--- title: "Chronic kidney disease: Symptoms & Treatment | HealthAnswers" description: "Chronic kidney disease (CKD) — stages, causes, symptoms, slowing progression, and when dialysis or transplant is needed." url: https://healthanswers.co.uk/conditions/chronic-kidney-disease/ robots: noindex --- # Chronic kidney disease: Symptoms & Treatment | HealthAnswers Health A–Z Chronic kidney disease (CKD) — stages, causes, symptoms, slowing progression, and when dialysis or transplant is needed. Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026 ## Quick answer What is chronic kidney disease? Chronic kidney disease (CKD) means kidneys gradually lose function over months or years — often caused by diabetes and high blood pressure. Early CKD has no symptoms — picked up on routine blood or urine tests. Stages 1 to 5 based on eGFR (kidney filtration rate) — stage 5 (eGFR under 15) may need dialysis or transplant. Treatment focuses on controlling blood pressure, blood sugar, and protecting kidneys with ACE inhibitors or ARBs. See a GP if you have diabetes or hypertension for annual kidney checks — or if persistent foamy urine, swelling, or fatigue. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Chronic kidney disease, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 7 sections ## Key facts about chronic kidney disease - About 1 in 10 adults in the UK have CKD — most early stage and managed in primary care. - Diabetes and high blood pressure cause about two-thirds of CKD — both are largely preventable and treatable. - eGFR and urine albumin:creatinine ratio (ACR) on two occasions diagnose and stage CKD. - ACE inhibitors or ARBs slow progression in proteinuric CKD — monitor potassium and eGFR after starting. - Stage 5 CKD (kidney failure) — options include haemodialysis, peritoneal dialysis, or transplant. ## Chronic kidney disease — silent until advanced **Chronic kidney disease (CKD)** is **abnormal kidney structure or function lasting over 3 months** — **measured by eGFR** and **urine albumin**. **~3 million UK adults** — **mostly stages 1–3** — **primary care management** ## Causes | Cause | Mechanism | | --- | --- | | Diabetes | Glomerular hyperfiltration → sclerosis | | Hypertension | Nephrosclerosis | | Glomerulonephritis | Immune kidney inflammation | | Polycystic kidney disease | Genetic cysts | | Reflux nephropathy | Childhood UTIs | | NSAIDs | Chronic interstitial damage | **Two-thirds from diabetes + hypertension** — **preventable progression** ## Diagnosis **Two readings needed:** - eGFR from creatinine — race-free equations now standard - Urine ACR — albumin leak **CKD confirmed if:** - eGFR <60 for ≥3 months , OR - eGFR ≥60 + ACR ≥3 mg/mmol or other damage markers **Ultrasound** — **structural assessment** — **size, obstruction, polycystic** ## Staging and monitoring **Stage 3+** — **more frequent bloods** **Bone-mineral disease** — **vitamin D, phosphate, PTH** **Anaemia** — **erythropoietin deficiency** — **treat if symptomatic** **Cardiovascular risk** — **CKD is heart disease equivalent** ## Treatment pillars **Blood pressure:** - ACEi/ARB first line if ACR elevated - Monitor creatinine rise <30% acceptable **Diabetes:** - SGLT2 inhibitors — kidney protection proven - GLP-1 agonists — additional benefit **Lifestyle:** - Salt restriction - Protein moderation if advanced - Smoking cessation **Avoid:** - Regular ibuprofen/naproxen - Contrast dye without precaution if eGFR low - Phosphate additives in processed food if hyperphosphataemia ## Kidney failure (stage 5) **Pre-dialysis education** — **modality choice** **Transplant** — **best quality of life** — **living or deceased donor** **Conservative care** — **valid choice** — **symptom-focused** — **some prefer no dialysis** ## Acute on chronic **Infection, dehydration, NSAIDs, ACEi during acute illness** — **sick day rules** — **pause ACEi/ARB/diuretics/SGLT2i if vomiting unwell** — **local policy** If you have **diabetes or hypertension** — **annual eGFR + ACR** — **15-minute test prevents dialysis decades later**. ## ! When to see a GP about chronic kidney disease See a GP for annual kidney checks if you have diabetes, high blood pressure, cardiovascular disease, or family history of kidney failure. Book an appointment if persistent ankle swelling, foamy urine, fatigue, nausea, itching, or reduced urine output — or if a previous blood test showed low eGFR or blood in urine. Do not take NSAIDs (ibuprofen) regularly if you have CKD without medical advice. ## Common questions about chronic kidney disease What are the symptoms of chronic kidney disease? Early CKD — usually no symptoms. Advanced CKD — fatigue, ankle swelling, foamy urine (protein), nausea, poor appetite, itching, muscle cramps, concentration problems, shortness of breath from fluid overload. Symptoms often appear only when kidneys significantly damaged — reason for screening high-risk groups. What are the stages of CKD? Stage 1 — eGFR 90+ with kidney damage markers. Stage 2 — eGFR 60–89. Stage 3 — eGFR 30–59 (split 3a and 3b). Stage 4 — eGFR 15–29. Stage 5 — eGFR under 15 or on dialysis — kidney failure. Higher stage number means lower function. How can I slow kidney disease progression? Control blood pressure — target often under 130/80 with proteinuria. Optimise diabetes — HbA1c individualised. ACE inhibitor or ARB if albumin in urine. Avoid nephrotoxic drugs — regular NSAIDs, some antibiotics. Stop smoking. Maintain healthy weight. SGLT2 inhibitors (dapagliflozin) now recommended in CKD with albuminuria even without diabetes. When do you need dialysis? When eGFR falls below 10–15 and symptoms of uraemia appear — nausea, confusion, fluid overload not controlled by diuretics, high potassium. Planned start better than emergency — attend low-clearance clinic beforehand. Haemodialysis (usually 3 times weekly hospital) or peritoneal dialysis (home) — discuss preferences early. Can you live a normal life with one kidney? Yes — living kidney donors and people born with one kidney often have normal lifespan if remaining kidney healthy. After donation, annual blood pressure and kidney function checks recommended. Contact sports caution — protect solitary kidney. ## Sources - [NHS — Chronic kidney disease](https://www.nhs.uk/conditions/kidney-disease/) - [NICE — Chronic kidney disease](https://www.nice.org.uk/guidance/ng203) - [Kidney Care UK](https://www.kidneycareuk.org/)