Understanding Chronic Kidney Disease (CKD)

What is CKD?

CKD means your kidneys don’t work quite as well as they should.

Your kidneys are like filters. They clean your blood by removing waste and extra water. They also help control your blood pressure.

When you have CKD, your kidneys still work – they just don’t work as well as they used to.

Good news: Having CKD does NOT mean your kidneys have stopped working or are about to stop working.

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How do we know you have CKD?

We use blood tests to check how well your kidneys are working. We look at something called your eGFR number.

• A normal eGFR is 90 or above
• CKD is when your eGFR is below 60 for 3 months or more
• We also check for protein in your urine, which can be a sign of kidney damage

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The stages of CKD

CKD has 5 stages. Most people we contact have Stage 3, which is mild to moderate.

• Stage 1-2: Very mild – kidneys work nearly normally
• Stage 3a: Mild – kidneys work between 45-59% (most common)
• Stage 3b: Moderate – kidneys work between 30-44%
• Stage 4: More serious – kidneys work between 15-29%
• Stage 5: Very serious – kidneys work less than 15%

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Most people with Stage 3 CKD stay at that stage for many years. Their kidneys keep working well enough.

Why am I only being told now?
Many people ask this question. There are several reasons why you might not have been told before.

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CKD doesn’t make you feel ill
Most people with CKD feel completely well. You probably feel fine now. This is normal. Because there are no symptoms, doctors didn’t always talk about it.

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We needed to check it was definite
One abnormal blood test doesn’t mean you have CKD. We need to see the same result for at least 3 months to be sure. Your doctor may have been waiting to confirm this.

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In the past, mild CKD wasn’t always discussed
Older people naturally have slightly lower kidney function. In the past, some doctors didn’t want to worry patients about this if it was very mild.

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Old record-keeping practices
Previously, some doctors put the test results in your notes but didn’t officially record CKD as a diagnosis. This has now changed.

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The NHS has changed how it handles CKD
In 2024 and 2025, the NHS asked all GP practices to:

• Look back through old blood tests
• Contact people who have CKD but weren’t told
• Make sure everyone with CKD knows about it
• Offer the right checks and support

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In short: Your CKD isn’t new. But the way we tell patients about it has changed. We now believe it’s better to be open about it so we can help you stay healthy.

Even mild CKD is important to know about for several reasons:

• It affects your heart health
  People with CKD have a higher chance of heart problems. But we can reduce this risk by looking after your blood pressure and giving you the right medicines.

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Some medicines need to be changed
When you have CKD, your kidneys can’t clear some medicines from your body as well. We might need to:

• Change the dose of some medicines
• Avoid certain medicines (especially some painkillers)
• Choose different medicines that are safer for your kidneys
• We need to check you regularly
• We’ll keep an eye on your kidney function with blood tests. This helps us spot any changes early.

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We can help keep your kidneys working well
There are simple things that can help protect your kidneys, like controlling your blood pressure and avoiding certain medicines.

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The good news: knowing about your CKD means we can help you stay healthy and reduce your risks.

For most people, the answer is NO.
Only a small number of people with CKD ever need dialysis. This usually only happens if:

You have Stage 4 or 5 CKD (more serious stages)
Your kidney function keeps getting worse over time
Most people with Stage 3 CKD (mild to moderate) stay stable. Their kidneys keep working well enough for their whole life.

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What is dialysis?
Dialysis is a treatment that cleans your blood when your kidneys can’t do this well enough anymore. It’s only needed if kidney function becomes very low.

Even if your CKD does get worse, it usually takes many years. We’ll monitor you carefully and talk to you about all your options if this happens.

What happens next?
Now we know you have CKD, we’ll make sure you get the right care.

We’ll check your blood and urine
We’ll do regular blood tests (usually once a year) to check:

• How well your kidneys are working
• Your blood pressure
• Your cholesterol
• If you have diabetes, your blood sugar
• We’ll also test your urine to check for protein.

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We’ll look at your medicines
We’ll check all your medicines to make sure:

• The doses are right for your kidney function
• You’re not taking anything that could harm your kidneys
• You’re taking medicines that can protect your heart and kidneys

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We’ll check your blood pressure
Keeping your blood pressure under control is the most important thing you can do for your kidneys. We’ll check it regularly and may give you medicine to help.

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If you have diabetes, we’ll check your sugar levels
Good diabetes control helps protect your kidneys.

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We’ll give you advice about staying healthy
We’ll talk to you about diet, drinking enough water, exercise, and stopping smoking if you smoke.

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You’ll usually be invited for a review once a year. If your CKD is more advanced, we’ll see you more often.

What can I do to help?

There are several simple things you can do to look after your kidneys.

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Keep your blood pressure under control

This is the single most important thing. Take any blood pressure medicines as prescribed. Check your blood pressure regularly if you have a home monitor.

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If you have diabetes, control your blood sugar

Good diabetes control protects your kidneys.

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Avoid some types of painkillers

Don’t take medicines like:

• Ibuprofen (Nurofen)
• Naproxen
• Diclofenac (Voltarol)

These can damage your kidneys if you have CKD.

Paracetamol is safe to use.

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Drink enough water

Try to drink 6-8 glasses of water a day. Drink more in hot weather or if you’re unwell.

