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Your kidneys work throughout the day to remove waste and extra fluid from your blood. They also help balance salts and minerals, regulate blood pressure and support the production of red blood cells. When the kidneys become damaged, these jobs can become harder for them to manage.
Kidney disease does not always cause noticeable symptoms at first. Someone may feel well and discover a problem only through routine blood or urine tests. Finding changes early gives you and your doctor an opportunity to understand the cause and take steps to protect your kidneys.
What does kidney disease mean?
Kidney disease includes conditions that affect the structure or function of the kidneys. When evidence of kidney damage or reduced kidney function has been present for at least three months, it is called chronic kidney disease, or CKD. The condition can range from mild changes to advanced loss of kidney function.
Kidney function can also worsen suddenly, sometimes during a serious infection, dehydration or a blockage in the flow of urine. This is called acute kidney injury, or AKI, and it needs prompt medical assessment. Some people recover fully with treatment, while others are left with lasting damage. Acute kidney injury can also happen in someone who already has CKD.
Why do kidney problems develop?
Diabetes and high blood pressure are common causes of chronic kidney disease. Persistently high blood glucose can damage the kidneys’ tiny filters, while high blood pressure can damage the blood vessels that supply them. Managing these conditions is therefore an important part of protecting kidney health.
Other causes include inflammation, inherited conditions such as polycystic kidney disease, and repeated or long-standing blockages in urine flow. Certain medicines can also contribute to kidney damage. Your doctor will consider your medical history, family history and medicines when investigating the cause.
Can you have kidney disease without symptoms?
Yes. Early CKD often develops without obvious warning signs, so feeling well does not necessarily mean your kidneys are healthy. Testing is particularly important if you have diabetes, high blood pressure, heart disease or a family history of kidney disease.
As kidney disease becomes more advanced, symptoms may include tiredness, swollen ankles or feet, poor appetite, nausea, itching or changes in urination. These symptoms can have other causes too. A doctor’s assessment and appropriate tests are needed to understand what is happening.
How do doctors check kidney health?
Two important checks are a blood test and a urine test. The blood test measures creatinine, a waste product, which is commonly used to calculate the estimated glomerular filtration rate, or eGFR. This estimates how well your kidneys filter blood.
The urine test checks for albumin, a protein that can leak into urine when the kidneys are damaged. It is often reported as the urine albumin-to-creatinine ratio, or uACR. Together, these tests provide more information than either result alone.
A single abnormal result does not automatically confirm chronic kidney disease. Your doctor may compare it with older reports, repeat tests or arrange further investigations. A sudden change may need assessment straight away; establishing whether a problem is chronic should not delay care for a possible acute illness.
What does treatment involve?
Treatment depends on the cause and severity of the problem. For CKD, care may include medicines to protect kidney function, management of blood pressure and diabetes, and regular checks for changes or complications. Food choices, physical activity and stopping smoking also form part of ongoing care.
Your doctor may need to adjust some medicine doses because the kidneys help remove medicines from the body. Check before taking painkillers such as ibuprofen or naproxen, and mention any supplements or herbal products you use. Do not stop prescribed treatment or make major dietary changes without discussing what is appropriate for you.
A diagnosis of kidney disease does not automatically mean you need dialysis. Many people are managed with medicines, monitoring and everyday changes. Dialysis or a kidney transplant may be considered when kidney disease becomes advanced, according to the person’s condition and needs.
When should you seek help promptly?
Seek urgent medical assessment if you suddenly pass much less urine than usual, develop new breathlessness or become unusually confused or drowsy. These changes are especially concerning during an illness involving vomiting, diarrhoea or dehydration. Do not wait for a routine appointment if you are becoming unwell.
For ongoing care, keep your blood and urine reports together and ask how the results compare with previous tests. Before leaving an appointment, make sure you understand when the next checks are due and whether anything needs to change in your treatment.