Chronic Kidney Disease: A Beginner-Friendly Start
Chronic Kidney Disease: the few things that matter most, and the mistakes that catch people out early.
Long-term reduction in kidney function, graded by filtration rate and protein leak.
Key takeaways
- Measured by: eGFR and urine albumin-to-creatinine ratio (ACR)
- Stages: G1 to G5 by eGFR, A1 to A3 by ACR
- Most useful single change: Control blood pressure and blood glucose; they drive most progression.
- Commonest mistake: Regular NSAIDs such as ibuprofen without medical advice.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Why bother
It is common, usually symptomless until advanced, and most of its harm is cardiovascular rather than renal.
Start here
Begin here, with two things rather than ten.
- Control blood pressure and blood glucose; they drive most progression
- Ask for your eGFR and ACR figures, not just "kidney function"
Then add these
Next, once the first two have stopped feeling like effort.
- Ask about SGLT2 inhibitors, which now slow progression in many people
- Have an annual review including ACR, not eGFR alone
The numbers, in one place
| Measure | Figure |
|---|---|
| Measured by | eGFR and urine albumin-to-creatinine ratio (ACR) |
| Stages | G1 to G5 by eGFR, A1 to A3 by ACR |
| Commonest causes | diabetes and high blood pressure |
| Main risk | cardiovascular disease, more than dialysis |
| Most people with early CKD | never progress to kidney failure |
Common early mistakes
- Regular NSAIDs such as ibuprofen without medical advice
- Herbal remedies and high-dose supplements, several of which are nephrotoxic
- Assuming a single abnormal eGFR means kidney disease; it needs repeating
Where to go next
- Chronic Kidney Disease in Five Minutes
- The Evidence on Chronic Kidney Disease, Without the Hype
- Chronic Kidney Disease — the reference entry
- What the Guidance Really Says About Kidney Stones
- Kidney Infection: Sorting the Evidence From the Noise
When to speak to a doctor
Seek urgent medical help for passing much less urine than usual, swelling of the legs or face with breathlessness, or confusion and drowsiness. Contact a GP promptly for blood in the urine, frothy urine, or a rapid fall in eGFR. Stop metformin, SGLT2 inhibitors, ACE inhibitors, ARBs and diuretics during dehydrating illness and seek advice.
Where this comes from
- NICE — Chronic kidney disease: assessment and management
- Kidney Care UK — understanding CKD
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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