lifestyle changes, the National
Institutes of Health recommend that you aim for the
following goals in your daily life:
-
Control your blood pressure: The blood pressure
goal is less than 140/90 millimeters of mercury (mm Hg)
for most people. If you cannot do so with diet and
exercise, speak with your healthcare provider about ACE
inhibitors and other drugs that can help.
-
Meet your blood sugar goals: You must regularly
check your blood glucose (sugar) levels and A1C (the
average blood glucose levels over the past three
months). The A1C goal for many people with diabetes is
under 7%.
-
Build a sustainable diet: Building a healthy,
balanced diet when foods are restricted is important. To
better meet your daily nutritional needs, ask your
healthcare provider for a referral to
a dietitian certified in managing CKD.
-
Manage your stress: Depression is
common among people with CKD and can make the disease
harder to manage. If you have trouble coping, speak with
a mental health professional, connect with a support
group, or reach out to friends or family members. Avoid
drugs and alcohol, and try to get at least seven to
eight hours of sleep per night.
It is also important to stay in touch with your care team.
Your kidney specialist (nephrologist) monitors your lab
results and adjusts treatment if there are changes in your
kidney function. Let your nephrologist and care team know
about any changes in your health or treatment, including
those unrelated to your kidneys.
Can You Prevent Chronic Kidney Disease?
Diabetes and high blood pressure are the number one and two
causes of CKD, respectively. By avoiding (or properly
managing) these chronic diseases, you may reduce your risk
of CKD. This includes eating right, exercising routinely,
maintaining your ideal weight, and quitting cigarettes.
What are common causes of kidney disease?
Kidney diseases happen when your kidneys are damaged and can’t filter
your blood. With chronic kidney disease, the damage tends to happen over
the course of several years.
High blood pressure (hypertension) and diabetes are
the two most common causes of chronic kidney disease. Other causes and
conditions that affect kidney function and can cause chronic kidney
disease include:
-
Glomerulonephritis. This type of kidney disease
involves damage to the glomeruli, which are the filtering units
inside your kidneys.
-
Polycystic kidney disease. This is a genetic disorder
that causes many fluid-filled cysts to grow in your kidneys,
reducing the ability of your kidneys to function.
-
Membranous nephropathy. This is a disorder where your
body’s immune system attacks the waste-filtering membranes in your
kidney.
-
Obstructions of the urinary tract from kidney stones, an
enlarged prostate or cancer.
-
Vesicoureteral reflux. This is a condition in which pee
flows backward back up your ureters to your kidneys.
-
Nephrotic syndrome. This is a collection of symptoms
that indicate kidney damage.
-
Recurrent kidney
infection (pyelonephritis).
-
Diabetes-related nephropathy. This is damage or
dysfunction of one or more nerves, caused by diabetes.
-
Lupus and other immune system diseases that cause kidney
problems, including polyarteritis
nodosa, sarcoidosis, Goodpasture
syndrome and Henoch-Schönlein
purpura.
Is kidney disease hereditary?
Yes, kidney disease can run in biological families. Risk factors for
CKD, like diabetes, also tend to run in families.
Risk Factors
CKD is common in people with diabetes. Approximately 1
in 3 adults with diabetes has CKD.
Each kidney is made up of millions of tiny filters
called nephrons. High blood sugar from diabetes can
damage blood vessels in the kidneys and nephrons so they
don't work well.
Approximately 1 in 5 adults with high blood pressure has
CKD. High blood pressure can make blood vessels
narrower, reducing blood flow. Over time, blood vessels
throughout the body weaken, including in the kidneys.
Damaged blood vessels in the kidneys may no longer work
properly. When this happens, the kidneys can't remove
all wastes and extra fluid from your body. Extra fluid
can raise your blood pressure even more.
Research shows a link between kidney disease and heart
disease. People with heart disease are at higher risk for
kidney disease, and people with kidney disease are at higher
risk for heart disease. Researchers are working to better
understand the relationship between kidney disease and heart
disease.
Family history of CKD
If your mother, father, sister, or brother has kidney
failure, you are at risk for CKD. Kidney disease tends to
run in families. If you have kidney disease, encourage
family members to get tested. Use tips from the family
health reunion guide and speak with your family during
special gatherings.
Having overweight or
obesity raises your risk for high
blood pressure and diabetes, the two biggest causes of
CKD. This means that having overweight or
obesity puts
you at greater risk for CKD.
