CKD

Hypertension

Chronic Kidney Disease

CKD

Chronic kidney disease (CKD) is a condition where the kidneys slowly lose their ability to filter the blood to remove waste. CKD also interferes with the kidney’s important roles in controlling blood pressure and regulating levels of essential minerals such as calcium, which are essential for bone strength.

Without treatment, CKD can lead to death. 100,000 Americans die from CKD-related conditions every year.

CKD is common:

  • 20 million American women have CKD
  • CKD is more common in women than men
  • X million women are on dialysis because of kidney failure
  • X0,000 women receive kidney transplants each year

The risk of CKD increases quickly with age. One in 3 adults over 65 years of age has CKD.

Black women have a particularly high risk of CKD

  • They are also 4 times more likely than White women to progress to end-stage kidney disease or kidney failure
Cholesterol
20 million — American women have CKD
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15% — of women have CKD versus 13% of men
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Black women — have a 3-4 times higher risk of CKD
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Black women — are 4x more likely develop kidney failure

How is Chronic Kidney Disease diagnosed?

CKD often has no symptoms until it is advanced.


When symptoms do occur, they may include:

  • Swelling of the legs or feet
  • Tiredness
  • Nausea
  • Itching
  • Shortness of breath
  • Changes in urination (more or less often, or producing less urine than usual)


Kidney health is measured using both a blood test and a urine test. Both tests matter as neither alone tells the full story.


The blood test measures eGFR (estimated glomerular filtration rate), calculated from the level of a protein called creatinine in your blood. eGFR represents the percentage of full kidney function you have.


The urine test measures albumin, a protein that leaks into the urine when the kidneys are damaged. This is reported as a urine albumin-to-creatinine ratio, or ACR.


Regular testing before symptoms appear is important, especially if you are at higher risk of CKD, for example if you have:

  • Diabetes
  • High blood pressure
  • A family history of kidney disease
  • A history of high blood pressure during pregnancy (pre-eclampsia) or pre-term delivery


For anyone with kidney disease, it is recommended that measurement of eGFR and ACR be performed at least once a year, and more often in people at high risk of disease progression.

How do I know if I have CKD?

A lower eGFR, means your kidneys are working less effectively. The standard classifications of eGFR are as follows:


Kidney function eGFR


Normal 90% or lower

Mildly reduced 60-89%

Moderately reduced 30-59%

Severely reduced 15-29%

Kidney failure Less than 15%


A normal ACR is less than 30mg/g. If the ACR is higher, a repeat test is usually conducted, ideally using a first-morning urine sample.


In older women, standard kidney function tests may sometimes overestimate the level of kidney damage, since the usual cut-off points don’t fully account for the natural decrease in kidney function with age.

Understanding and Managing Chronic Kidney Disease

Learn about the causes of chronic kidney disease, how it might be prevented and what treatments are available.

Action Plan

Taking Charge of Your Chronic Kidney Disease

For some women, lifestyle changes can help slow the progression of CKD. However, for most women, the most effective approach to managing CKD and reducing the risks of heart attack and stroke requires the use of appropriate medication.

Lifestyle Changes

Walk or do other exercise for around 20 minutes per day
Reduce salt by eating less table salt, fast food and salty snacks
Increase potassium by eating more fruit, vegetables and nuts
If you are overweight, try to lose at least 10 lbs

Treatment

Check your blood pressure regularly
In addition to making lifestyle changes, talk to your doctor about drug treatment
All the most commonly used drugs are effective and have few side effects
Treatment with two drugs is recommended
Medication should never be stopped abruptly

Ongoing benefits of treatment

Reductions of 25-50% in your risk of heart disease, stroke and kidney disease
Reductions of 25-50% in your risk of heart disease, stroke and kidney disease
Life-long treatment is usually required unless you make major lifestyle changes
Lifestyle changes and drug treatment together are likely to produce the largest benefits

Questions you might like to as your doctor or other healthcare professional

A GLP1-agonist (such as Mounjaro, Wygovy or Zepbound)? An ACE inhibitor (such as Avapro) or an ARB (such as Altace)? An SGLT-2 inhibitor (such as Farxiga or Jardiance)? A statin (such as Crestor or Lipitor) to reduce my risk of heart attack and stroke?

Advocate for yourself