Chronic Kidney Disease

The kidneys are the blood's filter, removing waste and extra fluid from the body. They also help make red blood cells, vitamin D, and hormones that control blood pressure. Chronic kidney disease (CKD) damages your kidneys and causes reduced kidney function.

When your kidneys don’t work as well as they should to filter and clean your blood, many aspects of your health can be affected. CKD is a chronic illness, which means it gets worse over time and is usually a lifelong condition. About 37 million American adults have CKD.

UPMC experts provide world-class care for people with CKD, offering the latest treatment options that slow the progression of the disease, protect your kidneys, and reduce your risk of complications.

On this page

• What Is CKD?
• What Are the Symptoms of CKD?
• How Do You Diagnose CKD?
• How Do You Treat CKD?

What Is CKD?

Chronic kidney disease (CKD) damages your kidneys and causes reduced kidney function. When your kidneys don’t work as well as they should to filter and clean your blood, it can impact many aspects of your health. CKD is a chronic illness, which means it gets worse over time and is usually a lifelong condition.

What are the stages of CKD? 

The five stages of CKD are based on how well your kidneys are working. Your doctor will use the results of a blood test called the glomerular filtration rate (GFR) to determine the stage of your kidney disease. Your GFR should be reduced for at least three months before it can be classified as chronic kidney disease.

Stages of CKD include:

• Stage 1 — Normal GFR results of 90 mL/min or more, but kidneys have some damage indicated by either protein or blood in the urine or abnormal imaging findings.
• Stage 2 — Mild loss of kidney function, with GFR results of 60-89 mL/min.
• Stage 3a — Mild to moderate loss of kidney function, with GFR results of 45-59 mL/min.
• Stage 3b — Moderate to severe loss of kidney function, with GFR results of 30-44 mL/min.
• Stage 4 — Severe loss of kidney function, with GFR results of 16-29 mL/min.
• Stage 5 — End-stage kidney disease, with GFR results of 15 mL/min.

What causes CKD?

Other illnesses or health conditions often cause CKD.

High blood pressure and diabetes are two of the most common causes of CKD, leading to two-thirds of cases. Injury to the kidneys — also called acute kidney injury (AKI) — can also cause CKD.

Other causes of CKD include:

• Blockages in your urinary tract — Kidney stones, chronic  urinary tract infections, or an enlarged prostate in men can prevent urine from exiting your body and cause kidney damage.
• Diabetes.
• Drugs — Overuse of medications or recreational drugs can harm your kidneys.
• Glomerulonephritis — Causes inflammation of the filtering part of your kidneys.
• Hypertension (high blood pressure).
• Malformed kidneys — Kidneys that have an abnormal shape or size or do not work normally from birth.
• Polycystic kidney disease — A genetic condition that causes cysts to grow in your kidneys.
• Systemic lupus erythematosus — An immune system disorder that can attack your kidneys.

What are CKD risk factors and complications?

CKD risk factors

CKD can affect anyone.

However, the risk is higher for:

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

Complications of CKD

As CKD progresses, it can cause complications, including:

• End-stage kidney disease.
• High blood pressure, leading to heart disease or stroke.
• Other health problems, such as anemia or bone disease.

How can I prevent CKD?

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 further reduce your risk of CKD, you can:

• Control chronic conditions — See a doctor for regular care if you have diabetes or high blood pressure.
• Eat healthy — Eat a healthy diet with lots of fruits and vegetables. They're high in potassium, which promotes healthy blood pressure. Limiting salt from shakers and processed foods also helps reduce blood pressure.
• Exercise — Aim for at least 30 minutes of moderate-intensity physical activity most days of the week.
• Get preventive care — Check your blood pressure and blood sugar (glucose) routinely.
• Keep track of medications — Inform your doctor if you routinely take over-the-counter drugs or herbal supplements and avoid or limit the use of NSAID medications (e.g., ibuprofen, naproxen).
• Manage stress — Take steps to manage stress and get at least seven to eight hours of sleep each night.
• Reduce alcohol intake — Limit alcohol to one drink a day for women and two drinks per day for men.
• Stop smoking — Quit smoking if you smoke cigarettes or marijuana.

How common is CKD?

According to the U.S. Centers for Disease Control and Prevention, 35.5 million American adults — or about 1 in 7 people — have CKD. It is more common in adults over 65, and many people do not know they have it.

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What Are the Signs and Symptoms of CKD?

Early-stage CKD often has no symptoms, and most people don’t realize they have it.

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

• Feel extremely tired.
• Have headaches or problems concentrating.
• Have trouble sleeping.
• Have a change in urination, either peeing more often or less often.
• Have swollen feet or ankles.
• Have dry, itchy skin.
• Have severe, unexplained weight loss.
• Lose your appetite or feel nauseous.

When should I see a doctor about my CKD symptoms?

If you catch CKD early, you can manage it with lifestyle changes — such as a new diet — and medicine, if needed. You may also be able to slow the progression of the disease, protect your kidneys, and reduce your risk of related complications.

If you have symptoms of CKD, speak with your primary care doctor. They may order tests to diagnose your condition or refer you to a kidney specialist called a nephrologist.

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How Do You Diagnose CKD?

Your doctor will perform a physical exam, talk to you about your health history, and order blood and urine tests to diagnose CKD. 

