Your kidneys are the main part of your urinary system and are found towards the back of your abdomen (tummy). Most people have two kidneys, although it’s possible to be born with just one. Your kidneys filter water and waste products from your blood to make urine, which is passed out of your body via your bladder. These waste products are toxic if not removed.
Kidney disease is common, affecting around 10 in 100 women and five in 100 men in the UK. The risk of getting kidney disease increases with age.
This factsheet focuses on chronic kidney disease.
Often there are no symptoms, especially in the early stages of the condition. But if you do have symptoms, they may include:
Advanced kidney disease can have the following symptoms:
If you have these symptoms, see your GP.
As your kidney disease gets worse, you can develop:
There are many possible causes of kidney disease. Some of the factors that increase your risk of kidney disease include:
You will often be diagnosed with kidney disease after you visit your GP about something else and have a blood test. Or your GP may test for kidney disease if you're at high risk of developing it.
Your GP will ask about your symptoms and examine you. You may need to give a blood or urine sample for testing.
Your GP may refer you to a urologist or a nephrologist. A urologist is a doctor who specialises in identifying and treating conditions that affect the urinary system. A nephrologist is a doctor specialising in conditions affecting the kidneys.
Your doctor will measure your glomerular filtration rate (GFR), which is the rate at which your kidneys remove waste products, to see how well your kidneys are working. You may need to have an ultrasound scan. If the cause isn't clear from these tests, your doctor may take a kidney biopsy. A biopsy is a small sample of tissue that is sent to a laboratory for testing.
Kidney failure is diagnosed if your kidneys are no longer working as they should be and you need dialysis or a transplant.
Your doctor may advise you to reduce your salt intake, only drink alcohol within the recommended limits, take regular exercise, keep to a healthy weight and stop smoking. This will help you stay as healthy as possible.
Try not to take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac unless your doctor prescribes them.
If there is a direct cause for your condition, you may need medicines to treat this. Your doctor may stop any medicines you’re taking that may be affecting how your kidneys are working.
You may need medicines to reduce high blood pressure. These might include angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).
Your doctor may also recommend medicines to reduce your risk of cardiovascular disease. These include statins to reduce cholesterol and antiplatelets to reduce the risk of blood clots.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
You may need to take other medicines as your condition progresses. For example, your doctor may suggest iron or erythropoietin if you have anaemia.
If your GP refers you to a specialist, you may be treated in hospital. For some treatments, especially for the later stages of kidney disease, you will need to be in the renal unit of a hospital.
If your kidneys aren’t working, you may need to have dialysis. Dialysis is an artificial way of getting rid of waste and unwanted water from your blood. Dialysis may be temporary or permanent.
There are two types of dialysis: haemodialysis and peritoneal dialysis. If you have haemodialysis, your blood passes through a machine to filter and clean it.
Peritoneal dialysis uses your peritoneum as a filter. The peritoneum is a thin membrane that lines the inside of your abdomen, and surrounds and supports your abdominal organs. In a similar way to your kidneys, your peritoneum contains tiny blood vessels, making it a useful filter. During dialysis, fluid is passed into your peritoneum and the peritoneal membrane then acts as a filter for dialysis.
When you're pregnant, your kidneys work harder to remove the waste products you and your baby produce, and this may affect your kidney disease. If you have chronic kidney disease, you should discuss any plans to get pregnant with your doctor.
If you need dialysis, discussing options with your healthcare professional can help you manage your condition effectively. You will need to regulate your diet, your fluid intake and weight if you have dialysis.
Some people decide that they don’t want to have treatment and choose to discuss end of life care with their doctor.
To stay as healthy as possible, try to maintain a healthy weight, eat a balanced diet, only drink alcohol within the recommended limits, keep active and quit smoking. Everyone over 40 should have their blood pressure checked. If you have diabetes, make sure you control your blood glucose as well as you can.
Talk to your GP about any medicines you are taking and be aware if they increase the risk of kidney disease so you get treatment early.
The stages of chronic kidney disease are a way of monitoring how well your kidneys are working.
The stages of chronic kidney disease use glomerular filtration rate (GFR) to measure how well your kidneys are filtering waste products out of your body. GFR is measured as ml/min/1.73m. This stands for millilitres (ml) per minute (min) per overall kidney function (1.73m). These stages are used only as a guide and can differ between people.
Symptoms often only occur at stages four and five of chronic kidney disease. Measuring these stages can help your doctor plan your treatment.
This differs between people and depends partly on the cause of your chronic kidney disease. It also partly depends on how well you take care of yourself and how soon you get treatment.
It's difficult to predict how quickly chronic kidney disease can progress as different causes may mean it develops at different rates. Not everyone with chronic kidney disease will get worse.
If you have certain conditions, such as cardiovascular disease and diabetes, you should try to control these as well as possible because they can make kidney disease worse. Other factors that are linked to worsening of chronic kidney disease are smoking and being African-Caribbean.
Making sure you get treatment as soon as possible and that it meets your needs is crucial. Your doctor will be able to provide guidance to help you limit the progression of chronic kidney disease.
Eating a healthy, balanced diet, keeping physically active, only drinking alcohol within the recommended daily limits and stopping smoking will all help you stay as well as possible. Taking any medicines as prescribed is also essential.
You generally only need dialysis if you have end-stage kidney disease. You can discuss which option is best for you with your doctor.
If you have end-stage kidney disease you will most likely need dialysis. The machine which most people associate with dialysis is a haemodialysis machine.
During haemodialysis, a needle is inserted into your arm and attached by a tube to a haemodialysis machine. Your blood is drawn into the haemodialysis machine and then back into your body after it has been filtered through the machine to remove waste products.
Haemodialysis is usually done in a clinic or hospital, but it may be possible to have it at home. You can read or watch TV when you're having dialysis and a nurse will take care of you.
Peritoneal dialysis uses your peritoneum as a filter. The peritoneum is a thin membrane that lines the inside of your abdomen, and surrounds and supports your abdominal organs. In a similar way to your kidneys, your peritoneum contains tiny blood vessels making it a natural filter. A tube (catheter) is inserted into your abdomen, near your belly button. Two bags are connected to the catheter. One bag is placed high up and passes fresh fluid into your abdomen, while the other bag is placed near the floor to allow fluid containing waste products to collect after passing through the peritoneal membrane. This process is called continuous ambulatory peritoneal dialysis (CAPD).
CAPD may be used in tandem with a machine that fills and drains your abdomen, usually while you are sleeping. This is called continuous cycling peritoneal dialysis (CCPD) or automated peritoneal dialysis (APD).
You can manage peritoneal dialysis at home so you don't need to visit a clinic or hospital. This makes it more convenient than haemodialysis. You can also take the bags with you if you go away. You do need to be fully trained to make sure you can manage your dialysis well on your own. There is a risk of infection so strict hygiene methods are needed.
If you have had abdominal surgery, your doctor may recommend haemodialysis rather than peritoneal dialysis, but this will depend on other factors too.
This is the care you will receive if your end stage kidney disease can no longer be treated or you decide you no longer want treatment.
You have the right to choose how you wish to be cared for if your kidney failure can no longer be treated with dialysis and you can't have a kidney transplant or you decide you no longer want treatment.
What palliative treatment you choose to receive if you need end of life care is your decision. If you would like information about end of life care, ask your doctor. He or she will be able to help guide you to ensure you make the choices that are right for you. You can agree a plan and discuss this together.