Kidney Disease and Kidney Failure: Causes, Symptoms, Prevention and Treatment

Kidney disease can develop quietly. Many people feel well during its early stages and discover a problem only through blood or urine tests. Recognising risk factors and getting appropriate testing can help identify problems before complications develop.

A diagnosis of kidney disease does not automatically mean kidney failure or a need for dialysis. Kidney problems differ in their causes, severity and treatment. Some develop suddenly and may improve with prompt care, while others require long-term management.

This guide explains the differences, the warning signs to recognise, the tests doctors use, and practical steps for protecting kidney health.

What Do the Kidneys Do?

The kidneys remove waste products and excess water from the blood to produce urine. They also help:

Balance important minerals in the body.

Maintain blood pressure.

Support the production of red blood cells.

Keep bones healthy.

When kidney function declines, these processes can be affected. This is why kidney disease can influence several aspects of health, rather than causing urinary symptoms alone.

Kidney Disease, Acute Kidney Injury and Kidney Failure: What Is the Difference?

Acute Kidney Injury

Acute kidney injury, or AKI, is a sudden decline in kidney function over hours or days. Possible causes include dehydration, severe infection, reduced blood flow, certain medicines and a blockage in the urinary tract.

AKI needs prompt medical assessment. Kidney function may recover after the underlying cause is treated, although recovery is not guaranteed.

Chronic Kidney Disease

Chronic kidney disease, or CKD, means an abnormality of kidney structure or function has been present for at least three months and has implications for health.

It may involve reduced filtering ability, persistent protein leakage into urine or other evidence of kidney damage.

Kidney Failure

Kidney failure describes a severe loss of kidney function. It can occur during severe acute illness or as an advanced stage of chronic kidney disease.

AKI and CKD can occur together. Someone with existing CKD may develop an additional sudden decline during illness.

What Causes Kidney Disease?

Diabetes

Persistently high blood glucose can damage the kidneys’ filtering structures. Diabetes is one of the most common causes of CKD in adults.

High Blood Pressure

High blood pressure can damage kidney blood vessels. Kidney disease can also make blood pressure harder to control.

Other Causes

Other causes include:

Inflammation affecting the kidney filters, such as glomerulonephritis.

Inherited conditions, including polycystic kidney disease.

Autoimmune diseases affecting the kidneys.

Certain infections.

Longstanding urinary obstruction.

Damage associated with some medicines or toxic substances.

Finding the cause helps doctors choose the most appropriate treatment.

Who Should Discuss Kidney Testing With a Doctor?

Testing is particularly important for people with:

Diabetes.

High blood pressure.

Heart disease.

A family history of kidney failure.

Ask your doctor how frequently you should be tested. The appropriate schedule depends on your medical history and previous results.

Do not wait for pain or a change in urine output before discussing testing if you have risk factors.

Common Symptoms of Kidney Disease

Early CKD often causes no noticeable symptoms. As kidney disease becomes more advanced, possible symptoms include:

Persistent tiredness or reduced energy.

Swelling around the ankles, feet or hands.

Shortness of breath.

Reduced appetite or nausea.

Itching.

Muscle cramps.

Passing urine more frequently at night.

Blood in the urine.

These symptoms can have other causes. They cannot confirm kidney disease without assessment and appropriate testing.

Symptoms of a Sudden Kidney Problem

AKI may cause a marked reduction in urine, vomiting, swelling, dizziness, unusual sleepiness, confusion or breathlessness. It may also be detected on blood tests before obvious symptoms appear.

Seek urgent medical assessment if a sudden kidney problem is suspected.

When to Seek Urgent Medical Care

Seek urgent assessment for:

Passing much less urine than usual or being unable to pass urine.

Persistent vomiting with difficulty keeping fluids down.

New or rapidly increasing swelling.

Breathlessness, particularly when lying down.

New confusion or unusual drowsiness.

Symptoms suggesting dehydration or serious infection.

Go to the nearest emergency department for severe breathlessness, chest pain, collapse or reduced consciousness.

Do not try to manage these symptoms with extra water, herbal remedies or leftover medicines. The correct treatment depends on the cause and your fluid balance.

How Is Kidney Disease Diagnosed?

Serum Creatinine and eGFR

Creatinine is a waste product measured in the blood. Doctors use it to estimate the glomerular filtration rate, or eGFR , which indicates how well the kidneys are filtering.

An eGFR value is not a direct percentage of kidney function. Its interpretation depends on the clinical situation and changes over time.