What to expect during your visit

During your visit, your doctor will:

• Ask about any medications you’re taking.
• Ask about recent activities, such as travel, injuries, or recreational drug use.
• Order blood or urine tests.
• Perform a physical exam.
• Review your health history.

Tests to diagnose CKD

Your doctor may order blood or urine tests to diagnose CKD. Blood tests include:

• Blood urea nitrogen (BUN) — Shows how well your kidneys are filtering urea nitrogen, a waste product, from your blood.
• Electrolyte and other tests — Checks for imbalances in electrolyte and mineral levels in your body, such as sodium, potassium, and bicarbonate.
• Estimated glomerular filtration rate (eGFR) — Shows how efficiently your kidneys are functioning based on your age, creatinine level, and sex.
• Serum (blood) creatinine — Shows how well your kidneys are filtering creatinine, a waste product, from your blood.

Urine tests include:

• Urinalysis — Looks for abnormalities in your urine, such as blood or a protein called albumin that shows up when your kidneys aren’t working well.
• Urine output — Tracks how much urine your body produces each day.

Other less common tests include:

• CT scan — A test that creates images of the organs, bones, and tissues in your body.
• Kidney biopsy — A procedure that involves taking small pieces of kidney tissue for examination under a microscope to check for signs of disease.
• Ultrasound — Uses sound waves to create images of your organs to check for problems.

What happens after you are diagnosed with CKD?

After you receive a CKD diagnosis, your doctor will refer you to a kidney specialist called a nephrologist if you aren’t already seeing one. Your nephrologist will work with you to develop a treatment plan based on the stage of your CKD and your lifestyle, treatment goals, and preferences.

You will have routine follow-up visits with your nephrologist, who will monitor your condition and adjust your treatment plan if needed.

CKD prognosis

CKD is a chronic illness that gets worse over time. Although there is no cure for CKD, early diagnosis and treatment may help slow the progression of the disease, protect your kidneys, and reduce your risk of complications. 

Can you live a long life with CKD?

Your age, overall health, and treatment outcomes all play a role in your prognosis. Some people with CKD respond well to medical treatments and may never enter end-stage kidney disease. Your doctor will keep you informed about your condition and prognosis.

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How Do You Treat CKD?

There is no cure for CKD.

However, the goals of treatment are to:

• Help you manage symptoms and maintain an optimal quality of life.
• Protect your kidneys.
• Slow the progression of the disease.

Your CKD treatments may change over time as your condition progresses, but treatments will be lifelong.

Treatment options include:

Lifestyle changes

Lifestyle changes may help slow the progression of CKD. Your CKD care team will provide detailed guidance on how to change your diet and lifestyle.

Your doctor may recommend:

• Improving your diet and exercise routines to help you achieve a healthier weight, reduce your blood pressure, and lower your blood sugar. A low-sodium diet is essential.
• Restricting certain nutrients in your diet, such as protein, phosphorus, or potassium. That's because your kidneys may not filter excess amounts of those nutrients from your blood. They can build up to dangerous levels in your body without proper filtering.
• Quitting smoking, limit alcohol use, and reduce stress.

Your doctor may refer you to other medical specialists, such as a registered dietitian or a cardiologist, to help you manage your condition.

Medicine to treat CKD

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

Your doctor may prescribe medications such as:

• Blood pressure drugs to reduce your risk of kidney failure.
• Diabetes drugs to lower your blood sugar.
• Diuretics to regulate fluid levels in your body.

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

Dialysis for CKD

End-stage kidney disease — which is defined as having less than 15% of your normal kidney function — can cause toxic waste to build up in your body. You may need to have dialysis, also called renal replacement therapy, to filter and clean your blood.

What happens during dialysis?

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

There are two common types of dialysis:

• Hemodialysis — Performed using a machine at a dialysis clinic or home three times a week for about four hours.
• Peritoneal dialysis — Performed through a catheter in your abdomen at home.

How effective is dialysis for CKD?

If you have end-stage kidney disease, dialysis is a lifesaving treatment option. Without it, toxins and fluid would build up in your body and cause death within days or weeks.

However, 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.
• Enhance your quality of life.
• Provide short-term treatment as you get ready for kidney transplant.

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 UPMC kidney transplant experts to provide care before, during, and after transplant.

How effective is treatment? 

The effectiveness of CKD treatment depends on the cause of your condition, the extent of kidney damage, and how quickly it progresses. Some people with CKD respond well to medical treatments and may never enter end-stage kidney disease.

How long does it take to recover after treatment for CKD?

There is no cure for CKD and after you are diagnosed, treatment will be lifelong.

Why choose UPMC for CKD care?

When you choose UPMC for CKD care, you will receive:

• Access to world-class nephrology expertise — Our world-renowned experts treat the full spectrum of kidney diseases using the latest diagnostic and treatment techniques.
• A full range of treatment options — We'll work with you to develop a treatment plan that slows the progression of your disease as much as possible and improves your quality of life.
• Multidisciplinary care — We partner with special dialysis clinics, experts in supportive care, and kidney transplant surgeons to ensure you receive complete care.

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By UPMC Editorial Staff. Last reviewed on 2025-04-24 by Cary Shiwarski, MD, PhD.