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Kidney disease

And chronic kidney disease (CKD)

Key points about kidney disease

Kidney disease is any condition that affects the functioning of your kidneys.
Chronic kidney disease refers to kidney damage that generally can't be reversed. Diabetes and high blood pressure are the most common causes of chronic kidney disease (CKD).
Māori and Pasifika people with diabetes have an increased risk of chronic kidney disease.
Because most people don’t have symptoms in the early stage, see your doctor regularly if you are at risk. Early detection and treatment can prevent or slow the condition.
Treatment includes changes to your lifestyle, medication and possibly dialysis.

Virtual view of kidney position from the back

(Kidney Health NZ, 2017)

Also available in the following languages:

Your kidneys filter and remove waste and water from your bloodstream. The 2 most common causes of kidney disease are diabetes and high blood pressure as they damage parts of your kidneys.

Diabetes

When your blood sugar is raised, it causes damage to many blood vessels in your body, including the blood vessels in your kidneys. About 1 in 3 people with diabetes will end up with some kidney damage. Diabetic kidney disease is also called diabetic nephropathy.

High blood pressure

High blood pressure damages the small vessels that take blood to the kidney filters and can also damage the filters themselves. Read more about blood pressure and kidney disease.(external link)

Other causes

Glomerulonephritis is a group of diseases that affects the filtering units in your kidneys.
Polycystic kidney disease causes cysts to form in your kidneys. This is an inherited disease, which means that it is passed down from your parents.
Lupus and other diseases that affect your body’s immune system can also affect your kidneys.
Obstructions caused by abnormally shaped ureters, kidney stones, tumours or an enlarged prostate gland can affect your kidneys.
Repeated urinary tract infections (UTIS) can also affect your kidneys.

You are at a higher risk of getting kidney disease if you:

have diabetes
have high blood pressure (hypertension)
have a body mass index (BMI) over 35
have cardiovascular disease, such as coronary heart disease, cerebrovascular disease or peripheral vascular disease)
have a family history of kidney disease
take nephrotoxic medicines
have some prostate conditions
are Māori, Pasifika or Indo-Asian
are aged over 60.

CKD is called a silent disease because it often causes no symptoms. It is not uncommon to lose up to 70% of kidney function before developing symptoms.

The first signs may be general and can include:

tiredness
poor appetite and weight loss
muscle cramps
a need to pee more often than usual
pain or burning when peeing
blood in your pee
puffiness or swelling around your eyes and ankles.

One of the main ways kidney disease is diagnosed is by the presence of albumin in your pee (urine). Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass from your blood into your urine. A damaged kidney lets some albumin pass into your urine. The less albumin in your urine, the better. Sometimes albuminuria is also called proteinuria.

Albumin in your pee is detected using a urine dipstick. Read more about albumin in the urine(external link). Having protein in your pee also increases your chance of having a heart attack, stroke and/or high blood pressure.

Other tests

Blood tests – these measure blood levels of creatinine and urea. Both of these are normally excreted in your pee, but if your kidneys are not functioning properly, increased amounts can be found in your blood. Read more about kidney function blood tests.
Renal imaging – this involves taking a picture of your kidneys using methods such as ultrasound, CAT scan or magnetic resonance imaging. These tests help work out if there are any unusual growths or blockages to the flow of pee.
Renal biopsy – this is a hospital procedure in which a needle is inserted through your skin into your kidney. A small sample of kidney tissue is removed to be looked at under a microscope.

When kidney disease is detected early, changes to lifestyle and diet can slow the disease and prevent serious consequences. Your treatment depends on what stage of kidney disease you have and what caused it in the first place.

Stages 1 to 2 (early to moderate kidney failure) – the treatment is to reduce blood pressure, keep diabetes well controlled and take medicines such as ACE inhibitors to reduce further damage to your kidneys. Other options include a calcium channel blocker, eg, dilitazem.
Stage 3 (glomerular filtration rate less than 60) – in addition to the above, you will also be referred to a nephrologist (kidney specialist).
Stages 4 to 5 (renal failure) – education and assessment for dialysis, renal transplantation or supportive measures is generally started as they may be needed in the near future. Read more about kidney failure.

When kidney disease is diagnosed early, changes to your lifestyle can slow the disease and prevent serious consequences.

This can include to:

avoid getting too thirsty
see your doctor if you have diarrhoea (runny poo), vomiting or other illness
avoid NSAIDs such as ibuprofen
follow a low-salt diet, and possibly a low-potassium diet if your potassium is high
get regular flu vaccinations
tell your doctor and pharmacist before you take any over‑the‑counter medicines and supplements.

Your healthcare provider may also talk to you about:

getting support to quit smoking
drinking less alcohol
doing more physical activity
eating healthy food.

Here are some videos on exercising(external link) when you have chronic kidney disease from the Kidney Society. Read more about treatment options for chronic kidney disease(external link) and conservative treatment(external link).

It is important to prevent your kidneys becoming damaged further.

Have your blood pressure checked at least once a year.
Have your blood sugar checked for diabetes.
Don't smoke – there is no safe level of smoking and it damages your blood vessel walls.
Check your cholesterol levels (high cholesterol damages blood vessels in you kidneys).
Maintain your weight within a healthy range for your height with a well-balanced diet. Read more about chronic kidney disease and nutrition(external link).
Regular exercise also helps control your weight
Have an annual check-up with a GP. If you need a blood test, ask for your kidney function to be checked. Ask for your urine to be checked for blood, protein and sugar.
Read more about how to protect your kidneys.

Kidney Health NZ has patient support centres(external link) around the country for people with kidney failure. These are run by trained volunteers who have experienced kidney failure in their own families/whānau, and who offer their time to talk and share stories.

Kidney Society Auckland(external link)
Factsheets – range of topics(external link) Kidney Health NZ

My kidney health plan(external link) NPS MedicineWise, Australia, 2022

What is diabetes?
High blood pressure | Mate pēhanga toto
Cholesterol - high| Mate toto hinuhinu
Kidney failure
Kidney function blood test – in-depth information
Kidney health topics
How to protect your kidneys
Kidney stones (Kōwhatu tākihi)