Kidney Disease

Overview

Kidney disease is a condition in which your kidneys lose their ability to filter waste and extra fluid from your blood. The kidneys are two bean-shaped organs, one on each side of your back. Healthy kidneys keep your body's balance of water, minerals, and other substances stable. When they become damaged, waste builds up in your body and can cause health problems.

Yes. Kidney disease is fairly common, especially in older adults. Many people have it and don't know because it develops slowly.

It can affect anyone at any age, but it is more likely in people over 60, those with diabetes or high blood pressure, and those with a family history of kidney problems.

Symptoms

Common symptoms

• Feeling more tired than usual
• Swelling in your feet, ankles, or hands
• Puffiness around your eyes in the morning
• Changes in how much you pee (more or less than usual)
• Feeling sick to your stomach or vomiting
• Itchy or dry skin
• Shortness of breath

Symptoms in children

• Poor appetite or slow growth
• Swelling of the face, feet, or belly
• Frequent stomach aches or headaches
• Bedwetting (in a child who has been dry at night before)

Symptoms in older adults

• Confusion or trouble thinking clearly
• Feeling weak or unsteady
• Less interest in food
• Needing to pee more often at night
• General decline in health without a clear reason

Causes

Main causes

• Diabetes – when blood sugar is too high for too long, it damages the kidney's filters
• High blood pressure – extra pressure can harm the blood vessels in the kidneys
• Glomerulonephritis – inflammation in the kidney's filtering units
• Polycystic kidney disease – an inherited condition where fluid-filled cysts grow on the kidneys
• Repeated kidney infections

Risk factors

• Being over 60
• Having a family history of kidney disease
• Smoking
• Being overweight
• Having heart disease
• Taking certain pain medicines regularly (like anti-inflammatory drugs) – always check with your pharmacist or doctor

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number right away.
• If you have sudden, severe pain in your back or side
• If you have a very high fever with chills and shaking

Book a routine appointment if:

• If you have diabetes, high blood pressure, or another condition that raises your risk, get your kidney function checked at least once a year
• If you notice any of the common symptoms and they last for more than a week
• If you have a family history of kidney disease and have not had a kidney check recently

Diagnosis

Your doctor will ask about your symptoms and health history, and check your blood pressure. They will usually order a blood test and a urine test to see how well your kidneys are working.

Tests that may be done

• Blood test for creatinine – this measures a waste product that healthy kidneys remove
• eGFR – a calculation from the blood test that estimates how many milliliters of blood your kidneys filter per minute (a lower number means the kidneys are not working as well)
• Urine test for protein – protein in your urine can be a sign of kidney damage
• Imaging, such as an ultrasound, to see the size and shape of your kidneys
• Sometimes a kidney biopsy – a small sample of kidney tissue – to find the exact cause

What to expect at your appointment

The main tests are simple. The blood test involves a needle in your arm, and the urine sample is the same as a routine pee test. You may need to fast before the blood test, but often you don't. Your doctor will explain what each result means and what happens next. If problems are found, you may be referred to a kidney specialist.

Treatment

There is no cure for kidney disease, but treatment can slow it down, manage symptoms, and prevent complications. The right treatment depends on how much kidney function you still have and what is causing the damage.

Self-care at home

• Follow the plan your healthcare team gives you for any health conditions like diabetes or high blood pressure
• Ask your healthcare provider about an eating plan that is right for your kidneys (they may suggest limiting salt, certain minerals, or protein)
• Drink fluids as advised by your healthcare team – too many or too few can be a problem
• Take all medicines as prescribed – never stop or change them without talking to your doctor
• Stay active with activities that your doctor approves, like walking

Medical treatments

Medical treatment focuses on controlling the cause and protecting your kidneys. This includes blood pressure medicines, diabetes medicines, medicines to help your body remove extra fluid, and treatments for anemia (low red blood cells). Some people take special binders to control minerals like potassium or phosphorus. Your doctor will choose treatments based on your individual needs. Your pharmacist can explain how to take them safely. For advanced kidney disease, treatments like dialysis (a machine that filters your blood) or a kidney transplant may be needed.

When is surgery considered?

If your kidneys fail completely, a kidney transplant is the best long-term treatment for many people. You may also need a small operation to create a place for dialysis access in your arm or belly. These procedures are done by specialists, and you will have a full evaluation first.

Living with this condition

Living with kidney disease means paying attention to your health and working closely with your care team. You may see a kidney specialist (nephrologist), a dietitian, and your regular doctor. Keeping track of your blood pressure, fluid intake, and how you feel helps you spot changes early.

Lifestyle tips

• Keep your blood pressure in the target range your doctor gives you
• If you have diabetes, keep your blood sugar in range
• Do not smoke – your doctor or local health service can help you quit
• Limit alcohol
• Take pain relievers only as advised – some common ones can be hard on kidneys
• Stay in touch with your care team and keep all appointments

Diet and exercise

A kidney-friendly diet often means controlling salt, and sometimes potassium, phosphorus, and protein. You do not need to figure it out alone – a dietitian can help make a plan based on your blood test results. Keep moving with gentle exercise, like walking, swimming, or cycling, as your energy allows. Rest when you need to.

Mental health and emotional wellbeing

It is normal to feel sad, worried, or overwhelmed when you have a long-term health condition. Talk to your healthcare team about how you are feeling – they can connect you with counseling or support groups. If you ever feel hopeless or think about harming yourself, reach out for help right away: call your local emergency number or a crisis line, or tell someone you trust.

Prevention

You cannot always prevent kidney disease, but you can lower your chances. The most important steps are keeping your blood pressure and blood sugar well controlled, staying active, eating a healthy diet, not smoking, and avoiding long-term use of pain medicines without medical advice.

Vaccines

Make sure you are up-to-date on vaccinations, including the flu and COVID-19 vaccines. People with kidney disease are at higher risk of infections. Ask your healthcare provider which vaccines you need.

Screening programmes

If you have risk factors such as diabetes, high blood pressure, or a family history, ask your doctor about regular blood and urine tests. These can catch kidney disease early, when treatment helps the most.

Complications

If left untreated

• Gradual loss of kidney function until your kidneys stop working (kidney failure)
• Heart and blood vessel problems, including heart attack and stroke
• Anemia (low red blood cells), which makes you tired and weak
• Weak bones and a higher risk of fractures
• Fluid buildup in your lungs or legs
• A sudden dangerous rise in potassium levels, which can affect your heart rhythm

Long-term outlook

Kidney disease is serious, but many people live well with it for years. Treatment can slow the disease and prevent complications. With support from your healthcare team, and by taking steps to care for yourself, you can protect your quality of life. There are many options to help – you are not alone, and there is always hope.

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