A nurse is caring for a client who has a new diagnosis of chronic renal failure

Kidney disease (also called renal disease) is a general term for when the kidneys are damaged and do not function as they should. If you have kidney disease that lasts for more than 3 months, it is called chronic kidney disease (or CKD).

When the kidneys do not work properly, wastes and fluids build up inside the body. Chronic kidney disease can lead to other problems like heart disease and high blood pressure, and eventually to complete kidney failure, so getting treatment early is vital.

About 1 in 10 Australian adults has signs of chronic kidney disease. Aboriginal and Torres Strait Islander people are twice as likely to have chronic kidney disease than non-Indigenous Australians.

Learn more here about kidneys and their function.

What are the symptoms of chronic kidney disease?

Kidney disease is sometimes called a 'silent disease' because there may be no warning signs.

In the early stages you will probably not have any symptoms.

As kidney disease progresses, you may start feeling unwell. Symptoms of the middle and late stages include:

• high blood pressure
• changes in the amount and number of times you pass urine, such as waking up in the night to urinate
• changes in how the urine looks (such as frothy or foaming urine)
• blood in the urine
• puffiness in the legs, ankles or around the eyes
• pain in the kidney area
• tiredness, lethargy
• loss of appetite
• headaches
• poor concentration
• itching
• shortness of breath
• nausea and vomiting
• bad breath and a metallic taste in the mouth
• muscle cramps
• pins and needles in the fingers or toes
• restless legs
• generally feeling unwell

What causes chronic kidney disease?

The most common cause of chronic kidney disease in Australia is diabetes. This is because high blood sugar levels damage the blood vessels in the kidneys, stopping them from filtering wastes properly. About 4 in 10 cases of chronic kidney disease are caused by diabetes. Chronic kidney disease caused by diabetes is also called diabetic nephropathy.

High blood pressure can also lead to kidney disease. So can glomerulonephritis, an inflammation of the kidneys that can either be inherited or follows an infection.

Other things that contribute to people getting chronic kidney disease are:

The kidneys can also be damaged by misuse of some painkillers, prescription medicines and illegal drugs.

ARE YOU AT RISK? — Are you at risk of type 2 diabetes, heart disease or kidney disease? Use the Risk Checker to find out.

When should I see my doctor?

If you notice any of the symptoms above, see your doctor. If you have one or more of the risk factors for kidney disease, it is particularly important to look after your kidney health and get your kidney function checked every 1 to 2 years.

The body can cope with the kidneys not working properly for quite a while. People can lose 90% of their kidney function before they experience any symptoms. This makes it particularly important to take notice of any symptoms that do appear, and seek medical advice.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

How is chronic kidney disease diagnosed?

If your doctor suspects you have kidney disease, they will talk to you about your health and the health of your family, and run some tests.

Tests that help to diagnose kidney disease include:

• checking blood pressure
• urine tests (to look for blood and/or albumin, a protein that is excreted by damaged kidneys)
• blood tests (to measure the level of waste products in the blood; for example, creatinine and urea)
• an Estimated Glomerular Filtration Rate (eGFR) test (a blood test that measures kidney function )
• imaging tests (for example, an ultrasound or CT scan to look for abnormalities in your kidneys and urinary tract)

If these tests show you have kidney damage, you may be referred to a specialist kidney doctor, called a nephrologist. They will try to work out the cause of your chronic kidney disease.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How is chronic kidney disease treated?

Chronic kidney disease cannot be cured but treatments can help prevent it from getting worse.

There are 5 stages of kidney disease. The type of treatment depends on the :

Stages 1-2: Your doctor will probably take steps to prevent you from developing cardiovascular disease. This may involve lifestyle changes and medication to lower blood pressure and keep your blood sugar under control. Make sure you tell your doctor of any medications you are taking, including natural or herbal remedies, as these can affect your kidneys. Your doctor will need to see you every 12 months.

Stages 3-4: People often discover they have kidney disease when it has already progressed and they start to feel unwell. You may need treatment to lower your blood pressure, blood fats and blood sugar. Your doctor will need to see you every 3 to 6 months.

