Kidney disease means your kidneys aren’t working properly and are beginning to lose their function. Chronic kidney disease (CKD) worsens over time. High blood pressure and diabetes are two common causes of CKD. There’s no cure for CKD, but you can take steps to preserve function for as long as possible. Late-stage kidney disease requires dialysis or a kidney transplant.
Chronic kidney disease (CKD and chronic renal disease) means that there’s damage to your kidneys and they aren’t working as well as they should. Your kidneys are like a filter in your body — filtering out wastes, toxins and extra water from your blood. They also help with other functions like bone and red blood cell health. When your kidneys begin to lose their function, they can’t filter waste, which means the waste builds up in your blood.
Kidney disease is called “chronic” because kidney function slowly decreases over time. CKD can lead to kidney failure, which is also called end-stage kidney disease. Not everyone with CKD will develop kidney failure, but the disease will often worsen without treatment. There’s no cure for chronic kidney disease. But there are steps you can take to slow kidney damage. Treatments like dialysis and transplantation are options for kidney failure (end-stage kidney disease).
You have two kidneys. They’re bean-shaped organs that are located toward your back, on either side of your spine, just underneath your rib cage. Each kidney is about the size of your fist.
Your kidneys have many jobs, but their main job is to clean your blood, getting rid of toxins, waste and excess water as urine (pee). Your kidneys also balance the amount of electrolytes (such as salt and potassium) and minerals in your body, make hormones that control blood pressure, make red blood cells and keep your bones strong. If your kidneys are damaged and don’t work as they should, wastes can build up in your blood and make you sick.
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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 (GFR). Your GFR is a number based on the amount of creatinine, a waste product, found in your blood.
|Stage||GFR (mL/min)||What It Means|
|Stage 1||90 and higher||Your kidneys are working well but you have signs of mild kidney damage.|
|Stage 2||60 to 89||Your kidneys are working well but you have more signs of mild kidney damage.|
|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.|
|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.|
|Stage 4||15 to 29||You have very poor kidney function; your kidneys are severely damaged and close to not working.|
|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.|
|90 and higher|
|What It Means|
|Your kidneys are working well but you have signs of mild kidney damage.|
|60 to 89|
|What It Means|
|Your kidneys are working well but you have more signs of mild kidney damage.|
|45 to 59|
|What It Means|
|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.|
|30 to 44|
|What It Means|
|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.|
|15 to 29|
|What It Means|
|You have very poor kidney function; your kidneys are severely damaged and close to not working.|
|Less than 15|
|What It Means|
|Your kidneys are very close to failing or have stopped working. You may need kidney dialysis or a kidney transplant at this stage.|
About 15% of adults in the United States have chronic kidney disease. Some 37 million people in the U.S. are living with chronic kidney disease.
In the early stages of kidney disease, you usually don’t have noticeable symptoms. As the disease worsens, symptoms may include:
Keep in mind that it can take years for waste to build up in your blood and cause symptoms.
You typically don’t have any signs of kidney disease, especially in its early stages. Once you begin having symptoms, the first sign something is wrong may involve swelling in your hands and feet, itchy skin or needing to pee more often. Since symptoms vary, it’s best to call your healthcare provider if you believe there’s something wrong.
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:
Yes, kidney disease can run in biological families. Risk factors for CKD, like diabetes, also tend to run in families.
Anyone can get chronic kidney disease. You’re more at risk for chronic kidney disease if you:
Some of the complications of chronic kidney disease include:
First, your healthcare provider will take your medical history, conduct a physical exam, ask about any medications you’re currently taking and ask about any symptoms you’ve noticed.
Your healthcare provider will order blood and urine tests to check kidney function.
Specifically, the blood tests will check:
Urine tests will look for protein (albumin) and blood in your pee. Well-functioning kidneys shouldn’t contain either.
Other tests may include imaging tests to look for problems with the size and structure of your kidneys — such as ultrasound, magnetic resonance imaging (MRI) and/or computerized tomography (CT) scans. Your healthcare provider may also order a kidney biopsy to check for a specific type of kidney disease or to determine the amount of kidney damage.
There’s no cure for chronic kidney disease (CKD), but steps can be taken to preserve your kidney function so they work as long as possible. If you have reduced kidney function:
Depending on the cause of your kidney disease, you may be prescribed one or more medications. Medications your nephrologist may prescribe include:
Because there’s no cure for CKD, if you’re in end-stage kidney disease, you and your healthcare team must consider additional options. Complete kidney failure will result in death if it’s left untreated. Options for end-stage kidney disease include dialysis and kidney transplantation.
Dialysis is a procedure that uses machines to remove waste products from your body when your kidneys are no longer able to perform this function. There are two major types of dialysis:
Kidney transplantation involves replacing an unhealthy kidney with a healthy kidney. Kidneys for transplantation come from two sources: living donors and deceased donors. Living donors are usually family members, partners or friends. A living kidney donor is possible because a person can live well with one healthy kidney.
Deceased donor kidneys usually come from people who are organ donors. All donors are carefully screened to make sure there’s a suitable match and to prevent any transmissible diseases or other complications.
On average, people wait about three to five years for a kidney from a deceased donor. It’s usually quicker to receive a kidney from a living donor.
Seeing your healthcare provider on a regular basis throughout your life is a good start for preventing kidney disease. About 1 in every 3 people in the United States is at risk for kidney disease. People at high risk may have regular tests to check for CKD so it’s detected as early as possible. Some other things you can do to prevent CKD are:
If you have kidney disease, you can still live a productive home and work life and enjoy time with your family and friends. To have the best outcome possible, it’s important for you to become an active member of your treatment team.
Early detection and appropriate treatment are important in slowing the disease progression, with the goal of preventing or delaying kidney failure. You’ll need to keep your medical appointments, take your medications as prescribed, stick to a nutritious diet and monitor your blood pressure and blood sugar.
While CKD can lead to death, many people with the condition live long and happy lives after diagnosis. Most people who seek treatment for kidney disease and manage their condition never progress to kidney failure or death. That’s why it’s important to attend all your checkups and work with your healthcare provider on a treatment plan.
The leading cause of death in people with CKD is actually heart disease, a complication of CKD. Managing other health conditions that negatively impact your kidneys is also key to maintaining your kidney function.
Early detection can help prevent kidney disease from worsening to kidney failure. Work with your healthcare provider to manage conditions that are known to cause kidney disease. These include diabetes, high blood pressure and other diseases that affect your kidneys.
Since kidney disease often doesn’t cause symptoms in the early stages, the best thing you can do is work with your provider to understand your risk and attend all annual or scheduled visits with your provider.
Most people don’t have symptoms until CKD is severe. Contact your provider if you:
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.
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:
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.
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.
A note from Cleveland Clinic
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.
Last reviewed by a Cleveland Clinic medical professional on 05/07/2023.
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