Kidney disease risk factors: who is at risk, and how to check

The main risk factors

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says you are at risk for developing CKD if you have (NIDDK):

• diabetes
• high blood pressure
• heart and blood vessel disease, also called cardiovascular disease
• a family history of kidney disease

Your risk also goes up with age, and the longer you have had diabetes, high blood pressure or heart and blood vessel disease, the more likely you are to develop CKD (NIDDK). NIDDK estimates that more than 35 million US adults, more than 1 in every 7, have CKD (NIDDK).

African Americans, Hispanic people, American Indians, Native Hawaiians and other Pacific Islanders are more likely to have advanced kidney disease, including kidney failure. NIDDK says the rates of diabetes and high blood pressure in these groups may contribute to that risk (NIDDK).

Diabetes and high blood pressure come first

NIDDK and MedlinePlus both name diabetes and high blood pressure as the most common causes of CKD in adults (NIDDK) (MedlinePlus).

• Diabetes. High blood glucose can damage the kidneys' filters. Over time the kidneys may no longer filter waste and extra fluid well, and proteins the body needs can pass into the urine (NIDDK).
• High blood pressure. It can damage blood vessels and other parts of the kidneys' filtering system. Extra fluid in the body can then raise blood pressure even more, which NIDDK calls a dangerous cycle (NIDDK).

To see where your readings fall, see blood pressure ranges.

Other causes

NIDDK lists other causes of CKD in adults, including (NIDDK):

• acute kidney injury
• drugs that are toxic to the kidneys
• glomerular diseases, such as IgA nephropathy
• autoimmune disorders such as lupus
• infections and kidney stones with complications
• metabolic syndrome and severe obesity
• polycystic kidney disease and rare genetic conditions
• sickle cell disease
• liver or heart disease that damages the kidneys
• certain cancers, such as multiple myeloma

The causes of kidney disease in children are different from those in adults (NIDDK). This page is about adults.

Why it is often silent

Most people in the early stages of CKD have no symptoms, and many have none until the disease is advanced. For many people the only way to know is a blood test and a urine test (NIDDK). MedlinePlus says the same: the damage happens slowly over many years, and blood and urine tests are the only way to know (MedlinePlus).

As CKD becomes more advanced, NIDDK lists symptoms that may include loss of appetite, nausea or vomiting, feeling tired or sleep problems, trouble concentrating, a change in how often you urinate, foamy urine, itching or dry skin, muscle cramps, weight loss, chest pain or shortness of breath, and swelling (edema) in the legs, feet or ankles (NIDDK). These symptoms have many other causes too, so they are a reason to see a health care professional, not a diagnosis.

The two tests that check your kidneys

NIDDK says health care providers use two tests (NIDDK):

• A blood test for GFR (glomerular filtration rate), estimated from creatinine. A GFR of 60 or more is in the normal range, less than 60 may mean kidney disease, and 15 or less is called kidney failure (NIDDK). Work out yours with the eGFR calculator.
• A urine test for albumin, a protein that can pass into the urine when the kidneys are damaged. A urine albumin-to-creatinine ratio of 30 mg/g or less is normal, and more than 30 mg/g may be a sign of kidney disease (NIDDK). A provider may repeat it one or two more times to confirm (NIDDK).

How the two results combine into stages is on kidney disease stages.

Who should get tested, and how often

NIDDK says to 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. Otherwise, ask your health care provider how often (NIDDK). NIDDK also encourages talking with family members who may be at risk about getting tested (NIDDK).

No results yet? The kidney disease risk score (SCORED) asks 9 questions to show whether testing is worth asking about.

Steps that may help protect your kidneys

NIDDK says preventing or managing the conditions that cause CKD, such as diabetes and high blood pressure, may help prevent CKD or slow it down. Healthy habits such as eating well, keeping a healthy weight, staying active and avoiding medicines that can injure the kidneys may also help (NIDDK). MedlinePlus lists (MedlinePlus):

• choosing foods with less salt (sodium)
• controlling your blood pressure; your provider can tell you what it should be
• keeping your blood sugar in the target range, if you have diabetes
• limiting the amount of alcohol you drink
• losing weight if you are overweight, and being physically active
• not smoking

NIDDK adds that regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can damage the kidneys, and that a urinary tract infection should be seen by a provider right away because untreated it can cause kidney damage (NIDDK). Talk with your provider before you change any medicine.

Common questions

What is the biggest risk factor for kidney disease?

Diabetes and high blood pressure are the most common causes of CKD in adults (NIDDK).

Can you have kidney disease and feel fine?

Yes. Most people with early CKD have no symptoms, and testing is the only way to know (NIDDK).

Does kidney disease run in families?

A family history of kidney disease is one of the risk factors NIDDK lists, and polycystic kidney disease and some rare genetic conditions are among its causes (NIDDK) (NIDDK).

Can kidney damage be reversed?

NIDDK says advanced, long-lasting CKD typically cannot be reversed, but the sooner you find out, the sooner you can make changes to protect your kidneys from further damage (NIDDK).