What is chronic kidney disease?

Chronic kidney disease means your kidneys have not worked right for a while.

Your kidneys have an important job. They remove waste and extra fluid from your blood. This waste and fluid goes out of your body in your urine.

When your kidneys don't work as they should, wastes build up in your blood. This makes you sick.

High blood pressure and diabetes can cause kidney damage. Other causes include kidney infections and some medicines.

Chronic kidney disease is also called chronic renal failure. Or it may be called chronic renal insufficiency.

How is chronic kidney disease diagnosed?

• Your doctor will do blood and urine tests to check your kidney function. This will help your doctor see how well your kidneys filter your blood.
• Your doctor will ask you about past kidney problems. He or she will ask if you have a family history of kidney disease. Your doctor will also want to know what medicines you take. This includes prescription and over-the-counter medicines.
• You may have a test, such as an ultrasound or CT scan. These tests let your doctor look at a picture of your kidneys. This can help your doctor measure the size of your kidneys and see if anything is blocking your urine flow.
• In some cases, your doctor may take a tiny sample of kidney tissue. This is called a biopsy. It helps the doctor find out what caused the kidney disease.

What are the symptoms?

You may not have symptoms if your disease is mild. If you lose more kidney function, you may:

• Have swelling and weight gain. This is from the extra fluid in your tissues. It is called edema (say "ih-DEE-muh").
• Often feel sick to your stomach (nauseated) or vomit.
• Have trouble sleeping.
• Urinate less than normal.
• Have trouble thinking clearly.
• Feel very tired.

What can you expect when you have chronic kidney disease?

• In the early stages of the disease, your kidneys are still able to regulate the fluids, salts, and waste products in your body. But if you keep losing kidney function, you may start to have problems, or complications.
• How long it takes for the kidney disease to get worse depends on your condition. Sometimes it gets worse very slowly over many years. Or it may get worse more quickly.
• When kidney function falls below a certain point, it is called kidney failure. Kidney failure affects your whole body. It can cause serious heart, bone, and brain problems and make you feel very ill. Untreated kidney failure can cause death.

How is it treated?

Manage your health problems

• If you have diabetes, it's important to control your blood sugar level with diet, exercise, and medicines. If your blood sugar level is too high for too long, it can damage your kidneys.
• If you have high blood pressure, it's important to control it with diet, exercise, and any medicines your doctor prescribes.
• Avoid long-term use of medicines that can damage the kidneys. These medicines include non-steroidal anti-inflammatory drugs. Examples of these are ibuprofen (Advil) and celecoxib (Celebrex).

Treat kidney complications

• If your doctor put you on a special diet, stay on the diet.
• If you have kidney failure, you'll probably have two treatment choices. Your doctor may recommend that you start kidney dialysis to filter wastes and extra fluid from your blood. Or it may be better to get a new kidney (transplant). Both treatments have risks and benefits. Talk with your doctor to decide which is best for you.

Practise healthy habits

• If your doctor recommends it, get more exercise. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 2½ hours a week.
• Don't smoke. Smoking can make chronic kidney disease worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Don't drink alcohol.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.