Urine Albumin-to-Creatinine Ratio

The urine albumin-to-creatinine ratio, or uACR , measures leakage of albumin, a protein, into urine.

The eGFR and uACR provide different information. A person may have evidence of kidney damage even when their filtering rate remains relatively well preserved.

Why Repeat Testing Matters

A single abnormal result does not automatically establish CKD. Doctors may compare earlier reports and repeat tests to determine whether the abnormality is persistent or related to a sudden illness.

However, a potentially serious abnormal result requires prompt assessment. The three-month definition of CKD is not a reason to delay care.

Depending on the suspected cause, additional investigations may include urine examination, blood tests, ultrasound or a kidney biopsy.

Understanding the Stages of Chronic Kidney Disease

Doctors assess CKD using its cause, eGFR category and urine albumin level.

eGFR categoryeGFR, in mL/min/1.73 m²General descriptionG190 or higherPreserved filtering rate with other evidence of kidney damageG260–89Mildly reduced filtering rate with other evidence of kidney damageG3a45–59Mild to moderate reductionG3b30–44Moderate to severe reductionG415–29Severe reductionG5Below 15Kidney failure

G1 or G2 results alone do not establish CKD. Other evidence of persistent kidney damage is needed. Urine albumin results also help doctors assess the risk of progression.

These categories should be interpreted by a clinician, particularly during acute illness when kidney function may be changing rapidly.

Can Kidney Disease Be Prevented?

Not every cause is preventable. However, several measures can reduce risk or help protect remaining kidney function.

Manage Diabetes and Blood Pressure

Follow your prescribed treatment and monitoring plan. Ask your doctor about your individual targets rather than using someone else’s readings as a guide.

Avoid Tobacco

Stopping smoking supports kidney and cardiovascular health.

Stay Active and Maintain a Healthy Weight

Choose regular activity suited to your health and ability. Ask for guidance if you have significant symptoms or advanced disease.

Reduce Excess Salt

Limit heavily salted and highly processed foods. In an Indian diet, frequent sources include pickles, papad, namkeen, instant noodles, packaged soups and salty sauces.

Get Appropriate Follow-Up

Keep appointments and bring previous reports so changes can be recognised over time.

Use Medicines and Supplements Carefully

Some painkillers, particularly nonsteroidal anti-inflammatory drugs such as ibuprofen and diclofenac, can harm the kidneys in susceptible people. Risk can increase during dehydration or when kidney disease is already present.

Before taking an over-the-counter medicine, supplement or herbal preparation:

Tell the doctor or pharmacist about your kidney condition.

Share a complete list of your medicines.

Ask whether the dose needs adjustment.

Check whether combination cold or pain medicines contain an NSAID.

Do not stop prescribed medicines on your own. Some medicines protect the kidneys, but their use may need review during vomiting, diarrhoea or other acute illness. Ask your care team for a clear illness-management plan.

Kidney Disease Diet: Why Advice Must Be Individualised

There is no single diet suitable for every person with kidney disease. Advice depends on kidney function, blood results, nutritional status, other illnesses and whether dialysis is being used.

Salt

Reducing excess sodium can help manage blood pressure and fluid retention.

Protein

Protein needs differ. Some people with CKD who are not on dialysis may need moderation, while people receiving dialysis often need more protein. Avoid starting a high-protein diet or severely restricting protein without professional advice.

Potassium and Phosphorus

Restrictions depend on blood levels and treatment. Not everyone with CKD needs to avoid the same fruits, vegetables, pulses or dairy foods.

Some salt substitutes contain potassium chloride and may be unsuitable for people with high potassium.

Fluids

Drinking extra water does not reverse kidney disease. Some people need help avoiding dehydration; others need a fluid limit because they retain water.

Follow your individual fluid advice. A renal dietitian can help build a practical plan around familiar foods and adequate nutrition.

How Is Kidney Disease Treated?

Treatment for Acute Kidney Injury

Treatment focuses on the cause. It may involve treating infection, correcting dehydration or circulation problems, reviewing medicines, or relieving urinary obstruction.

Fluids are not appropriate for every patient. People with fluid overload need a different approach. Severe AKI may require temporary dialysis.

Treatment for Chronic Kidney Disease

CKD care aims to protect remaining function, reduce cardiovascular risk and manage complications.

Depending on the diagnosis, treatment may include:

Blood pressure and diabetes management.

