Chronic Kidney Disease (CKD)
Chronic Kidney Disease (CKD) is a common condition and is not the same as Kidney Failure. It means that your kidneys are not working as well as they once did. Chronic means ongoing, persistent and long term. It does not mean severe. Many people have mild CKD.
It is estimated that 1 in 10 people have some degree of CKD. It becomes increasingly common with age, with about half of over 75-year olds having the condition. In many cases, it does not progress quickly and can be considered as a normal part of ageing. It only progresses to kidney failure in about 1 in 50 people with the condition.
The disease is usually found incidentally by a GP whilst performing investigations for another condition or as part of routine health checks.
Risk Factors for CKD include high blood pressure, high cholesterol, diabetes, kidney and prostate conditions, conditions affecting your cardiovascular system such as heart disease or stroke, long term use of some medications such as ibuprofen, naproxen or diclofenac. This is one reason why your doctor will ask you to have routine blood and /or urine tests if you are in one or more of these groups.
It is unlikely that you will develop symptoms of CKD out of the blue, but you should contact your GP if you are concerned that you have persistent symptoms which you think could be caused by kidney disease. These symptoms can include:
- General symptoms such as weight loss, tiredness, headaches, insomnia, itchy skin and muscle cramps
- Kidney symptoms such as increased need to pass urine and blood in your urine
- Digestive symptoms such as feeling or being sick, diarrhoea and reduced appetite
- Sexual symptoms such as periods stopping or being unable to get a satisfactory erection
- Heart and lung symptoms such as swollen feet, ankles or hands and shortness of breath.
These symptoms can be signs of other health problems, so your GP may decide to carry out some blood and urine tests to help to decide what is happening.
When diagnosed as CKD, your doctor will inform you and ‘Read-code’ the problem in your notes. This computer code allows your doctor to use the computer to automatically search and list patients who are due monitoring of their condition.
The importance of diagnosing and monitoring CKD is so that your GP can identify patients whose kidneys are worsening too quickly and require treatment. Importantly, CKD is a risk factor for developing other problems involving blood vessels e.g. heart disease and stroke as well as these illnesses being a risk factor for CKD. Having CKD ‘read-coded’ in your notes will also ensure that your doctor takes care to reduce your risk of these conditions too.
Once you have visited your GP and have been tested for CKD (blood and urine tests), your results can determine how healthy your kidneys are. There are several stages of CKD. Some causes and more advanced stages of CKD need other hospital tests for diagnosis and treatment such as Chest X-Ray, ultrasound scan or kidney biopsy. Your GP will refer you for these if needed.
You can visit Kidney Research UK to view what the stages are.
Selfcare and more information
Managing my condition
People diagnosed with CKD can usually lead a normal life.
It is not possible to repair the damage that has already happened to your kidneys; however, your condition won’t necessarily get worse. The aims of treatment include:
- If possible, to treat any underlying kidney condition – e.g. good sugar control for people with diabetes, antibiotic treatment for people with recurring kidney infections, surgery for people with a blockage to urine flow.
- To prevent or slow down progression of CKD – good blood pressure control and avoiding medications such as NSAIDS which can damage the kidneys.
- Reducing the risk of developing cardiovascular disease – control blood pressure, diabetes, cholesterol and tackle lifestyle risks as below.
- Relieving symptoms and problems caused by CKD if these have developed – anaemia, abnormal levels of calcium or phosphate.
Most people with CKD will be able to control their condition with healthy lifestyle changes and medication. It is important to continue to take your prescribed medication even if you feel well.
More rarely, if the condition progresses then dialysis is used to replace the functions of the kidney or a transplant may be considered.
You will be advised to have regular check-ups to monitor your condition. You can read more on how CKD is treated.
Lifestyle Changes
You can get help with all these lifestyle measures
Diet
A balanced diet can help improve general health and reduce your risk of developing further problems. This should include:
- A variety of fruit & vegetables.