Stages 4-5 (kidney failure): When the kidneys can no longer function on their own, people need kidney replacement therapy. This may include:

• kidney transplant, in which a diseased kidney is replaced by a healthy one from a donor
• dialysis, which uses a machine (haemodialysis) or other parts of the body (abdominal dialysis) to remove waste and extra fluid from the blood
• supportive care, which means providing all health care and support possible, but not attempting to cure the kidney failure. In this case the person with kidney failure will eventually die

You can buy a book about living with kidney failure from Kidney Health Australia.

What lifestyle changes can I make?

Chronic kidney disease will gradually get worse, but there is plenty you can do to slow the progression and improve your quality of life. Changes you should make include:

• stop smoking
• eat a healthy diet. That means eating a variety of vegetables, fruits, wholegrain cereals, lean meats, poultry, fish, eggs, nuts and seeds, legumes and beans, and low-fat dairy products. Make sure you limit salt to less than 6g a day and limit your intake of saturated and trans fats. In the later stages of chronic kidney disease, you may need to follow specific instructions from your doctor on what you can eat or drink
• maintaining a healthy weight. If you have chronic kidney disease, you should ideally have a BMI of 25 or less
• limit alcohol to less than 2 standard drinks a day
• be physically active on most, preferably all, days of the week. Aim for 150 to 300 minutes of moderate or 75 to 150 minutes of vigorous physical activity each week, and make sure you do some muscle strengthening exercises
• take medicines to treat high blood pressure, diabetes, high cholesterol or other underlying conditions

If you are being treated for chronic kidney disease, your doctors may need to change other medicines you are on, since many medicines can affect the kidneys, such as blood pressure drugs and anti-inflammatories. Some medicines which leave the body through the kidneys may need to have their dose adjusted.

Can chronic kidney disease be prevented?

There is plenty you can do to help keep your kidneys healthy and help prevent kidney disease.

• watch your weight — being overweight increases your risk of diabetes and high blood pressure, which in turn increase your risk of kidney disease
• eat healthily — a diet high in fruit and vegetables and low in salt, sugar and fats is best
• drink plenty of water — avoid sugary drinks (such as soft drinks)
• exercise regularly
• do not smoke
• limit your alcohol intake to less than 2 standard drinks a day
• find ways to help you relax and reduce stress
• be aware of your risk factors — if you know you are at risk of kidney disease, you can have your kidneys checked regularly

NEED TO LOSE WEIGHT? — Use the BMI Calculator to find out if your weight and waist size are in a healthy range.

What if I am at 'high risk' for kidney disease?

If you have diabetes, it's very important to keep your blood sugar level under control. You should also have your doctor check your blood pressure regularly, as well as your cholesterol and blood sugar levels, and make sure that any urinary tract infections (UTIs) are treated straight away.

What are some complications of chronic kidney disease?

Kidney disease can cause many different problems, including:

• anaemia (a lack of red blood cells, which in turn can make you tired, breathless, dizzy, depressed and prone to feeling the cold)
• pain in the bones, joints, muscles or nerves
• muscle cramps, especially in the legs
• changes in bowel habits, such as constipation or diarrhoea
• nausea, vomiting and loss of appetite
• problems with your mouth or teeth (for example, bad breath, a metallic taste in the mouth)
• itchy skin
• bruising
• depression, anxiety, irritability, moodiness
• trouble sleeping
• hair loss

Acute kidney injury and other kidney conditions

If kidney damage happens quickly, it is called acute kidney injury, or acute kidney failure. This can happen if there is reduced blood supply to the kidneys, such as in surgery or through dehydration, damage caused by a medication, a physical injury to the kidney, kidney stones or enlarged prostate. Though often short-lived, this can still cause lasting kidney damage. If you experience acute kidney injury, it's important to keep a close eye on your kidney health in future.

Other types of kidney-related conditions include:

Some of these are curable. Some are not. But in all cases, there are ways to make you feel better and ease symptoms.

If you have an infection, you will need antibiotics.

If you have kidney stones, you may need painkillers, antibiotics or surgery.

Resources and support

For more information about chronic kidney disease and kidney health in general, visit the Kidney Health Australia website, or call their Kidney Helpline on 1800 454 363.

Kidney Health Australia also has resources for Aboriginal and Torres Strait Islander people.

You can read about diabetes and kidney health on the Diabetes Australia website.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: January 2021