Chronic kidney disease

Also called CKD, Kidney failure, Renal failure

Kidneys losing function slowly and silently. Most people who have it do not know.

What it is

Chronic kidney disease is the quietest serious condition in this library. Around 7.2 million people in the UK have it, and most have no idea, because kidneys give almost no warning until a great deal of function has gone.

It is measured in five stages by eGFR, a blood test. Stages one and two are usually silent. By stage four the effects are obvious, and by then the options have narrowed.

The two commonest causes are diabetes and high blood pressure, both of which are themselves manageable. That is the whole argument for finding it early.

Signs you might notice

Nothing at all, for years. That is the point.

Later: swollen ankles, tiredness that is really anaemia, poor appetite, itching, breathlessness, needing to pass urine at night.

Blood tests showing a falling eGFR, or protein in the urine, which is often the first real signal.

How it can affect day-to-day life

The trap is medication. Kidneys clear a great many drugs, so as function falls, ordinary doses become overdoses. Ibuprofen and other anti-inflammatories are the commonest offenders and they are sold in every supermarket.

Sick day rules matter enormously and are barely known. Certain medicines, including some blood pressure tablets and diuretics, should be paused during vomiting, diarrhoea or fever, because dehydration plus those drugs damages kidneys quickly.

Dialysis, when it comes, takes over a life: three sessions a week, four hours each, plus travel and recovery.

Supporting someone well

Learn the sick day rules and keep the list somewhere findable. This single measure prevents a meaningful share of acute kidney injuries.

Avoid ibuprofen, naproxen and diclofenac unless a kidney doctor has said otherwise. Paracetamol is usually the safer choice.

Treat blood pressure seriously. It is the most effective lever available for slowing decline.

Watch salt rather than protein, unless a dietitian has said otherwise. Processed food, not the salt cellar, is where most of it comes from.

Check every new medicine, including over-the-counter ones, against the kidney function. A pharmacist will do this for free.

In a care service, Fiducia Together holds medicines and clinical observations in one place, so an eGFR that has dropped is visible to whoever is reviewing the medication rather than sitting in a letter.

Where to get help

A GP monitors most CKD. Ask what your eGFR is and whether it is changing, because a stable number and a falling one are entirely different situations.

Ask for referral to a kidney specialist if eGFR is below 30 or falling quickly.

Kidney Care UK have a free helpline and practical guides on benefits and work.