- Meals based on starchy foods i.e. potatoes, bread, rice or pasta
- Dairy or dairy alternatives in moderation
- Protein such as beans or pulses, fish, eggs and meat in moderation
- Low levels of saturated fat, salt and sugar
- Eating appropriately to be a healthy weight
You may be given advice about dietary changes that can specifically help with kidney disease. For example, limiting the amount of potassium or phosphate in your diet.
Exercise
Regular physical activity is good for anyone with kidney disease, no matter how severe.
If you have mild to moderate kidney disease, your ability to exercise shouldn’t be limited. You can exercise as often and as vigorously as someone who is the same age as you with healthy kidneys.
If your condition is more advanced or you are on dialysis, your ability to exercise is likely to be reduced and you may become breathless and tired more quickly.
You should not be deterred as exercise will still be beneficial. You can start slowly and build up gradually.
Smoking
If you smoke, stopping will improve your overall health and reduce your risk of many other health problems.
You can speak to an NHS stop smoking service if you think you may need help quitting. They can provide support and if necessary, prescribe stop smoking treatments.
Alcohol Intake
You should limit your alcohol consumption. You may still be able to drink alcohol if you have kidney disease; however, it is recommended to drink less than 14 units per week.
You should speak to your care team or your GP if you are finding it difficult to cut down on the amount of alcohol you drink. Click here for tips on cutting down alcohol.
Medication
Get Vaccinated
Kidney disease can put a significant strain on your body and make you more vulnerable to infections. Everyone with the condition is encouraged to have the annual flu jab and the one-off pneumococcal vaccination. You can have these vaccinations at your GP surgery or at a local pharmacy that offers a vaccination service.
Medication to control risk factors
The most important treatment to prevent or delay the progression of CKD, whatever the cause, is to keep your blood pressure well controlled. Lifestyle changes can help but often you will need medication as well.
If you have high levels of protein in your urine, then you may be advised to take medication even if your blood pressure is normal. A type of medication called an angiotensin converting enzyme (ACE) inhibitor has been shown to be beneficial for some people with CKD. It reduces the risk of cardiovascular disease and can prevent worsening of kidney function.
You may need medication such as a statin to reduce your cholesterol. Your doctor will also advise you about avoiding some medications such as NSAIDS used for pain which can affect your kidneys adversely and will recommend alternatives.
Dialysis and Kidney Transplant
Both dialysis and kidney transplant would require you to be referred to the hospital. There are strict criteria for referral. You can speak to your GP or care team if you are concerned about these aspects.
Reviews and Monitoring
You will have regular contact with your care team to monitor your CKD.
These appointments usually involve:
- Talking about your symptoms – how they are affecting you and whether the symptoms are getting worse.
- A discussion about lifestyle changes and any support you need to help with this.
- A discussion about your medication – this includes if you think you may be experiencing any side effects.
- Tests to monitor your kidney function and general health.
It is also a good opportunity to ask any questions you may have or raise any other issues you’d like to discuss with your care team.
You may also want help to monitor your condition at home by using a home blood pressure monitor.
You should contact your GP or care team if your symptoms are getting worse or you develop new symptoms.
Useful Information about my CKD
Further general information about CKD is available:
There is a calculator you can use to figure out your risk of developing moderate to severe kidney disease over the next five years. The calculator is only valid if you do not already have a diagnosis of CKD at stage 3b or worse. You can ask your GP if you are unsure.
For more information on holidays and respite breaks see the link below:
For help with holidays including insurance:
Information on sex and pregnancy for couples with kidney disease:
Benefits for renal patients and carers
Videos about my CKD
Kidney disease | https://www.kidneycareuk.org
Kidney Care UK | published April 16 2018
Lifestyle advice | www.kidneyresearchuk.org
Kidney Research UK | published March 17 2014
Symptoms | www.kidneyresearchuk.org
Kidney Research UK | published March 17 2014
Waiting for a specialist opinion
If you have been referred for a specialist opinion your details will be reviewed, and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found below.
How long will I wait?
If a hospital assessment and/or treatment is clinically recommended you will be referred for to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.