Chronic kidney disease (CKD) is a widespread condition that affects one in ten adults, contributing to an estimated 45,000 deaths each year—a figure exceeding combined fatalities from breast and prostate cancer. Despite its significant impact, the disease is often asymptomatic and goes undetected by the majority of those affected.
CKD is characterized by a gradual decline in kidney function, where the organs become less efficient at filtering waste and excess water from the blood. While only about 2% of CKD patients eventually experience complete kidney failure requiring dialysis or transplant, the primary danger lies in the strain CKD places on the cardiovascular system. Individuals with CKD are approximately 20 times more likely to die from a heart attack or stroke than from kidney failure.
Early stages of CKD typically present no noticeable symptoms because the body can compensate for reduced kidney function. Diagnosis often occurs incidentally through routine blood or urine tests ordered for other health concerns. When symptoms do emerge, they are often vague, such as fatigue, brain fog, or itchy skin. More advanced signs can include weight loss, swelling in the extremities, breathlessness, blood in the urine, increased urination frequency, or muscle cramps. By the time these symptoms become apparent, the disease has often been present for years, and unlike many other conditions, CKD cannot be reversed; the existing damage is irreversible.
Key risk factors for CKD include diabetes and high blood pressure, with a reciprocal relationship where each condition can worsen the other. Lifestyle factors such as an unhealthy diet, lack of exercise, excessive alcohol consumption, and smoking are common triggers for these conditions.
Diagnosis of CKD is typically achieved through two simple tests available at a general practitioner's office. A blood test measures creatinine levels, a waste product the kidneys are responsible for clearing, to assess kidney function. A urine test checks for albumin, a protein that indicates kidney damage when present in the urine. Individuals diagnosed with diabetes or high blood pressure are strongly advised to request these tests from their GP.
While CKD cannot be cured, early detection is crucial for halting its progression. Managing blood pressure and diabetes through lifestyle modifications—including weight loss, a balanced diet rich in fruits, vegetables, and whole grains, and reduced intake of salt and sugar—is vital. Maintaining an active lifestyle and moderating alcohol consumption are also important. For smokers, quitting is recommended.
Significant advancements in treatment have occurred in recent years, particularly with the development of SGLT2 inhibitors, such as dapagliflozin and empagliflozin. Originally used for diabetes management, these medications have demonstrated in clinical trials the ability to substantially slow the decline of kidney function and reduce the risk of heart failure and death in CKD patients, regardless of whether they have diabetes. Patients with CKD who have not been offered these medications should discuss the possibility with their GP.
For individuals aged 40 to 74 without pre-existing health conditions, regular NHS health checks are available every five years. These checks include assessments of blood pressure, blood glucose, and cholesterol, and kidney function testing if high blood pressure is detected. Experts urge individuals to seek medical evaluation proactively to avoid the potential for serious complications, such as heart attack, rather than waiting for symptoms to appear.