Chronic Kidney Disease: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Chronic Kidney Disease?
A nephrologist, a doctor who treats kidney disease, usually treats chronic kidney disease (CKD). Blood and urine tests are how doctors check for CKD. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is chronic kidney disease?
Chronic kidney disease (CKD) usually causes the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body. CKD can cause a buildup of fluid and waste products in the body.
There is no cure for CKD, but treatment can help slow it down. In some people, CKD can lead to kidney failure. The final stage is called end-stage renal disease (ESRD). At this stage, a person needs dialysis or a kidney transplant.
Symptoms
Early kidney disease usually does not cause symptoms, and many people are not diagnosed until they have lost most of their kidney function. Early symptoms may include appetite loss, feeling tired, headaches, itching and dry skin, nausea, and weight loss without trying.
As CKD becomes more advanced, symptoms may include:
- Loss of appetite, nausea, or vomiting.
- Feeling tired, having sleep problems, or having trouble concentrating.
- Muscle twitching or cramps, or numbness in the hands and feet.
- Abnormally dark or light skin.
CKD can also cause swelling, called edema, in the ankles, feet, and hands.
Trouble breathing is an emergency. See the 911 line below.
Causes and who gets it
Diabetes and high blood pressure are the 2 most common causes of CKD and account for most cases.
Other causes include birth defects of the kidneys, such as polycystic kidney disease, kidney stones and infection, and injury to the kidney. Some toxic chemicals and some medicines, such as antibiotics and pain and cancer medicines, can also damage the kidneys.
You are at higher risk if you have diabetes, high blood pressure, heart disease, or a family history of kidney failure.
How doctors diagnose it
To check for kidney disease, providers use a blood test for GFR and a urine test for albumin. GFR stands for glomerular filtration rate. Albumin is a protein that can pass into the urine when the kidneys are damaged.
A GFR of 60 or more is in the normal range, and a GFR of less than 60 may mean you have kidney disease. A damaged kidney lets some albumin pass into the urine, so the urine test matters even with a GFR of 60 or more. A GFR of 15 or less is called kidney failure. A urine albumin-to-creatinine ratio (UACR) of more than 30 mg/g may be a sign of kidney disease.
A urinalysis may show protein or other changes in the urine months to years before symptoms appear. Ultrasound, CT scans, MRI scans, and a kidney biopsy may be done to look for the cause or type of kidney disease.
Treatment
Blood pressure control will slow further kidney damage. Medicines called ACE inhibitors or angiotensin receptor blockers (ARBs) are used most often.
SGLT2 inhibitors, medicines that lower blood sugar, can also help keep the kidneys working for longer. One of them, dapagliflozin, is used to treat CKD, often in people who also have diabetes. They are not right for everyone with CKD, so your care team decides.
Lifestyle changes can help protect the kidneys:
- Do not smoke.
- Eat meals that are low in fat and cholesterol.
- Get regular exercise, after talking to your provider first.
- Keep your blood sugar under control and avoid eating too much salt or potassium.
Talk to your provider before taking any over-the-counter medicine, including vitamins, herbs, and supplements. Pain medicines such as ibuprofen can harm your kidneys, so use them only when a medical professional says it is safe. Other treatments may include medicines called phosphate binders, which help prevent high phosphorous levels. To treat anemia, you may need extra iron, erythropoietin shots, or blood transfusions. Your provider may also have you follow a special diet, such as limiting fluids or eating less protein.
Dialysis removes waste from your blood when your kidneys can no longer do their job. In most cases, you will go to dialysis when you have only 10 to 15% of your kidney function left.
When to see a doctor
Get checked for kidney disease if you have diabetes, high blood pressure, heart disease, or a family history of kidney failure. If you have diabetes, get checked every year. Call 911 or go to the emergency room if you have chest pain, trouble breathing, fainting, or confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A doctor like this can order the blood and urine tests that check for kidney disease. They can also tell you what your blood pressure target is.
Common questions
Does CKD cause symptoms early on?
Usually not. Early kidney disease often has no symptoms, so blood and urine tests are the way to find it.
What causes CKD most often?
Diabetes and high blood pressure are the two most common causes of CKD.
How do doctors test for CKD?
Doctors use a blood test for GFR and a urine test for albumin.
Does CKD lead to kidney failure?
It depends. Whether CKD worsens to end-stage renal disease, and how quickly, depends on the cause of kidney damage and how well you take care of yourself.
Sources
- MedlinePlus - Chronic kidney disease
- NHS - Chronic kidney disease: Treatment
- National Institute of Diabetes and Digestive and Kidney Diseases - Chronic Kidney Disease Tests & Diagnosis
- National Institute of Diabetes and Digestive and Kidney Diseases - What Is Chronic Kidney Disease in Adults?
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