Living with Chronic Kidney Disease
Living with chronic kidney disease is tough, but many find strength in
sharing their stories. They connect with others who get what they’re
going through. By focusing on quality
of life, they find ways to deal with the ups and downs.
Many find that healthy coping
mechanisms improve their well-being. These include mindfulness,
counseling, and support from loved ones.
Here are some strategies that help:
Coping Strategy |
Benefits |
Joining a support group |
Provides a sense of community and shared understanding |
Engaging in hobbies and activities |
Promotes a sense of purpose and enjoyment |
Practicing mindfulness and relaxation techniques |
Reduces stress and anxiety related
to the condition |
Seeking professional counseling |
Helps process emotions and develop healthy coping strategies |
Patients with chronic kidney disease share hope and valuable insights.
They show that a fulfilling life is possible despite the challenges. By
using effective coping
mechanisms and focusing on quality
of life, they inspire others.
Medicare Costs
In 2019, treatment for Medicare beneficiaries with
CKD cost $87.2 billion, and treatment for people
with ESKD cost an additional $37.3 billion.
Costs can be reduced by preventing:
Who is part of my health care team?
The following health care providers may be part of the health care team
involved in your treatment:
Primary care provider. Your
primary care provider (PCP)—doctor, nurse practitioner, or physician
assistant—is the person you see for routine medical visits. Your PCP may
monitor your kidney health and help you manage your diabetes and high
blood pressure. A PCP also prescribes medicines and may refer you to
specialists.
Nurse. A nurse may help
with your treatment and teach you about monitoring and treating kidney
disease, as well as managing your health conditions. Some nurses
specialize in kidney disease.
Registered dietitian. A
registered dietitian is a food and nutrition expert who helps people
create a healthy eating plan when they have a health condition such as
kidney disease. Dietitians can help you by creating an eating plan based
on how your kidneys are doing. “Renal dietitians” often work in dialysis centers
and are specially trained to work with people with kidney failure.
Diabetes educator. A
diabetes educator teaches people with diabetes how to manage their
disease and handle diabetes-related problems.
Pharmacist. A pharmacist
educates you about your medicines and fills your prescriptions. An
important job for the pharmacist is to review all of your medicines,
including over-the-counter (OTC) medicines, and supplements, to avoid
unsafe combinations and side effects.
Social worker. When you
are close to needing dialysis, you may have a chance to meet with a
social worker. A dialysis social worker helps people and their families
deal with the life changes and costs that come with having kidney
disease and kidney failure. A dialysis social worker also can help
people with kidney failure apply for help to cover treatment costs.
Nephrologist. A
nephrologist is a doctor who is a kidney specialist. Your PCP may refer
you to a nephrologist if you have a complicated case of kidney disease,
your kidney disease is quickly getting worse, or your kidney disease is
advanced.
Resources and Support for Those Affected by CKD
Living with chronic kidney disease can be tough, but you’re not alone.
Many patient
organizations offer support and community for those with kidney
disease and their families. They provide educational
resources to help you understand your condition and treatment
options.
There’s also emotional and practical help available. Organizations
offer financial
assistance for treatment costs like medications and dialysis. Don’t
be afraid to look for the help you need.
Knowledge is key in managing chronic kidney disease. Use educational
resources like brochures and online communities to stay informed.
Connecting with others and getting the support you need can improve your
life and help you face challenges with confidence.
Outlook
The prognosis (outlook) of acute kidney injury is generally
good if treated appropriately. In some cases, AKI may be a
one-off event without impacting your long-term health or
life expectancy.
The prognosis of chronic kidney disease can vary by the
individual. With that said, most people with CKD do not
progress to ESRD because symptoms tend to develop in later
life and can usually be managed with medications and diet.
The most common cause of death in people with CKD is heart
disease rather than kidney failure.
The risk of death is largely influenced by the stage of CKD.
According to a 2017 study in Pediatric
Nephrology, a 30-year-old male with an eGFR of 60 and
over can expect to live to 79, while a counterpart with an
eGFR under 15 may only live to 45.
Prognosis for End-Stage Renal Failure
For those who progress to ESRD, dialysis and kidney
transplantation are the only options for survival. If
neither is pursued, death usually occurs within several days
or weeks.
Those pursuing dialysis have a far better outlook, with an
average life expectancy of five to 10 years.
Success rates for kidney transplants are equally optimistic,
with 78.2% of those who received a kidney from a deceased
donor living for at least five years. Around 88.1% of those
who received a kidney from a living donor surviving for a
least five years.
