Over 1 in 7 adults in the United States are estimated to have chronic kidney disease (CKD), a condition in which the kidneys lose some of their ability to remove waste products and excess fluid from the bloodstream. As waste products and fluids build up in the body, other body systems are affected, which can be harmful to your health or even fatal.
The most common causes of chronic kidney disease are unchecked hypertension (above 140/90) and diabetes. These two conditions were the primary diagnosis for 76% of kidney failure cases between 2015 and 2017. If you have either one or both of these conditions, it is important to work with your healthcare provider to manage them. Your provider should also be monitoring you for signs of chronic kidney disease through routine blood and urine tests.
Most people with chronic kidney disease do not have symptoms. Typically, a diagnosis is made as a result of routine blood testing or testing performed for another medical issue. Because of the lack of symptoms in the early stages, only about 10% of adults with chronic kidney disease are aware they have it. Catching the disease early is important to help prevent its progression - there is no cure.
How Is Chronic Kidney Disease Diagnosed?
Healthcare providers typically diagnose chronic kidney disease using your estimated Glomerular Filtration Rate (eGFR), an approximation of how fast your kidneys can filter blood to remove waste products. The lower your eGFR, the worse your kidney function. The formula used to estimate a patient’s GFR takes into account creatinine levels in the blood (creatinine is a waste product filtered by the kidneys), as well as a patient’s age, sex, and weight.
The formula is often also adjusted for race, specifically if the patient is Black vs. non-Black. This is called a “race-based adjustment.” The result of adjusting for race in this way is that patients listed as Black in the system end up with a higher eGFR even if their other characteristics are identical to that of a patient that is listed as non-Black. Because a higher eGFR should mean better kidney performance, this patient may then go longer without being diagnosed with chronic kidney disease, losing critical time to receive care that will prevent the progression of their disease. Without the race-adjustment, an estimated 1 million Black Americans might be treated earlier for kidney disease.
However, eGFR is just one of the indicators of your kidney health. Your healthcare provider will also check to see if you have protein(s) in your urine. If your provider sees that both urine protein is significantly increased and your eGFR is declining, that is a clear indicator of chronic kidney disease that can possibly be severe.
If chronic kidney disease is not treated, it can progress to kidney failure and a need for dialysis or a kidney transplant. Both of these can mean a serious change in quality of life.
The good news is that medications as well as certain lifestyle changes aimed at keeping hypertension and diabetes in check can help slow or stop the progression of chronic kidney disease.
This is why early detection is so important. If you have hypertension or diabetes, know that your provider should be monitoring your kidney health regularly. If you are Black and your eGFR level is borderline, know that you can ask for urine protein testing to provide a more complete picture of your kidney health so as not to delay essential treatments. The official recommendation from the American Society of Nephrology and National Kidney Foundation is to remove any race modifiers in the equation to estimate kidney function.
To learn more about chronic kidney disease visit Chronic Kidney Disease Basics. If you think you are at risk for chronic kidney disease, make an appointment with your healthcare provider and ask them about monitoring for warning signs.
