kidney risks and benefits for patients

Overview

Your kidneys are two bean-shaped organs that filter waste and extra fluid from your blood to make urine. They also help control blood pressure, make red blood cells, and keep your bones healthy. Kidney health means your kidneys are working well to do these jobs. Risks are things that can damage your kidneys over time, like high blood pressure or diabetes. Benefits come from keeping your kidneys healthy, which helps your whole body.

Chronic kidney disease (CKD) is very common worldwide. It affects about 1 in 10 adults. Many people do not know they have it because early stages have no symptoms.

Kidney problems can affect anyone, but they are more common in people with diabetes, high blood pressure, heart disease, or a family history of kidney disease. They also become more common as you get older. People from certain ethnic backgrounds, such as African, Caribbean, South Asian, or Indigenous communities, may have a higher risk.

Symptoms

Common symptoms

• Feeling more tired than usual
• Swelling in your feet, ankles, hands, or face (from fluid buildup)
• Changes in how much you urinate or how often you go at night
• Foamy or bubbly urine (a sign of protein in the urine)
• Dry, itchy skin
• Nausea or vomiting
• Loss of appetite
• Muscle cramps, especially at night

Symptoms in children

• Poor growth or weight gain
• Frequent headaches or feeling tired
• Swelling around the eyes or in the body
• Bedwetting or changes in urination
• Nausea or poor appetite

Symptoms in older adults

• Confusion or trouble concentrating
• Feeling weak or dizzy
• Swelling in the legs or belly
• Changes in urination patterns
• Nausea or loss of appetite (may be mistaken for other conditions)

Causes

Main causes

• Diabetes (high blood sugar damages kidney filters over time)
• High blood pressure (damages the small blood vessels in the kidneys)
• Glomerulonephritis (inflammation of the kidney filters)
• Polycystic kidney disease (an inherited condition with cysts in the kidneys)
• Repeated kidney infections
• Long-term use of certain over-the-counter pain medicines (like NSAIDs) if used too often

Risk factors

• Diabetes
• High blood pressure
• Heart disease
• Family history of kidney disease
• Being over 60 years old
• Obesity
• Smoking
• African, Caribbean, South Asian, or Indigenous ancestry
• Frequent use of pain relievers like ibuprofen or naproxen
• Long-term use of certain herbal supplements or medications without medical advice

When to see a doctor

See a doctor urgently if:

• You have any symptoms from the 'urgent' list above
• You notice a sudden change in your urination (very little urine, blood, or pain)
• You have severe swelling in your legs or face that comes on quickly

Book a routine appointment if:

• You have diabetes, high blood pressure, or heart disease and have not had a kidney check in the last year
• You are over 60 and have not had a kidney function blood test recently
• You have a family history of kidney disease and want to check your own kidney health
• You notice mild swelling in your ankles or feet that does not go away

Diagnosis

Doctors use blood and urine tests to check how well your kidneys are working. They may also do imaging tests to look at the structure of your kidneys. The earlier kidney problems are found, the more you can do to slow them down.

Tests that may be done

• Blood test: checks levels of creatinine and estimated glomerular filtration rate (eGFR) – a number that tells how well your kidneys filter waste
• Urine test: checks for protein or blood in your urine – signs of kidney damage
• Blood pressure check: high blood pressure can both cause and result from kidney disease
• Ultrasound: a painless scan to see the size and shape of your kidneys and check for blockages or cysts
• Kidney biopsy: a small sample of kidney tissue taken with a needle to look for damage under a microscope (only in some cases)

What to expect at your appointment

Your doctor will explain what the tests measure and what your results mean. You may be referred to a kidney specialist (a nephrologist) if the tests show a problem. Many tests are simple blood and urine samples. Imaging tests like an ultrasound are painless and take about 30 minutes. You will usually get results within a few days to a week.

Treatment

Treatment for kidney problems depends on the stage and cause. The main goals are to slow the loss of kidney function, treat the underlying condition (like diabetes or high blood pressure), and manage symptoms. Early stages may only need lifestyle changes, while more advanced stages may require medicine and sometimes dialysis or a transplant.