Even recipients in their 60s can expect to live anywhere
from 11 to 15 years after a transplant.
FAQ's
Q: What is chronic kidney disease?
A: Chronic kidney disease (CKD) is a condition where the
kidneys slowly lose function. It happens when the kidneys
can’t filter waste and extra fluids from the blood well.
This leads to a buildup of these substances in the body.
Q: What are the stages of chronic kidney disease?
A: CKD has five stages, based on the glomerular
filtration rate (GFR). Stage 1 is the least severe, with
a GFR of 90 or more. Stage 5 is the most severe, with a GFR
below 15, indicating end-stage
renal disease.
Q: What are the main causes of chronic kidney disease?
A: The main causes of CKD are diabetes and hypertension.
Other factors include genetics, family history, and
conditions like proteinuria.
Q: What are the common symptoms of chronic kidney disease?
A: Symptoms of CKD include fatigue,
swelling in the legs and feet, changes in urination, and anemia.
These symptoms often appear in later stages of the disease.
Q: How is chronic kidney disease diagnosed?
A: CKD is diagnosed through blood and urine tests. These
tests measure the glomerular
filtration rate and creatinine levels.
Imaging tests and kidney biopsy may also be used to find the
cause of kidney damage.
Q: What are the treatment options for chronic kidney
disease?
A: Treatments for CKD include lifestyle changes,
medications, dialysis,
and kidney
transplantation. The goal is to manage symptoms, slow
disease progression, and replace lost kidney function.
Q: How can diet help manage chronic kidney disease?
A: A low-protein
diet, sodium
restriction, and phosphorus
control can help manage CKD. These dietary
changes support kidney health and slow disease
progression. Q: What advances are being made in chronic kidney disease
research and treatment?
A: Advances in CKD research and treatment include stem
cell therapy, regenerative
medicine, and artificial kidneys. These developments
offer hope for better management and treatment of the
condition in the future.
Q: How do you know if your kidneys are struggling?
A: You may not know your kidneys are struggling. Most people don’t have
symptoms of kidney disease in the early stages. That’s why it’s
important to attend annual wellness exams with your primary care
provider to manage chronic conditions like diabetes or high blood
pressure that can lead to kidney disease.
Q: What foods are bad for kidneys?
A: In people with healthy kidneys, there aren’t necessarily bad foods or
foods that hurt your kidneys. But, if you have CKD, your healthcare
provider may recommend a kidney-friendly diet. Elements of a
kidney-friendly diet may include:
-
Avoiding foods that are high in salt. This also helps
control blood pressure.
-
Eating the right amount of protein. Protein creates more
waste than other food groups. So, since your kidneys remove waste,
lowering protein can help preserve their function.
-
Eating heart-healthy
foods.
-
Eating foods low in phosphorus. This includes fresh fruits
and vegetables and whole grains. Foods like dairy and beans are high
in phosphorus.
-
Avoiding foods high in potassium like bananas, oranges and
potatoes.
Since following a kidney-friendly diet is hard to understand and to do,
it’s always a good idea to consult a dietitian as part of your treatment
plan. They can help make sure you’re eating the right types of food if
you have chronic kidney disease.
Q: What color is urine when your kidneys are failing?
A: Your pee shouldn’t change color, but may be foamy or frothy, which means
there’s excess protein in your pee. Excess protein means your kidneys
aren’t filtering toxins from your body.
Q: Will my kidneys get better?
A: Kidney disease is often “progressive”, which means it gets worse over
time. The damage to your kidneys causes scars and is permanent.
You can take steps
to protect your kidneys, such as managing your blood pressure and
your blood glucose, if you have diabetes.
Q: What happens if my kidneys fail?
A: Kidney failure means that your kidneys have lost most of their ability
to function—less than 15 percent of normal kidney function. If you have
kidney failure, you will need treatment to maintain your health.
One Final Note..
A CKD diagnosis can make a profound impact on your life. Treatment for
the condition is lifelong, and it takes time and patience. Don’t be
afraid to ask your healthcare providers any questions you have. Try to
take comfort in the fact that managing kidney disease is possible. In
fact, many people live many years with kidney disease. Lean on your
family members or friends to help you cope. There are also online and
in-person support groups available to help people with CKD connect with
each other. Seek support from those who love you, so that together, you
can work through treatment for CKD.
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