Chronic Kidney Disease (CKD)
Stages & eGFR, red-flags, symptoms, common causes, key tests and targets, kidney-smart medicines, salt & potassium tips, safe hydration, sick-day rules, and when to see a kidney specialist.
What is CKD?
In short Chronic Kidney Disease means the kidneys are not filtering blood as well as they should for 3 months or longer — often shown by a lower eGFR or protein/leakage in urine (albumin). Goals: protect kidney function, control blood pressure & diabetes, and prevent heart problems.
Good to know: Many people live well with early CKD by following steady routines: low-salt eating, movement, safe medicines, and regular checks.
When to seek urgent help
- Severe shortness of breath, chest pain, or confusion
- Very little urine, sudden leg/face swelling, or rapid weight gain
- High potassium symptoms: muscle weakness, palpitations
- Blood in urine, severe flank pain with fever (possible infection/stone)
These may be emergencies. Seek care immediately.
Common symptoms
- Tiredness, low appetite, morning nausea
- Swelling in feet/ankles, puffiness around eyes
- Night urination, foamy urine (protein)
- Itching, muscle cramps, trouble concentrating (later stages)
Related topics
CKD stages & eGFR
| Stage | eGFR (mL/min/1.73m²) | Notes |
|---|---|---|
| G1 | ≥ 90 | Normal eGFR with other kidney markers (e.g., albumin) abnormal |
| G2 | 60–89 | Mildly reduced; protect with BP, sugar, and salt control |
| G3a | 45–59 | Moderate; check medicines, labs, and albumin regularly |
| G3b | 30–44 | Moderate-to-severe; plan ahead and review diet/minerals |
| G4 | 15–29 | Severe; close follow-up, discuss advanced planning |
| G5 | < 15 | Kidney failure; dialysis or transplant planning if appropriate |
Albumin in urine (A1/A2/A3) adds risk information; both G and A categories guide care.
Common causes
- Diabetes (high blood sugar damages filters)
- High blood pressure (long-term strain on kidneys)
- Glomerular diseases, polycystic kidney disease
- Repeated kidney infections, stones, obstruction (prostate)
- Long-term high-dose painkillers/NSAIDs or certain medicines
Key tests & monitoring
- Blood: eGFR/creatinine, electrolytes (especially potassium), bicarbonate, HbA1c if diabetic
- Urine: albumin-creatinine ratio (ACR) to measure leak
- BP checks: home BP log; share averages
- Mineral & bone: calcium, phosphate, vitamin D, parathyroid hormone (later stages)
- Medication review: avoid kidney-straining drugs when possible
Frequency depends on stage and albumin level (often every 3–6 months, closer in advanced CKD).
Medicine safety & kidney-protective meds
Often protective (ask your clinician)
- BP control (targets individualized); medicines may include ACE-inhibitor/ARB
- For diabetes with CKD: selected options that can protect kidneys (ask about eligibility)
- Statins for heart protection in many older adults with CKD
Use carefully / avoid unless advised
- NSAIDs (ibuprofen, diclofenac) — can reduce kidney blood flow
- Certain antibiotics and contrast dyes — dose/choice may change
- Herbal supplements of unknown content
Always check doses against kidney function and review all OTC/supplements with your clinician.
Kidney-smart diet (salt, protein, potassium, phosphorus)
Salt (sodium)
- Aim for lower-salt choices to help BP and swelling
- Rinse canned foods; choose fresh or low-salt versions
Protein
- Moderate portion sizes; lean proteins (fish, poultry, tofu)
- Adjustments may be needed in advanced CKD under dietitian guidance
Potassium
- Some CKD stages run high potassium — ask if you need limits
- Favor lower-potassium choices if advised; learn smart swaps
Phosphorus
- Limit cola drinks and processed foods with “phos-” additives
- Dairy portions may need review in later stages
Hydration & sick-day rules
Hydration
- Steady small sips through the day unless on a fluid limit
- Evening cut-down if night urination is troublesome
Sick-day rules (ask for a written plan)
- During vomiting/diarrhea, some medicines may be paused — confirm which
- Re-start when eating/drinking normally and approved by your clinician
If you cannot keep fluids down or feel faint, seek medical advice promptly.
When to see a nephrologist
- eGFR persistently < 30 (G4–G5) or fast decline
- Heavy albumin in urine or difficult-to-control BP
- Frequent high potassium, acid-base issues, or anemia of CKD
- Planning for advanced CKD and education about options
Daily tips & home setup
Home BP & weight log
- Measure BP the same way each time; bring averages
- Daily weights can catch fluid changes early
Movement & energy
- Gentle walks most days; pace activities
- Manage swelling with leg-up breaks if advised
Medication list
- Keep an updated list; include doses and reasons
- Check for drug interactions and kidney dosing
Questions for your clinician
- What is my current stage and urine albumin level?
- What BP and A1c targets should I aim for?
- Which medicines protect my kidneys and which should I avoid?
- Do I need diet changes for potassium or phosphorus?
- How often should I repeat blood/urine tests?
- When should I see a kidney specialist?
Quick answers
Can CKD improve?
Early CKD can stabilize or improve when the cause is treated and blood pressure, sugar, and salt are well controlled.
Is high potassium dangerous?
Yes — it can affect the heart. Your team will guide diet and medicines to keep levels safe.
Do I need to stop all painkillers?
Not always. Many avoid routine NSAIDs; safer options and doses depend on your kidney function — ask for a personalized plan.
How often should I check labs?
Varies by stage and albumin. Commonly every 3–6 months in mild/moderate CKD and more often in advanced stages.