Understanding chronic kidney disease: Symptoms, causes, and treatment options

Written by: Dr Andrew Coutinho
Edited by: Conor Dunworth

Chronic kidney disease (CKD) is a prevalent condition affecting millions of individuals worldwide. It is characterised by the gradual loss of kidney function over time. CKD requires careful management to prevent complications and maintain overall health. In his latest online article, esteemed Consultant Nephrologist Dr Andrew Coutinho delves into what CKD is, its early warning signs, causes, treatment options, and whether it can be cured.



What is chronic kidney disease?


Chronic kidney disease refers to the progressive deterioration of kidney function over months or years. The kidneys play a vital role in maintain overall health, filtering waste and excess fluids from the blood, maintaining electrolyte balance, and regulating blood pressure. When CKD develops, these functions become compromised, leading to a buildup of toxins and fluids in the body. These eventually impact other body systems leading to a global deterioration in health.


Early warning signs and common symptoms


Identifying CKD in its early stages can be challenging, as symptoms may be subtle or not manifest until significant kidney damage has occurred. However, some early warning signs include:


  • Fatigue and weakness
  • Difficulty concentrating
  • Frequent urination, especially at night
  • Swelling in the ankles and legs
  • Persistent itching
  • High blood pressure


As CKD progresses, symptoms may worsen, and additional signs may appear, such as:

  • Loss of appetite
  • Nausea and vomiting
  • Muscle cramps
  • Shortness of breath
  • Abnormalities in urine output (increased or decreased)


Causes of chronic kidney disease


Various factors can contribute to the development of CKD, including:

  1. Diabetes: Uncontrolled high blood sugar levels can damage the kidneys over time, leading to CKD.
  2. Smoking: Smoking is well known to lead to poor health and lead to high blood pressure.
  3. Hypertension: Chronic high blood pressure puts strain on the kidneys, impairing their function gradually.
  4. Glomerulonephritis: Inflammation of the kidney's filtering units, known as glomeruli, can result in CKD.
  5. Polycystic kidney disease (PKD): An inherited condition characterised by the growth of cysts on the kidneys, leading to kidney damage.
  6. Other causes: Certain medications, autoimmune diseases, urinary tract obstructions, and recurrent kidney infections can also contribute to CKD.


Treatment options and prognosis


While CKD is a chronic condition with no cure, early detection and management can help slow its progression and reduce complications. Treatment strategies typically focus on:

  • Managing underlying conditions: Controlling blood sugar levels in diabetes, the stoppage of smoking and maintaining healthy blood pressure are crucial for preserving kidney function.
  • Medications: Certain medications, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), Sodium- Glucose co-transporter 2 inhibitors ( SDLT2 inhibitors) may be prescribed to control blood pressure and protect the kidneys.
  • Lifestyle modifications: Adopting a healthy lifestyle, including a balanced diet low in sodium and potassium, regular exercise, and avoiding smoking, can help manage CKD.
  • Dialysis and kidney transplant: In advanced stages of CKD, dialysis or kidney transplant may be necessary to replace lost kidney function and improve quality of life.


It's essential for individuals with CKD to work closely with their healthcare providers to develop a personalised treatment plan tailored to their specific needs and stage of the disease.


In conclusion, chronic kidney disease is a complex condition that requires comprehensive management to slow its progression and mitigate complications. By understanding its early warning signs, causes, and available treatment options, patients can take proactive steps to maintain their kidney health and overall well-being.




If you suspect you may have CKD or have concerns about your kidney health, you can book a consultation with renowned consultant nephrologist Dr Andrew Coutinho via his Top Doctors profile.

By Dr Andrew Coutinho

Dr Andrew Coutinho (FRCP) is a consultant nephrologist based in Royal Tunbridge Wells, specialising in chronic kidney disease, vasculitis, hypertension, acute kidney injury, geriatric nephrology, and hereditary kidney disease.
Dr Coutinho currently practises privately at Spire Tunbridge Wells Hospital. He also has over 20 years of experience within the NHS.
Dr Coutinho is a fellow of the Royal College of Physicians, London, and obtained his MBBS degree from the Rajiv Gandhi University of Health Sciences, Karnataka, India. He completed his specialist training in the East of England Deanery, at Addenbrookes Hospital in Cambridge and at the Ipswich General Hospital, Ipswich. He also worked at the West London Kidney and Transplant centre at the Hammersmith Hospital, London before taking up his Consultant posts at Kings College Hospital, London and at Darent Valley Hospital, Dartford. He currently works as a Consultant Nephrologist at Tunbridge Wells hospital at Tunbridge Wells and at Guys Hospital of Guys and St. Thomas’ Hospital NHS Trust in London. He also serves as an MRCP examiner for the Royal College of Physicians in the UK.
Apart from clinical practice and teaching, Dr Coutinho has contributed to research in the field of Nephrology. He is a member of esteemed organisations such as the Royal College of Physicians, the General Medical Council and the British Medical Association.
With a background in academia, extensive experience, and a commitment to excellence, Dr Andrew Coutinho is dedicated to providing exceptional care and advancing medical knowledge in urology.

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