Chronic Kidney Disease: Common but Misunderstood and Severely Underdiagnosed

The kidneys are vital organs that filter toxins from the blood, regulate your body’s fluid levels, make vitamin D to keep bones strong, help control blood pressure and increase red blood cells. They have a crucial job, filtering blood at about a half cup per minute. The kidneys don’t recover from damage as well as other organs, and in many cases, decreased kidney function is irreversible, so it’s essential to take care of them.

When people hear the term chronic kidney disease, CKD for short, they often think of things like kidney transplants or dialysis. What people may not know is that CKD is actually a progressive condition that starts far before the point of needing these types of medical procedures.

What is CKD?

CKD is the gradual loss of kidney function over time, and it affects an estimated 37 million, or 1 in 7, Americans. Yet as many as 9 in 10 adults living with this disease don’t know they have it because symptoms usually don’t appear until CKD is advanced.

How well your kidneys function affects every other system in the body, including the heart, which is very closely connected. Damage to one can lead to damage to the other and can cause serious health issues. As people age, kidney function naturally declines, but with CKD, it occurs at a more rapid rate. It’s important to understand if you are at risk for CKD so you can get screened and take action to slow the progression of this disease.

CKD Risk Factors

CKD is called a “silent disease” because most people experience no symptoms in the early stages. Worsening kidney function can lead to end stage kidney disease (ESKD), which can only be treated with dialysis or a kidney transplant to keep the body functioning. This is why it’s important to be aware of risk factors, causes and serious complications that can occur.

In the United States, type 2 diabetes and high blood pressure, also known as hypertension, are leading causes of CKD. More than one-third of people with diabetes are affected by CKD – however, many of them are unaware that they may be at risk.

Other common risk factors include people with a family history of kidney failure, cardiovascular disease, smoking, age, obesity, and race and ethnicity. Those at risk for CKD should talk to their doctor about getting tested for CKD.

The Importance of Understanding eGFR and uACR

The two key markers for CKD are estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR).

CKD is classified as Stages 1 through 5, which are determined by eGFR – a measure of how well the kidneys are filtering waste from the body. eGFR is often included as part of routine blood work for physical exams. You can think of eGFR as your kidney function number. As CKD progresses, your eGFR number decreases. Fortunately, eGFR is easy for your doctor to track, and test results can provide signals that your kidney function is declining.

Similarly, uACR is a simple urine test that is also often part of routine physical exams. uACR checks for signs of kidney damage by detecting if you have albumin in your urine – a protein that is normally found in your blood. A normal uACR test result is less than 30 mg/g. Anything above the normal range may mean indicate early stage kidney disease.

Partnering with Your Doctor

Lost kidney function can rarely be recovered, so it’s important to take early action, which has been shown to help slow disease progression, reduce the risk of worsening kidney function and delay, or even prevent, dialysis. 

Until recently, CKD had been managed by treating underlying risk factors of the disease. However, treatment options are now available to help slow the progression of CKD and delay ESKD.

Other ways to slow down CKD progression include:

  • Actively managing your diabetes
  • Monitoring and controlling your blood pressure
  • Keeping your cholesterol under control
  • Consulting with a dietician and eating a kidney-friendly diet
  • Exercising to maintain a healthy weight
  • Avoiding smoking cigarettes, which can worsen kidney damage
  • Speaking with your doctor about all medications you are taking, including vitamins

If you are at risk for CKD, it’s important to review your lab results and speak with your doctor to understand your eGFR and uACR and the best treatment options available for you.

You may consider using this discussion guide during your next doctor visit. By communicating with your healthcare team, you can feel in more control of your kidney health.

Helpful Resources to Support

In addition to speaking with your doctor, there are many resources available to support people at risk for CKD or early on in their CKD journey.

For more information about living with CKD, please visit the websites of our advocacy partners.