Chronic kidney disease (CKD) means the kidneys are damaged and gradually lose their ability to filter waste and extra fluid from the blood. It affects roughly one in seven American adults, and most people who have it do not know it, because early kidney disease usually causes no symptoms. Finding it early matters: straightforward treatments can slow or even stop its progression toward kidney failure. People with diabetes, high blood pressure, heart disease, or a family history of kidney failure should have their kidney function checked at least once a year. Causes: Most chronic kidney disease in the United States is caused by diabetes and high blood pressure, which damage the kidneys' small blood vessels over many years. Common causes and risk factors include:

Diabetes: Persistently high blood sugar from diabetes injures the kidneys' filtering units and is the leading cause of kidney failure.
High blood pressure: Uncontrolled blood pressure strains and scars the delicate vessels inside the kidneys.
Glomerulonephritis: Inflammation of the kidneys' filtering units, which can follow infections or immune conditions.
Polycystic kidney disease: An inherited condition in which fluid-filled cysts gradually replace normal kidney tissue.
Blockage or repeated stones: Recurrent kidney stones, an enlarged prostate, or other urinary blockage can damage the kidneys over time.
Long-term NSAID use: Regular use of pain relievers such as ibuprofen or naproxen can harm kidney function.

Symptoms: Early CKD rarely causes symptoms, which is why routine screening is so important for people with risk factors. As kidney function declines, people may notice:

Fatigue and trouble concentrating: Wastes build up in the blood, and reduced red blood cell production can cause anemia.
Swelling: Puffiness in the ankles, feet, hands, or around the eyes from retained fluid.
Foamy urine: A sign of protein leaking into the urine through damaged filters.
Urinating more at night, poor appetite, nausea, muscle cramps, or itching: These tend to appear in later stages.

Diagnosis: CKD is diagnosed with two simple tests: a blood test that estimates the glomerular filtration rate (eGFR), a measure of how well the kidneys filter, and a urine test for albumin, a protein that leaks through damaged filters. Abnormal results persisting for at least three months confirm the diagnosis, and the findings are used to assign a stage from 1 (mild) to 5 (kidney failure). An ultrasound is sometimes ordered to look at kidney size and structure. Treatment: Treatment focuses on slowing progression and protecting the heart, since cardiovascular disease is the most common complication of CKD:

Blood pressure control: ACE inhibitors such as lisinopril or ARBs such as losartan lower blood pressure and reduce protein loss in the urine.
SGLT2 inhibitors: Medications such as dapagliflozin and empagliflozin slow the loss of kidney function in many patients, with or without diabetes.
Diuretics: Water pills such as furosemide help control swelling and blood pressure.
Blood sugar control: Careful diabetes management protects the kidney function that remains.
Kidney-safe habits: Limiting sodium, avoiding NSAIDs, staying hydrated, and not smoking.
Treating complications: Anemia and mineral and bone problems, including secondary hyperparathyroidism, are monitored and treated as CKD advances.

Complications: Advanced CKD can lead to fluid overload, high potassium levels, worsening blood pressure, bone disease, and a substantially higher risk of heart attack and stroke. A minority of patients eventually progress to kidney failure, which is treated with dialysis or kidney transplant — but with modern therapy started early, most people with CKD never reach that point. People with CKD do best with regular lab monitoring and coordinated chronic-disease care. The internal-medicine team at Zimmer Medical Group screens for kidney disease as part of routine care and adjusts treatment early, when it makes the biggest difference.

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Chronic Kidney Disease (CKD)

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