Kidney Health

Kidney Health: Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD) means the kidneys become damaged over time and can’t do important jobs like removing waste and helping keep blood pressure in a healthy range. At Kidney Konnect, our mission is to make kidney health information easier to understand—so you can spot risk early, get the right tests, and feel supported in what comes next.

What your kidneys do

Your kidneys help keep your whole body in balance by removing natural waste and extra water, helping make red blood cells, balancing key minerals, helping maintain blood pressure, and supporting bone health. When kidney function declines, it can also raise the risk for other serious health problems, including heart disease and stroke.

About CKD (and why it’s often missed)

CKD is defined by kidney damage lasting at least three months, and it often develops slowly with few or no symptoms at first. Because CKD can be “quiet” early on, it’s commonly described and managed in stages (five stages) to guide treatment decisions and next steps.

Signs and symptoms

Many people living with CKD don’t notice symptoms until later stages and/or when complications develop. If symptoms occur, they can include foamy urine, urinating more often or less often than usual, itchy and/or dry skin, feeling tired, nausea, loss of appetite, and weight loss without trying.

With more advanced CKD, some people may also notice trouble concentrating, numbness or swelling in the arms/legs/ankles/feet, achy muscles or cramping, shortness of breath, vomiting, trouble sleeping, or breath that smells like ammonia (sometimes described as urine-like or “fishy”). If anything here sounds familiar, it doesn’t automatically mean CKD—but it does mean it’s worth getting checked and talking with a healthcare professional.

Causes and risk factors

Anyone can develop CKD at any age, but some people have a higher risk than others. The most common CKD risk factors include diabetes, high blood pressure (hypertension), heart disease and/or heart failure, obesity, being over age 60, family history of CKD or kidney failure, personal history of acute kidney injury (AKI), and smoking or using tobacco products.

For many people, CKD isn’t caused by one single reason—often it’s shaped by multiple physical, environmental, and social factors, and early detection matters because noticeable symptoms may not appear at first. Other possible causes include glomerular diseases (such as glomerulonephritis, IgA nephropathy, and HIV nephropathy), inherited conditions like polycystic kidney disease, autoimmune conditions like lupus (lupus nephritis), severe infections such as sepsis or hemolytic uremic syndrome (HUS), and other conditions like kidney cancer, kidney stones, repeated untreated or long-lasting UTIs, hydronephrosis, or kidney/urinary tract abnormalities present before birth.

Complications (what CKD can lead to)

As CKD worsens, the risk of complications increases. Some examples include cardiovascular disease (heart disease and/or stroke), high blood pressure, anemia (low red blood cell levels), metabolic acidosis (too much acid buildup in the blood), mineral and bone disorder (calcium and phosphorus imbalance that can affect bones and/or the heart), hyperkalemia (high potassium), and kidney failure.

It’s also important to know the connection can go both ways: conditions like high blood pressure and cardiovascular disease can cause or worsen CKD, and CKD can raise risk for them too.

Diagnosis: two key tests

Checking for CKD is typically done with two simple tests—both are needed for a clearer picture of kidney health. These tests are:

A blood test called estimated glomerular filtration rate (eGFR).
A urine test called urine albumin-creatinine ratio (uACR).

In general, having an eGFR under 60 and/or a uACR over 30 for three months or more can be a sign of kidney disease. Your care team may order additional tests (such as imaging or, in some cases, a kidney biopsy) to better understand what’s happening and what kind of support you need.

Treatment: what “management” usually focuses on

CKD care is usually centered on four goals: managing the condition(s) most likely causing CKD (like diabetes or high blood pressure), taking steps to slow CKD progression, lowering cardiovascular risk (heart attack/stroke), and treating any complications related to CKD. Treatment plans depend on your stage of CKD and any other conditions you’re managing, so your plan should be personalized—not one-size-fits-all.

Medications (as appropriate for you)

A healthcare professional may prescribe medicines to help slow CKD progression, such as an ACE inhibitor/ARB, an SGLT2 inhibitor, and/or a non-steroidal mineralocorticoid receptor antagonist (nsMRA). Some people with CKD may also be prescribed a statin (cholesterol medicine), especially if they have diabetes, a history of heart disease, or are age 50 or older, because statins can help lower heart attack or stroke risk even if cholesterol isn’t high.

You may also need other medications or supplements to manage complications if they arise. Kidney Konnect encourages you to ask what each medication is for, how it supports kidney or heart health, and what side effects to watch for.

Nutrition: kidney-friendly foundations

Nutrition is a powerful tool in kidney health, and it works best when it’s based on your labs and your whole health picture. One of the most important general recommendations is sodium (salt): many people with CKD are advised to limit sodium intake to less than 2300 mg per day (about 1 teaspoon of salt from all foods and drinks), and some people may be advised to aim even lower depending on other conditions like high blood pressure.

Because sodium can be surprisingly high in packaged or restaurant foods (even when food doesn’t taste salty), label-reading becomes a real kidney-health skill. Based on blood test results, your clinician or kidney dietitian may also recommend adjusting potassium, phosphorus, and/or calcium in your diet.

Meeting with a dietitian can be especially helpful if you’re also managing high blood pressure, diabetes, or heart failure, because it can feel overwhelming to track multiple goals at once—and a dietitian can help build a plan that fits your daily life.

Lifestyle support (small steps add up)

Healthy lifestyle choices can support your kidneys and your heart. Recommendations commonly include stopping smoking/tobacco use, exercising regularly (starting slowly—short walks count), aiming for good sleep, working toward a healthier weight if needed, and finding practical ways to reduce and manage stress.

Managing related conditions like high blood pressure, diabetes, and high cholesterol is also a key part of lowering risk and protecting kidney function.

Medicine safety (important!)

People with CKD are commonly advised to avoid certain pain medicines called NSAIDs, because they can be harmful to kidneys—especially at higher doses and/or with long-term use. Examples include ibuprofen, indomethacin, naproxen, diclofenac (tablets/capsules), celecoxib, meloxicam, and aspirin when the dose is more than 325 mg/day.

Some NSAIDs are sold over the counter and can be mixed into other products (including some cough/cold medicines), so it’s important to read labels and ask a healthcare professional if you’re unsure. The reference notes that acetaminophen (Tylenol) is generally considered safe for kidneys at recommended doses, but you should still check with your healthcare professional to confirm what’s best for your situation and to identify the cause of pain.

If you’ve been told you have metabolic acidosis, increasing fruits and vegetables may help lower acid levels in the blood and may help slow CKD progression—again, this should be individualized based on your labs and care plan.

Preparing for your appointment

You deserve clear answers and a plan you can act on. The following questions can help you get the most out of your next visit:

What are my eGFR and uACR numbers, and what stage of CKD am I in?
How high is my risk for heart disease or stroke, and what can I do to lower it?
When should I have my eGFR and uACR tested again?
Am I at a healthy weight for my overall health goals?
Is my blood pressure within the recommended goal range?
Do I have diabetes or prediabetes, and is my A1C within the recommended goal range?
Do I have albuminuria?
Are there any changes I should make to my diet (sodium, potassium, phosphorus, calcium)?
Should I take any medication(s) to help lower my risk for CKD getting worse?