Kidney Disease
Kidney disease refers to any condition that impairs the kidneys' ability to filter waste from the blood. It often develops silently over years before causing symptoms.
Table of Contents
Quick Facts
- Type: Renal disease
- ICD-10: N00–N29
- Top causes: Diabetes, hypertension
- Often silent: Until advanced
Overview
Kidney disease (also called renal disease) covers a wide range of disorders that damage the kidneys or reduce their ability to filter blood. It can be acute (developing quickly, often reversible) or chronic (gradual, irreversible damage over months to years).
Types
- Acute kidney injury — sudden loss of kidney function, often from dehydration, medications, or severe illness.
- Chronic kidney disease (CKD) — gradual decline; staged 1–5 by GFR.
- Polycystic kidney disease — inherited; cysts replace kidney tissue.
- Glomerular disease — damage to the kidney's filtering units.
- Kidney stones — mineral deposits causing pain and blockages.
Symptoms
Early kidney disease is often silent. As function declines, symptoms may include:
- Swelling in legs, ankles, or around the eyes
- Fatigue
- Trouble concentrating
- Changes in urination (more or less, foamy, bloody)
- Persistent itching
- Nausea, loss of appetite
- Muscle cramps
- Trouble sleeping
- High blood pressure
- Shortness of breath
Causes
- Diabetes (leading cause)
- High blood pressure
- Glomerulonephritis
- Polycystic kidney disease (inherited)
- Long-term obstruction (kidney stones, enlarged prostate)
- Recurrent kidney infections
- Medications (long-term NSAIDs, certain antibiotics)
- Autoimmune diseases (e.g., lupus)
Diagnosis
- Blood tests — creatinine, estimated GFR, BUN, electrolytes
- Urine tests — protein, blood, microscopy
- Imaging — kidney ultrasound, CT, MRI
- Kidney biopsy in selected cases
Treatment
Slow progression
- Control blood pressure (typically <130/80 mmHg)
- Tightly manage diabetes
- ACE inhibitors or ARBs to protect the kidneys
- SGLT2 inhibitors for many patients with CKD
- Cholesterol management
- Avoid NSAIDs and nephrotoxic medications when possible
Manage complications
- Anemia (iron, erythropoiesis-stimulating agents)
- Bone and mineral disorders
- Acidosis
- Volume overload
Advanced disease
- Dialysis (hemodialysis or peritoneal)
- Kidney transplant
Prevention
- Maintain healthy blood pressure and blood sugar
- Stay hydrated
- Limit NSAID use
- Don't smoke
- Maintain a healthy weight
- Screen if you have diabetes or hypertension
When to See a Doctor
See a doctor for changes in urination, persistent swelling, or unexplained fatigue. Seek urgent care for severe symptoms — confusion, severe chest discomfort, or sudden inability to urinate.
Frequently Asked Questions
Acute kidney injury is often reversible. Chronic kidney disease is generally not reversible, but progression can be slowed considerably with proper treatment.
Most people with CKD never need dialysis. It becomes necessary only when kidney function falls below about 10–15% of normal (Stage 5 CKD).
Glomerular filtration rate (GFR) estimates how well your kidneys are filtering. Below 60 ml/min/1.73 m² for 3+ months meets criteria for chronic kidney disease.
Staying adequately hydrated supports kidney health, but excessive water intake doesn't 'detox' the kidneys and can actually be harmful in advanced disease.
References
- National Kidney Foundation. Kidney Disease Information.
- KDIGO Guidelines. Clinical Practice Guideline for the Evaluation and Management of CKD.