Chronic kidney disease (CKD): symptoms, tests, treatment and which doctor to see
What chronic kidney disease is, why it is often silent, the blood and urine tests that find it, how to slow it, and when to see a nephrologist.
Also known as: CKD
What chronic kidney disease is
The kidneys filter waste and extra water from the blood to make urine, and they help control blood pressure, salt balance, red blood cell production and bone health. In chronic kidney disease (CKD), the kidneys are damaged and their filtering slowly falls over months or years.
Doctors describe CKD in stages, based on how well the kidneys filter and how much protein leaks into the urine. Most people never reach kidney failure; many stay at an early stage for years, especially with good treatment. But CKD also raises the risk of heart attack and stroke at every stage, which is why it deserves attention even when it causes no symptoms.
Symptoms — often none until late
The kidneys have a large reserve, so early CKD usually causes no symptoms at all. It is found through blood and urine tests. As it advances, people may notice:
- Swelling of the feet, ankles or around the eyes
- Tiredness and weakness, often from anaemia
- Foamy urine, a sign of protein leaking
- Passing urine at night more often
- Loss of appetite, nausea or a metallic taste
- Itching and dry skin
- Breathlessness, muscle cramps or difficulty sleeping
By the time these appear, kidney function is often substantially reduced. That is why people at risk should be tested regularly rather than waiting for symptoms.
Causes and who is at higher risk in India
Diabetes and high blood pressure are the commonest causes. Others include:
- Glomerulonephritis — inflammation of the kidney's filters
- Kidney stones or an enlarged prostate blocking urine flow for long periods
- Repeated kidney infections
- Inherited conditions such as polycystic kidney disease
- Long-term use of painkillers from the NSAID family, and some unregulated herbal or traditional preparations that may contain heavy metals
- In some farming regions, kidney disease of uncertain cause is seen in people without diabetes or high blood pressure
Your risk is higher if you have diabetes, high blood pressure, heart disease, a family history of kidney disease, obesity, or were born with a low birth weight. If any of these apply, ask for a yearly kidney check.
How it is diagnosed
Two simple tests find most CKD:
- Serum creatinine — a blood test used to calculate the eGFR (estimated glomerular filtration rate), which shows how well the kidneys filter.
- Urine albumin-to-creatinine ratio — a spot urine test for protein leaking through damaged filters, often the earliest sign in diabetes.
CKD is diagnosed when these remain abnormal for at least three months, because a single abnormal result can be caused by dehydration, an infection or a medicine. Other tests include a urine routine for blood and protein, a kidney ultrasound to look at size, structure, stones or blockage, blood count, salts, calcium, phosphate and sometimes a kidney biopsy to find the exact cause.
Which doctor to see
Your general physician or diabetologist can test for and manage early CKD. A nephrologist should be involved when kidney function is moderately or severely reduced or falling quickly, when there is a lot of protein or blood in the urine, when blood pressure is hard to control, or when the cause is unclear. A cardiologist helps manage the higher heart risk.
You can find nephrologists in Bengaluru on The Doctor Index, each with a registration you can check.
Treatment
Treatment cannot undo established damage, but it can slow CKD considerably, protect the heart and treat complications.
Slowing the disease
- Blood pressure control to a target your doctor sets — the single most important step
- ACE inhibitors or angiotensin receptor blockers, which also reduce protein leakage
- SGLT2 inhibitors, which slow kidney decline in many people with or without diabetes
- Good sugar control if you have diabetes
- Statins to lower heart risk
- Less salt, no tobacco, and staying active
Avoid NSAID painkillers such as ibuprofen and diclofenac, and check with your doctor before taking any new medicine, supplement or herbal product. Many medicines need lower doses in CKD. Do not stop prescribed medicines on your own.
Treating complications
As CKD advances, your team may treat anaemia, high potassium, bone and mineral problems and fluid build-up. A dietitian can advise on protein, potassium and phosphate — the right advice depends on your stage and blood tests, so avoid generic 'kidney diets'.
Kidney failure
If the kidneys fail, dialysis or a kidney transplant is needed. Haemodialysis filters the blood through a machine, usually several times a week at a centre; peritoneal dialysis uses the lining of the abdomen and can be done at home. Under the Pradhan Mantri National Dialysis Programme, dialysis is provided at district hospitals, with the cost covered for poor patients. A transplant, from a living related or deceased donor, offers the best long-term outcome for suitable people. Planning ahead gives time to choose.
Living with it: follow-up
- Blood and urine tests at intervals your doctor sets, more often in later stages
- Blood pressure checks at every visit, and at home if advised
- Vaccines your doctor recommends, including hepatitis B if dialysis may be needed
- Protecting the veins in one arm if a dialysis fistula may be needed later
- Telling every doctor, dentist and pharmacist that you have CKD
When it is an emergency
Call 112 or 108, or go to the nearest emergency department, for:
- Severe breathlessness, or being unable to lie flat
- Chest pain, palpitations or severe muscle weakness, which can be caused by high potassium
- Confusion, drowsiness or fits
- Passing very little or no urine
- Fever with chills if you have a dialysis catheter
Questions to ask at your appointment
- What stage is my CKD, and what is causing it?
- Is it stable or getting worse?
- What blood pressure should I aim for?
- Which medicines should I avoid or have adjusted?
- What should I eat, and should I see a dietitian?
- When should we start planning for dialysis or a transplant?
Common questions
Questions people ask
- Can chronic kidney disease be reversed?
- Established damage usually cannot be reversed, but its progress can often be slowed substantially with blood pressure and sugar control, the right medicines and avoiding harmful painkillers. Many people with early CKD never need dialysis.
- Does high creatinine always mean kidney disease?
- Not always. Creatinine can rise temporarily with dehydration, infection, some medicines or a high-protein meal, and varies with muscle mass. CKD is diagnosed only when abnormal results persist for months, alongside urine tests and the eGFR.
- Should I drink more water to protect my kidneys?
- Drinking enough to avoid dehydration is sensible, especially in hot weather. Drinking large amounts does not treat CKD, and in later stages or with heart failure your doctor may limit fluids. Follow the advice you are given for your stage.
- Are herbal remedies safe for kidney disease?
- Some are not. Certain herbal and traditional preparations contain heavy metals or substances that damage the kidneys, and others interact with medicines. Always discuss any remedy with your nephrologist before taking it.
This condition is usually assessed by a nephrologist. Every profile shows the doctor’s registration and what has been checked.
Nephrologists in Bangalore
A few nephrologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Chronic Kidney Disease; ask the clinic whether the doctor sees it.
Related conditions
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Chronic Kidney Disease
- NIDDK, US National Institutes of Health — Chronic Kidney Disease (CKD)
- National Health Portal, MoHFW — Pradhan Mantri National Dialysis Programme
- MedlinePlus, National Library of Medicine — Chronic Kidney Disease — Public-domain health-topic summary
- Human Phenotype Ontology Consortium — terminology definitions — HPO licence; definitions reproduced without alteration
Chronic kidney disease (CKD): symptoms, tests, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0510.