Chronic kidney disease is a condition in which the kidneys are not working correctly. It is caused by damage to tiny structures within the kidneys called nephrons. In the early stages, chronic kidney disease does not cause symptoms; therefore, most people don’t know they have the condition.
The kidneys are bean-shaped organs located in the lower back just below the rib cage. Each kidney is about the size of a fist. The two kidneys filter blood, catch needed substances, return them to the circulation, and dispose of wastes in the urine. If the kidneys don’t filter properly, wastes build up in the blood. The kidneys also maintain the balance of water in the body and release hormones. These hormones keep the bones strong, control blood pressure, and help the body make red blood cells. If your kidneys stop working, your bones may become weak, your blood pressure may increase, and your red blood cell count may decrease.
Anatomy of the Kidneys
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Chronic kidney disease is a progressive condition. Doctors use stages to describe how serious it is. The stage is based on the glomerular filtration rate (GFR).
|Stage||Glomerular Filtration Rate (GFR)|
|1||Over 90 mL/min (normal)|
|2||60 to 89 mL/min (mild decrease)|
|3||30 to 59 mL/min (moderate decrease)|
|4||15 to 29 mL/min (severe decrease)|
|5||under 15 mL/min (kidney failure or end-stage renal disease)|
The two most common causes of chronic kidney disease are diabetes and hypertension.
occur when the body doesn’t process the sugar in the blood well. The amount of sugar in the blood increases. High blood glucose damages the kidneys, the heart, blood vessels, and eyes.
, also known as high blood pressure, occurs when there is high pressure within the arteries of the body. Hypertension damages the kidneys. Chronic kidney disease can also cause hypertension.
Other conditions that can cause chronic kidney disease include:
Intrinsic renal disease such as
polycystic kidney disease
Glomerular disease leading to renal damageRenal tubular disorders
Diseases of the immune system such as
, tumors, or in men, an
, causing obstructive kidney diseases
urinary tract infectionsToxic exposuresProlonged use of medications, such as ibuprofen, aspirin, or phenacetinBilateral renal artery stenosis
HIVObstructive sleep apneaTubular interstitial nephritis
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http://www.kidney.org/kidneydisease/aboutckd.cfm. Accessed July 2, 2013.
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http://www.kidney.org/atoz/pdf/11-10-1814.pdf. Published 2010. Accessed July 2, 2013.
Chronic kidney disease. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed July 2, 2013.
Chronic kidney disease: patient information handout. American Academy of Family Physicians website. Available at:
http://familydoctor.org/online/famdocen/home/common/kidney/832.html. Updated November 2010. Accessed July 2, 2013.
Kidney disease basics. National Kidney Disease Education Program website. Available at:
http://www.nkdep.nih.gov/patients/kidney_disease_information.htm. March 1, 2012. Accessed July 2, 2013.
National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in chronic kidney disease.
Am J Kidney Dis.
National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.
Am J Kidney Dis.
National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease.
Am J Kidney Dis.
Snyder S, Pendergraph B. Detection and evaluation of chronic kidney disease.
Am Fam Physicians.
8/10/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Molnar M, Mucsi I, et al. Association of incident obstructive sleep apnoea with outcomes in a large cohort of US veterans. Thorax 2015 June 2 early online.
Last reviewed May 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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