THE SILENT PROBLEM YOU MAY NOT KNOW YOU HAVE
You probably don’t spend much time thinking about your kidneys.
Your heart gets plenty of attention. Your brain gets plenty of attention. Even your knees let you know when they’re unhappy.
Your kidneys?
They quietly show up for work every day, filter your blood, balance fluids and minerals, help control your blood pressure, and get rid of waste.
And they rarely complain.
Unfortunately, that is part of the problem with chronic kidney disease, or CKD.
You can lose a significant amount of kidney function and still feel perfectly fine.
So today, let’s talk about what chronic kidney disease actually means, who is at risk, and—most importantly—what you can do about it.
What Is Chronic Kidney Disease?
Chronic kidney disease simply means that your kidneys have been damaged or aren’t working as well as they should for at least three months.
It doesn’t necessarily mean kidney failure.
That distinction is important.
When people hear “kidney disease,” they often immediately think about dialysis.
But CKD exists on a spectrum.
Many people have mild or moderate kidney disease for years and never need dialysis. The goal is to discover the problem early and do everything we can to keep it from progressing.
Think of kidney function like money in your retirement account.
You don’t want to wait until the account is almost empty before you start paying attention.
The Problem: You May Feel Completely Normal
This is one of the reasons chronic kidney disease deserves more attention.
Early CKD often causes no obvious symptoms.
You aren’t necessarily going to wake up one morning and say:
“I think my kidneys aren’t filtering properly today.”
As kidney disease becomes advanced, people may develop symptoms such as:
- Fatigue
- Swelling in the feet or ankles
- Shortness of breath
- Nausea or loss of appetite
- Itching
- Muscle cramps
- Changes in urination
- Difficulty concentrating
But here’s the important point:
We don’t want to wait for symptoms.
By then, significant kidney function may already have been lost.
Remember This
Chronic kidney disease is often discovered through blood and urine tests—not because someone feels sick.
Who Is Most at Risk?
Two conditions account for a large portion of chronic kidney disease:
Diabetes
High blood sugar can gradually damage the tiny blood vessels inside your kidneys.
Imagine running sugary, sticky fluid through a very delicate filter year after year. Eventually, that filter may begin to suffer.
That’s an oversimplification, of course, but you get the idea.
High Blood Pressure
High blood pressure and kidney disease have an unfortunate relationship. High blood pressure can damage your kidneys. Damaged kidneys can make blood pressure more difficult to control. It can become a vicious cycle.
Other risk factors include heart disease, obesity, smoking, a family history of kidney disease, previous kidney injury, and simply getting older.
This doesn’t mean aging automatically causes kidney disease. It means kidney function deserves more attention as we age.
Three Kidney Numbers Worth Knowing
If you’re over 50—especially if you have diabetes or high blood pressure—there are several numbers worth discussing with your healthcare provider.
1. Creatinine
Creatinine is a waste product produced by your muscles. Your kidneys remove it from your blood. If kidney filtration declines, the creatinine level may rise.
But creatinine alone doesn’t tell the whole story.
2. eGFR
The estimated glomerular filtration rate, or eGFR, gives us an estimate of how effectively your kidneys are filtering your blood.
Generally, a lower number means reduced kidney filtration.
One abnormal eGFR doesn’t automatically mean you have chronic kidney disease. Doctors look at the number in context and often repeat testing because CKD requires evidence of an ongoing problem.
3. Urine Albumin
This one sometimes gets overlooked.
Albumin is a protein that normally stays in your bloodstream. Damaged kidney filters may begin allowing albumin to leak into the urine.
A urine albumin-to-creatinine ratio, often called a UACR, can detect this.
And albumin in the urine may be an early warning sign even when your eGFR still looks relatively good.
Dr. Mike’s Take
Don’t just ask, “How’s my creatinine?”
Ask whether you know your eGFR and urine albumin-to-creatinine ratio as well.
Together, these tests give us a much better picture of kidney health.
If You Have CKD, Can You Slow It Down?
Often, yes.
We can’t promise that every case of chronic kidney disease can be stopped or reversed. Some kidney damage is permanent, and certain diseases progress despite excellent care.
But there is a lot we can do to protect the kidney function you still have.
Control Your Blood Pressure
This may be one of the most important things you can do. If you have high blood pressure, take it seriously.
Take your medications as prescribed, monitor your pressure when appropriate, exercise regularly, maintain a healthy weight, and watch excessive sodium intake.
Control Diabetes
If you have diabetes, good blood sugar management helps protect your kidneys along with your eyes, nerves, heart, and blood vessels.
Your individual blood sugar goals should be determined with your healthcare team.
Don’t Smoke
Smoking damages blood vessels throughout the body—including the blood vessels supplying your kidneys. There aren’t many organs that enjoy cigarette smoke. Actually, I can’t think of one.
Stay Active
Exercise won’t magically repair damaged kidneys.
But regular physical activity can help improve blood pressure, blood sugar, cardiovascular health, body weight, and overall function.
Those benefits indirectly help protect your kidneys.
For most adults, a combination of aerobic activity and strength training is an excellent place to start, adjusted for your health and physical abilities.
Be Careful With Certain Medications
Here’s something many people don’t realize.
Some common over-the-counter pain relievers can cause kidney problems, particularly when used frequently or in people who already have impaired kidney function.
This includes NSAIDs such as ibuprofen and naproxen.
That doesn’t mean nobody can ever take an NSAID.
It means that if you have chronic kidney disease—or are at increased risk—you should discuss their use with your healthcare provider rather than assuming that “over the counter” means “completely harmless.”
The same principle applies to supplements.
“Natural” does not automatically mean kidney-safe.
Tell your healthcare team what you’re taking.
What About Protein?
This can get confusing, especially because I frequently encourage adults over 50 to eat enough protein to protect their muscles.
If your kidneys are healthy, adequate protein is an important part of maintaining muscle as you age.
But if you have significant chronic kidney disease, your nutritional needs may change.
This is not the time to randomly slash protein from your diet after reading something on the internet.
Your protein needs depend on your kidney function, nutritional status, activity level, and whether you’re receiving dialysis.
Work with your physician and, when appropriate, a registered dietitian familiar with kidney disease.
We want to protect your kidneys without sacrificing your muscles unnecessarily.
Kidney Disease Isn’t Just About Your Kidneys
Here’s another reason CKD matters.
Chronic kidney disease is closely connected with cardiovascular disease. People with CKD have a higher risk of heart attack, stroke, heart failure, and other cardiovascular problems.
That’s why treating CKD isn’t simply about preventing dialysis someday.
It’s about protecting the entire person.
Your blood pressure matters. Your blood sugar matters. Your cholesterol matters. Exercise matters. Smoking matters. Nutrition matters.
It’s all connected.
The Bottom Line
Chronic kidney disease can quietly develop for years without causing obvious symptoms.
That’s the bad news.
The good news is that we have simple blood and urine tests that can help identify kidney problems much earlier.
And once we know there is a problem, there are often things we can do to slow its progression.
So if you’re over 50—particularly if you have diabetes, high blood pressure, heart disease, or other risk factors—ask about your kidney numbers.
Know your creatinine.
Know your eGFR.
And don’t forget your urine albumin.
You can’t change your age.
You can’t change your family history.
But you can control many of the things that determine what happens next.
And that is really the message I want you to remember:
Finding chronic kidney disease early gives you something incredibly valuable—the opportunity to protect the kidney function you still have.
This article is for educational purposes and isn’t a substitute for individualized medical advice. If you have kidney disease or abnormal kidney tests, discuss them with your healthcare professional.