Living with kidney

Overview

Kidney disease means your kidneys — two bean-shaped organs in your lower back — are not filtering your blood as well as they should. Waste can build up, and your body may hold extra fluid. Many people have no symptoms at first, and it often shows up on a routine blood test.

Yes. Kidney disease is common, especially in people over 60. Many people have it without knowing it, but it can be found with simple tests.

Anyone can develop kidney disease, but it is more likely in people with diabetes, high blood pressure, or a family history of kidney problems. It also becomes more common with age.

Symptoms

Common symptoms

• No symptoms in the early stages
• Feeling more tired than usual
• Puffy eyes, hands, ankles or feet
• Passing urine more often, especially at night
• Urine that is foamy, darker, or has blood
• Poor appetite or nausea
• Muscle cramps, especially at night
• Itchy, dry skin

Symptoms in children

• Slower growth than expected
• Bedwetting after a dry period
• Unusual thirst
• Puffiness around the eyes
• Poor appetite and tiredness

Symptoms in older adults

• Confusion or feeling off-balance
• Falls and unsteadiness
• Swelling in the legs
• Episodes of being very tired or weak
• Difficulty concentrating

Causes

Main causes

• Diabetes — high blood sugar can slowly damage the kidneys' filters
• High blood pressure — it puts extra strain on the kidneys
• Inflammation of the kidney filters (glomerulonephritis)
• Kidney infections
• Kidney stones that repeatedly block the flow of urine
• Inherited conditions, such as polycystic kidney disease
• Long-term regular use of certain painkillers

Risk factors

• Being over 60
• Diabetes
• High blood pressure
• A family history of kidney problems
• Smoking
• Being overweight
• Having heart or blood vessel disease

When to see a doctor

See a doctor urgently if:

• If you have symptoms in the emergency list, call your local emergency number right away.
• See a doctor the same day if you pass urine that is visibly red or you stop passing urine.
• If you have a high temperature with back pain or a burning feeling when urinating.

Book a routine appointment if:

• If you notice swelling in your ankles, a foamy or darker urine, tiredness without reason, or appetite changes.
• If you have diabetes or high blood pressure and have not had your kidneys checked for over a year.

Diagnosis

Kidney disease is usually found by chance during a blood or urine test at a routine check-up. Your doctor will review your results, ask about your symptoms and medicines, and check your blood pressure.

Tests that may be done

• A blood test to check your eGFR (estimated glomerular filtration rate) — a number that shows how well your kidneys are filtering
• A urine test to look for protein or blood
• A blood pressure measurement
• An ultrasound scan of your kidneys to see their size and shape
• Sometimes a biopsy (a small sample of kidney tissue) if more detail is needed

What to expect at your appointment

You do not need to prepare much. You may need to do a urine sample in a container. The doctor will explain your results in person or by phone. If the results show reduced kidney function, you may be referred to a kidney specialist (nephrologist).

Treatment

The goal of treatment is to slow kidney damage, manage symptoms, and reduce the risk of complications. It involves looking after your blood pressure and blood sugar, eating a kidney-friendly diet, staying active, and following your care team’s advice.

Self-care at home

• Stay well hydrated, but do not drink excessive amounts — ask your care team how much is right for you
• Reduce salt in your meals to help control blood pressure
• Avoid over-the-counter painkillers unless your pharmacist says they are safe
• Stop smoking and limit alcohol
• Keep to gentle exercise such as walking, swimming, or cycling
• Attend every blood test and clinic appointment

Medical treatments

Your doctor may prescribe medicines to lower blood pressure, protect the kidneys, or control blood sugar. They may also treat anaemia (low red blood cells) or manage bone problems. In later stages, dialysis (a treatment that filters the blood) or a kidney transplant may be considered. Always take medicines exactly as prescribed and ask your pharmacist before buying any over-the-counter product.

When is surgery considered?

Surgery is not usually needed, but some people may need a procedure to remove a stone, widen a narrowed blood vessel, or remove a kidney in advanced cases. A kidney transplant is an operation that gives you a healthy donor kidney and is considered when kidney failure is severe.

Living with this condition

Living with kidney disease means having a steady routine. You will have check-ups, blood tests, and a care plan. Many people feel fine and keep working, travelling and enjoying family time. The most important things are taking your medicines, keeping appointments, and asking questions whenever you are unsure.

Lifestyle tips

• Use a pill organiser or phone alarm to remember medicines
• Check your blood pressure at home if your doctor suggests it
• Follow your meal plan and work with a kidney dietitian
• Stay active for your heart and general wellbeing
• Tell friends and family how they can support you

Diet and exercise

What you eat matters for your kidneys. A renal dietitian can help you choose the right amounts of salt, protein, potassium and phosphate. In general, eat plenty of vegetables and fruit, choose whole grains, and limit salty snacks and processed meats. Regular exercise, even a daily 20–30 minute walk, supports your heart and kidneys. If you sweat a lot, your fluid needs may change, so ask your team for guidance.

Mental health and emotional wellbeing

It is normal to feel anxious or low when you are told you have kidney disease. You may worry about the future, medicines, or dietary changes. These feelings are not a sign of weakness. Talk to your health care team, a counsellor, or a support group. If you feel overwhelmed most days, ask your GP about mental health support.

Prevention

Some causes of kidney disease cannot be prevented, but many cases can be delayed. Keeping your blood pressure under control, managing diabetes, not smoking, and avoiding high doses of certain painkillers are the best prevention steps.

Vaccines

Staying up to date with recommended vaccines, including flu and COVID-19, is important because a serious infection can put stress on your kidneys. Ask your pharmacist or kidney clinic about which vaccines are suitable for you.

Screening programmes

If you have diabetes or high blood pressure, you should have a simple blood and urine test at least once a year to check your kidney function. If you have kidney disease, your doctors will monitor you regularly.

Complications

If left untreated

• Waste products building up in your blood (known as uraemia) causing tiredness, nausea and confusion
• Fluid building up in your body, leading to swollen feet, ankles or shortness of breath
• High blood pressure that worsens and can damage your heart or eyesight
• Anaemia — a low red blood cell count — which can make you pale and breathless
• Sudden kidney failure, also called acute kidney injury, after a severe illness or infection

Long-term outlook

Most people receive a kidney disease diagnosis years or decades before it becomes serious. With the right treatment, many people keep their kidney function stable for a long time. A healthy lifestyle, good support, and following medical advice all make a real difference.

Find support

International organisations

• International Society of Nephrology ↗
• Kidney Care UK ↗

Local organisations

• NHS Kidney disease information ↗ · United Kingdom

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