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Eat a healthy, balanced diet

You don’t need a special diet for CKD. Just eat healthily:

• Plenty of fruit and vegetables
• Not too much salt
• Not too much processed food
• A healthy weight

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Keep active

Try to do 150 minutes of exercise each week. This could be walking, swimming, gardening – anything that gets you moving.

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Stop smoking if you smoke

Smoking makes CKD worse. We can help you stop.

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Come to your appointments

Don’t miss your check-ups. They’re important so we can keep an eye on your kidney function.

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Remember: small changes can make a big difference to your kidney health.

Common questions

Will my CKD get worse?

Not always. Many people with mild CKD stay at the same level for many years. Good control of blood pressure and diabetes helps keep your kidneys stable.

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Can CKD be cured?

CKD usually can’t be cured, but it can often be stopped from getting worse. Sometimes, if we find and treat the cause, kidney function can improve a bit.

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Will this affect my insurance?

If you apply for new life insurance or income protection, you’ll need to tell them about your CKD. Mild CKD (Stage 3a) doesn’t usually affect the cost much. For insurance you already have, check your policy – you may not need to tell them unless you make a claim.

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Can I still take my usual medicines?

Most medicines are fine, but we may need to adjust some doses. Never stop taking medicines without talking to your doctor first.

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Should I change what I eat?

For mild to moderate CKD, you don’t need a special diet. Just eat healthily and try to use less salt. If your CKD is more advanced, we might refer you to a dietitian.

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How often will I need blood tests?

Usually once a year if your CKD is stable. More often if your kidney function is changing or if your CKD is more advanced.

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What symptoms should I look out for?

Most people with CKD have no symptoms. Contact us if you get:

• Swelling in your ankles or around your eyes that doesn’t go away
• Much less urine than normal
• Blood in your urine
• Feeling very tired all the time
• Feeling sick or being sick a lot
• Sudden weight loss or gain

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Can I still exercise?

Yes! Exercise is good for your kidneys and your overall health. There’s no need to limit your activity because of CKD.

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Should I drink more or less water?

Drink a normal amount – about 6-8 glasses a day. You don’t need to force extra water, but don’t let yourself get dehydrated.

Where can I get more information?

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Kidney Care UK

A charity that helps people with kidney disease.

Website: kidneycareuk.org
Helpline: 01420 541 424
Email: info@kidneycareuk.org

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NHS website

Lots of information about kidney disease.

www.nhs.uk/conditions/kidney-disease/

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UK Kidney Association

Information for patients and the public.

www.ukkidney.org/patients-and-public

References

This information is based on:

UK Kidney Association (2024). Tests for Chronic Kidney Disease. Kidney Care UK. Available at: https://kidneycareuk.org/kidney-disease-information/about-kidney-health/tests-for-chronic-kidney-disease/

NICE NG203 (2021). Chronic kidney disease: assessment and management. National Institute for Health and Care Excellence. Available at: https://www.nice.org.uk/guidance/ng203

UK Kidney Association (2024). eCKD Guide: CKD Staging and Management. Available at: https://www.ukkidney.org/health-professionals/information-resources/uk-eckd-guide

Patient.info (2024). Chronic Kidney Disease (Professional Reference). Available at: https://patient.info/doctor/renal-disorders/chronic-kidney-disease-pro

Kidney Care UK (2024). Chronic Kidney Disease – Patient Information. Available at: https://kidneycareuk.org/kidney-disease-information/kidney-conditions/patient-info-ckd-chronic-kidney-disease/

NHS RightCare (2018). Abdul’s Story: Progressive Chronic Kidney Disease Narrative. Available at: https://www.england.nhs.uk/rightcare/

Kidney Care UK (2024). Failure to Recognise the Seriousness of CKD Is Costing Lives. Available at: https://kidneycareuk.org/about-us/policy-updates/

Healthtalk (2023). When Should Doctors Inform People of a Mild Kidney Impairment? Available at: https://healthtalk.org/experiences/kidney-health/

Oxford Health Experiences Institute (2024). Kidney Health Communication Project. Available at: https://hexi.ox.ac.uk/kidney-health/

Kidney Care UK (2025). Bloody Amazing Kidneys Campaign. Available at: https://kidneycareuk.org/health-professionals/kidney-care-bloody-amazing-kidneys-campaign/

NHS (2025). NHS Health Check Programme. Available at: https://www.nhs.uk/tests-and-treatments/nhs-health-check/

South West London ICB (2025). Pilot Programme to Identify Kidney Disease Early and Offer Better Care. Available at: https://www.southwestlondon.icb.nhs.uk/

Kidney Research UK (2024). Barriers to Effective CKD Diagnosis and Care. Available at: https://www.kidneyresearchuk.org/

Think Kidneys NHS (2017). Interventions Toolkit for Primary Care. Available at: https://www.thinkkidneys.nhs.uk/

BMJ Open (2020). Chronic Kidney Disease Is Often Undiagnosed and Untreated. Available at: https://bmjopen.bmj.com/content/10/10/e041788

NIHR Evidence (2024). Chronic Kidney Disease Is Often Undiagnosed and Untreated. Available at: https://evidence.nihr.ac.uk/alert/

World Kidney Day UK (2025). Detect Early, Protect Kidney Health. Available at: https://www.worldkidneyday.co.uk