Self-care at home

• Keep your blood pressure under control with a low-salt diet, exercise, and regular checks
• Manage your blood sugar if you have diabetes – monitor levels and follow your meal plan
• Stay at a healthy weight – losing even a little weight can help if you are overweight
• Stop smoking – smoking damages blood vessels and makes kidney disease worse
• Limit alcohol – too much can raise blood pressure and harm kidneys
• Stay active – aim for 30 minutes of moderate activity most days (walking, swimming, cycling)
• Drink enough water – but if you have advanced kidney disease, your doctor may tell you to limit fluids

Medical treatments

Doctors may prescribe medicines to lower blood pressure (such as ACE inhibitors or ARBs), control blood sugar, reduce cholesterol, or manage mineral imbalances. If kidney disease is advanced, treatments include dialysis (a machine that filters your blood) or a kidney transplant. Your healthcare team will explain your options based on your stage of kidney disease and overall health. Always follow your doctor's advice about any medicine.

When is surgery considered?

Surgery is usually not needed for early kidney disease. In some cases, surgery may be needed to remove a kidney tumor, a large cyst, or a blockage (like a stone that cannot pass). A kidney transplant is a major surgery where a healthy kidney from a donor is placed in your body to take over filtering.

Living with this condition

Living with kidney disease means paying attention to your health every day. You will likely have regular appointments with your doctor or kidney specialist. Keeping a routine for taking medicines, checking blood pressure, and following your diet plan helps you stay in control. Many people with early kidney disease live full, active lives without major changes.

Lifestyle tips

• Follow a kidney-friendly diet: limit salt, and sometimes limit potassium, phosphorus, and protein (your doctor or dietitian will guide you)
• Check your blood pressure at home if your doctor recommends it
• Monitor your weight and report any sudden gain or loss
• Avoid over-the-counter pain medicines like ibuprofen unless your doctor says it is safe
• Get enough sleep and manage stress with relaxation techniques like deep breathing
• Stay socially active and talk to family or friends about how you feel

Diet and exercise

A kidney-friendly diet often means eating less salt, processed foods, and red meat. Fresh fruits and vegetables are good, but some are high in potassium (like bananas and potatoes) – your doctor or dietitian will advise you. Staying active helps control blood pressure and weight. Gentle activities like walking, yoga, or swimming are excellent. If you are on dialysis, exercise may need to be adjusted – ask your healthcare team.

Mental health and emotional wellbeing

Coping with a chronic condition like kidney disease can be stressful. You may feel anxious, sad, or frustrated. It is normal to have these feelings. Talking to a counselor, joining a support group, or even just sharing with trusted friends can help. If you feel overwhelmed, please reach out to your doctor or a mental health professional. You are not alone.

Prevention

You cannot always prevent kidney disease, especially if it runs in your family. But you can reduce your risk by managing diabetes and high blood pressure, eating healthy, staying active, not smoking, and taking medicines only as directed. Regular check-ups that include blood and urine tests can catch problems early, when they are easier to treat.

Vaccines

People with kidney disease are at higher risk for infections like flu and pneumonia. Vaccines are recommended. Ask your doctor about the flu shot, pneumonia vaccine, and other vaccinations you may need. If you have advanced kidney disease or are on dialysis, you may also need a hepatitis B vaccine.

Screening programmes

Screening for kidney disease is important if you have risk factors like diabetes, high blood pressure, or a family history. It involves a simple blood test (creatinine and eGFR) and a urine test (for protein). Your doctor may recommend screening every year. If you are over 60, ask if a kidney check is right for you.

Complications

If left untreated

• Kidney failure (end-stage renal disease) – needing dialysis or a transplant
• High blood pressure that becomes harder to control
• Heart disease and stroke (kidney problems increase your risk)
• Anemia (low red blood cells, causing tiredness and weakness)
• Bone disease (weak bones from mineral imbalances)
• Fluid buildup in the lungs (pulmonary edema, causing shortness of breath)

Long-term outlook

The outlook for kidney disease has improved greatly with modern care. Many people with early-stage kidney disease can keep their kidneys working well for many years with good management. Even if kidney disease progresses, treatments like dialysis and transplants allow people to live long, fulfilling lives. Working closely with your healthcare team gives you the best chance of staying healthy.

Find support

International organisations

• International Society of Nephrology
• World Kidney Day

Local organisations

• Kidney Care UK · United Kingdom
• National Kidney Foundation · United States
• Kidney Health Australia · Australia

Helplines

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