ACE inhibitors or ARBs in appropriate patients.

SGLT2 inhibitors for eligible patients, including some without diabetes.

Treatment directed at a specific kidney disease.

Management of anaemia, fluid overload and mineral or acid–base disturbances.

Not every medicine is suitable for every person. Selection and monitoring depend on kidney function, potassium levels and other clinical factors.

When Should a Kidney Specialist Be Involved?

A nephrologist may be needed for advanced disease, a rapid decline in function, an uncertain diagnosis, significant protein leakage or difficult complications.

Ask your treating doctor whether specialist assessment is appropriate. Early planning can be valuable when kidney function is worsening.

Treatment Options for Kidney Failure

Haemodialysis

Haemodialysis filters waste and excess fluid from the blood through a machine. The schedule and setting depend on the patient’s needs and available services.

Peritoneal Dialysis

Peritoneal dialysis uses the lining of the abdomen as a filtering surface. It can be performed at home after appropriate assessment and training.

Kidney Transplantation

A kidney transplant may be an option for suitable patients. It requires specialist evaluation and ongoing care, including medicines to prevent rejection.

Conservative Kidney Management

Conservative management is active medical care without dialysis or transplantation. It focuses on symptom control, quality of life and support, following an informed discussion of the person’s goals and likely benefits and burdens of treatment.

Dialysis is not started solely because creatinine reaches a particular number. Doctors consider symptoms, complications, blood results, fluid balance and the overall clinical situation.

Questions to Ask at Your Next Appointment

What is causing my kidney problem?

Is it acute, chronic or both?

What do my eGFR and urine albumin results mean?

How have my results changed over time?

Which medicines or supplements should I avoid?

Do I need changes to salt, protein, potassium or fluids?

When should my tests be repeated?

Do I need a nephrologist or renal dietitian?

Frequently Asked Questions

Can Kidney Disease Be Reversed?

Some acute kidney problems improve after treatment. Established chronic damage is often not fully reversible, but treatment can slow progression and manage complications. Improvement depends on the cause.

Does Everyone With CKD Need Dialysis?

No. Many people with CKD do not progress to kidney failure. Monitoring and treatment help manage their individual risk.

Can I Have Kidney Disease If I Urinate Normally?

Yes. Early CKD may cause no obvious symptoms. Blood and urine tests are more informative than urine quantity alone.

Does One High Creatinine Result Mean Kidney Failure?

No. It needs interpretation alongside previous results, eGFR, symptoms and other tests. It may indicate an acute problem, CKD or another influence, so follow-up is important.

Are Kidney Stones the Same as Kidney Failure?

No. They are different conditions. However, a urinary blockage caused by stones can impair kidney function and may need urgent treatment.

Are “Kidney Detox” Products Necessary?

Do not use such products as a substitute for diagnosis or treatment. Supplements and herbal preparations should be checked for safety, particularly when kidney function is reduced.

Can Someone With CKD Follow a Vegetarian Diet?

Yes, a vegetarian eating pattern can be adapted to individual needs. Portions, protein sources and any mineral restrictions should be planned with a renal dietitian rather than using a universal food-ban list.

Living With Kidney Disease

A kidney diagnosis can feel overwhelming, but understanding your condition can make decisions more manageable. Keep an organised record of test results, medicines and symptoms, and involve your care team when something changes.

Seek support if worry, low mood or treatment demands are affecting daily life. Kidney care includes emotional wellbeing as well as medical treatment.

Medical Disclaimer

This article provides general health information and does not replace an individual medical consultation. Do not start, stop or change medicines, supplements, dietary restrictions or fluid intake without appropriate medical advice. Seek urgent care for severe or rapidly worsening symptoms.

References

World Health Organization — Kidney Disease

KDIGO — 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

National Kidney Foundation — Stages of Chronic Kidney Disease

NIDDK — Causes of Chronic Kidney Disease

NIDDK — Chronic Kidney Disease Tests and Diagnosis

NIDDK — Managing Chronic Kidney Disease

NIDDK — Preventing Chronic Kidney Disease

NIDDK — Keeping Kidneys Safe: Smart Choices About Medicines

NIDDK — Healthy Eating for Adults With Chronic Kidney Disease

National Kidney Foundation — Nutrition and Kidney Disease, Stages 1–5, Not on Dialysis

NIDDK — Choosing a Treatment for Kidney Failure

NHS — Acute Kidney Injury

NHS — Symptoms of Chronic Kidney Disease