Chronic kidney disease (CKD) means that the kidneys have been damaged or have filtered less well than normal for at least 3 months. It is staged from 1 to 5 using the estimated glomerular filtration rate (eGFR) together with the amount of protein leaking into the urine. About 1 adult in 10 has some degree of it.
Lost kidney function does not come back, but the speed of decline can often be slowed a great deal. Most people with CKD never reach dialysis; their greater risk is heart disease and stroke. Care is a matter of steady, regular follow-up over years, not a single treatment.
Symptoms
- Usually none in stages 1 to 3, where it is found on routine blood or urine tests
- Tiredness and poor concentration
- Swollen ankles, feet or eyelids
- Foamy urine, or passing urine more often at night
- Raised blood pressure that is hard to control
- Poor appetite, nausea and a metallic taste in later stages
- Itching, muscle cramps and restless legs
- Breathlessness from fluid overload or anaemia
Causes and risk factors
Diabetes and high blood pressure account for most cases. Other causes are glomerulonephritis, polycystic kidney disease and other inherited disorders, repeated kidney infections or reflux, long-standing obstruction from stones or an enlarged prostate, autoimmune diseases such as lupus, and long-term use of anti-inflammatory painkillers, lithium and some herbal remedies. Risk rises with age, smoking, obesity, cardiovascular disease, a family history of kidney failure and a previous episode of acute kidney injury. Some decline in eGFR with ageing is normal, so results in older people need interpreting with care.
How it is diagnosed
- Creatinine and eGFR: A blood test estimating filtering capacity. Two results at least 3 months apart are needed for the diagnosis. Cystatin C can refine a borderline result.
- Urine albumin to creatinine ratio: Measures protein leak, which predicts progression and cardiovascular risk independently of eGFR.
- Urine dipstick and microscopy: Blood or casts in the urine suggest inflammation within the kidney.
- Kidney ultrasound: Shows kidney size, cysts, scarring and obstruction.
- Blood count, potassium, bicarbonate, calcium, phosphate and PTH: Look for anaemia, acid build-up and mineral bone disorder, which appear from stage 3 onward.
- Kidney biopsy: Considered when the cause is unclear, protein loss is heavy or function is falling quickly.
Treatment options
- Blood pressure control: Usually with an ACE inhibitor or ARB, which also reduces protein leak. The usual aim is below 130 over 80 when there is proteinuria.
- SGLT2 inhibitors: Dapagliflozin or empagliflozin slow progression and protect the heart in people with and without diabetes.
- Finerenone and GLP-1 medicines: Additional protection in diabetic kidney disease.
- Cardiovascular risk reduction: A statin, stopping smoking, exercise and weight management.
- Diet: Less salt, moderate protein, and potassium or phosphate limits only when blood tests call for them, ideally planned with a renal dietitian.
- Managing complications: Iron and erythropoietin type injections for renal anaemia, vitamin D and phosphate binders for bone disease, bicarbonate for acidosis.
- Medicine safety: Avoiding anti-inflammatory painkillers, adjusting doses to kidney function and taking care with contrast dye and during dehydrating illness.
- Preparing for kidney replacement: From around stage 4: education about transplant, including pre-emptive living donor transplant, dialysis options and fistula creation, or conservative care for those who choose it.
When it is urgent
Seek emergency care locally for severe breathlessness, chest pain, confusion or drowsiness, a marked drop in urine output, muscle weakness or palpitations (possible high potassium), or persistent vomiting. If you take ACE inhibitors, diuretics, metformin or SGLT2 inhibitors and become dehydrated from vomiting or diarrhoea, ask a doctor about pausing them.
Travelling to Türkiye for treatment
CKD is the clearest example of a condition that needs continuous local care: blood and urine tests every 3 to 12 months depending on stage, dose adjustments and a team that knows you. No single trip replaces that. A visit can reasonably offer a full nephrology work-up and second opinion in 2 to 3 days, a kidney biopsy when the cause is unknown, fistula surgery, or evaluation for a living related donor transplant. Holiday dialysis can be arranged, but must be booked weeks ahead. Bring at least 2 years of creatinine results, since the trend matters more than any one value.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Can CKD be reversed?
Established scarring cannot. A reversible element, such as obstruction, a harmful medicine or uncontrolled blood pressure, can sometimes be corrected, and progression can often be slowed substantially.
Will I need dialysis?
Most people with stage 3 CKD never do. The risk is higher with heavy proteinuria, diabetes, younger age at diagnosis and a rapid fall in eGFR.
How much water should I drink?
Drink to thirst unless told otherwise. Forcing large volumes does not protect kidneys, and in advanced disease fluid may need limiting.
My eGFR changed between tests. Is that bad?
Small swings are normal with hydration, meat meals and muscle mass. A sustained downward trend over months is what counts.
Do I need a special diet?
Everyone benefits from less salt. Further restrictions depend on your own results, and unnecessary restriction can cause malnutrition.