Chronic Kidney Disease

Chronic kidney disease (CKD) is the gradual, long-term loss of kidney function, most commonly caused by diabetes and hypertension. It often progresses silently and can lead to kidney failure if not identified and managed early.

• Often no symptoms in early stages
• Fatigue and weakness
• Swelling of the legs, ankles, or around the eyes
• Changes in urination — frequency, foaminess, or reduced output
• Loss of appetite and nausea in more advanced disease
• Itching and difficulty concentrating in later stages

• Diabetes and hypertension are the leading causes.
• Chronic glomerulonephritis and recurrent urinary tract infections or obstruction can also damage the kidneys over time.
• Risk is increased by prolonged use of certain medicines that harm the kidneys, and by a family history of kidney disease.

• Diagnosed and staged using blood tests to estimate glomerular filtration rate (eGFR) together with urine testing for protein (proteinuria), on at least two occasions three months apart to confirm chronicity.
• Blood pressure and blood glucose are assessed, as they are the leading underlying causes.
• Kidney ultrasound may be used to assess kidney size and structure where available.

Management focuses on controlling the underlying cause — good blood pressure and blood glucose control are central to slowing progression.

An ACE inhibitor or angiotensin receptor blocker is often preferred for blood pressure control in CKD, as these medicines also help protect kidney function, alongside careful monitoring of kidney function and potassium levels.

Dietary advice includes moderating salt and protein intake as guided by a health worker, and avoiding medicines that can further harm the kidneys, such as prolonged NSAID use.

Patients with advanced or rapidly worsening kidney disease, or with complications such as severe anaemia or fluid overload, are referred to a specialist for further management, which may eventually include dialysis or transplantation.

• Maintain good control of blood pressure and blood sugar if you have diabetes or hypertension.
• Avoid unnecessary or prolonged use of NSAIDs and other medicines that can harm the kidneys.
• Stay well hydrated and seek prompt treatment for urinary tract infections.
• Attend routine health checks, especially if you have diabetes, hypertension, or a family history of kidney disease.