Chronic kidney disease (CKD) is an umbrella term for conditions that weaken your kidneys’ ability to filter waste and water from your blood.

Over time, several conditions — including diabetes, high blood pressure, as well as some autoimmune and congenital diseases — can damage the kidneys.

As the damage progresses, your kidneys fail, and you may require a kidney transplant or dialysis.

Early detection and appropriate treatment are critical in slowing disease progression and preventing or delaying kidney failure.

At the urology clinic, our approach is to manage your disease for as long as possible with medications and a special diet.

What Are Symptoms of CKD? 

If you have CKD, you may notice:

• Feeling tired and having less energy

• Urinating less often

• Trouble concentrating or sleeping

• Loss of appetite

• Nighttime muscle cramps

• Swollen feet and ankles

• Puffy eyes

• Dry and itchy skin

Diagnosis

How CKD is Diagnosed

Clinicians perform two blood tests to diagnose CKD:

1. Glomerulofiltration rate (GFR): Determines how well your kidneys are filtering blood.

2. Serum creatinine measurement: Indicates how well your kidneys are removing waste products.

We assess the results of these tests along with your age, race, gender, and other factors to determine your kidney function.

Stages of Chronic Kidney Disease

Treatment Options

Treatment is designed to delay the progression of CKD to kidney failure.

Most patients benefit from:

• Medications

• Dietary changes

If your kidney function drops below a GFR of 20, you will be evaluated for a kidney transplant.

If you are not a candidate for transplantation, dialysis will be started once your kidney function reaches 10 (or sooner if necessary).

Medical Therapy

You will likely be prescribed:

• ACE inhibitors or ARBs to lower blood pressure in the kidneys

• Diuretics to eliminate extra fluid

If you have glomerulonephritis, you may receive:

• Steroids

• Immunosuppressants such as cyclosporine

Other possible medications include:

• Phosphate binders (if your kidneys cannot eliminate phosphate)

• Vitamin D and calcitriol (to prevent bone loss)

• Erythropoietin (to build red blood cells if you are anemic)

Dietary Guidelines

A CKD diet is as important as taking medications.

It aims to:

• Limit sodium to prevent swelling and high blood pressure

• Restrict protein (in certain patients) to prevent disease progression

• Balance calcium and phosphorus to prevent bone loss

• Maintain potassium levels to prevent arrhythmia

Because many foods must be avoided, nutritional supplements may be added to ensure you get enough calories.

Tip: If you stick to your diet, control your blood sugar and blood pressure, and take medications as instructed, you should feel better, retain less fluid, be less itchy, and maintain better bone health.

Kidney Transplantation

If your GFR drops below 20, you will be evaluated for a kidney transplant, even before dialysis becomes necessary.

A successful transplant can:

• Improve strength, stamina, and energy

• Allow you to return to a more normal lifestyle

• Enable you to eat and drink normally

• Potentially resolve anemia

• Reduce or eliminate the need for blood pressure medications

Preferred Option: Kidney transplantation is often preferred over starting dialysis.

For patients with diabetic nephropathy, a kidney/pancreas transplant may eliminate the need for insulin or diabetes medications entirely.

Dialysis

When kidney function drops dramatically, dialysis becomes necessary to remove waste and fluid from the body.

Types of Dialysis

1. Hemodialysis

   • Blood is circulated through a machine that removes waste and fluid.

   • Requires several hours, multiple times per week, at a dialysis center.

2. Peritoneal Dialysis

   • A solution is run directly into the abdomen, absorbing waste.

   • Waste-filled solution is then drained at scheduled intervals.

CKD Clinic

Patients with a GFR less than 45 may benefit from visiting a CKD Clinic.

What to Expect:

• Kidney function testing

• Comprehensive cardiovascular risk assessment, including:

  • BP Tru (accurate blood pressure measurement)

  • Central BP assessment

  • Cholesterol testing

At follow-up visits, a registered dietitian will provide tailored nutrition and dietary plans for CKD and associated conditions (cardiovascular disease, diabetes, etc.).

Important: Becoming an active participant in your treatment is essential to delay the need for transplantation or dialysis.

Tips for Success:

• Keep medical appointments

• Take medications as prescribed

• Stick to your diet

• Monitor blood pressure and blood sugar regularly

Bring a “patient advocate” — a family member or friend — to appointments to help ask the right questions and support your treatment journey.