What is kidney disease?

Kidney disease describes a variety of disease and disorders that affect the kidneys. Most disease of the kidney attack the filtering units of the kidneys—the nephrons—and damage their ability to eliminate wastes and excess fluids.

Chronic kidney disease (CKD) is the presence of kidney damage, or a decreased level of kidney function, for a period of three months or more. Kidney disease can range from mild to severe and in some cases, lead to kidney failure (sometimes referred to as end-stage kidney disease, or ESKD). Kidney disease often starts slowly and develops without symptoms over a number of years, so CKD may not be detected until it has progressed to the point where your kidney function is quite low. Fortunately, most people do not progress to end-stage kidney disease, especially if they are diagnosed early and are able to take steps to preserve their remaining kidney function.

“End-stage” kidney disease does not mean the end of your life. End-stage means the end of your kidney function: your kidneys no longer adequately filter your blood. If your kidneys fail, there are a number of different treatment options including non-dialysis supportive care (conservative care), transplantation, or different forms of dialysis.

Sometimes kidney failure occurs rapidly and this is called acute kidney injury. This may be a result of infection, diseases that specifically attack the kidney filters, or other causes. For acute kidney injury, dialysis treatment may be urgently needed for a period of time, but kidney function often recovers.

The following information provides an overview to help you understand CKD at different phases, including potential symptoms and treatment. The amount of kidney function (GFR) you have remaining, your symptoms, your overall health and other factors (such as the amount of albumin in your urine) will be used to help you and your healthcare team to manage your health, monitor your kidney function and determine the type of treatment that’s best for you.

KIDNEY FUNCTION, SYMPTOMS AND TREATMENT
Kidney Function Symptoms Treatment options
Normal
(> 60%)*
No symptoms observed. Identify cause and try to reverse it. Monitor albumin and GFR.
Mild
(45% - 59%)
No symptoms observed. Monitor albumin and GFR, blood pressure, general health and well-being. Try to stop or slow down the worsening of kidney function.
Moderate
(30% - 44%)
Early symptoms may occur and could include tiredness, poor appetite, and itching. Monitor albumin and GFR, and continue to try to stop or slow down the worsening of kidney function. Learn more about CKD and treatment options.
Severe
(15% - 29%)
Tiredness, poor appetite and itching may get worse. Monitor albumin and GFR, and continue to try to stop or slow down the worsening of kidney function. Discuss and plan for treatment choice: dialysis access, assessment for transplant, or information on non-dialysis supportive care.
Kidney failure
(< 15%)
Symptoms may include severe fatigue, nausea, difficulty breathing and itchiness. Monitor albumin and GFR, and continue to try to stop or slow down the worsening of kidney function. Continue with non-dialysis supportive care, plan for transplant or start dialysis (depending on symptoms)**.



* Normal unless there is an underlying issue, kidney damage or albumin in the urine.
** The timing of starting dialysis treatment depends on a large number of factors. This should be discussed with your doctors and healthcare team.



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