time, related health problems become more likely. However, CKD-related health problems can improve with treatment. Heart Disease and Stroke ● Having CKD increases the chances of having heart disease and stroke. ● Managing high blood pressure, blood sugar, and cholesterol levels—all factors that increase the risk for heart disease and stroke—is very important for people with CKD. Early Death Adults with CKD are at a higher risk of dying earlier than adults of similar age without CKD. Health Problems Due to Low Kidney Function ● Anemia or low red blood cell count, which can cause fatigue and weakness. ● Extra fluid in the body, which can cause high blood pressure, swelling in the legs, or shortness of breath. ● A weakened immune system, which make it easier to develop infections. ● Loss of appetite or nausea. ● Decreased sexual response. ● Confusion, problems with memory and thinking, or depression. ● Low calcium levels and high phosphorus levels in the blood, which can cause bone disease and heart disease. ● High potassium levels in the blood, which can cause an irregular or abnormal heartbeat and lead to death. Kidney Failure Kidney failure happens when kidney damage is severe and kidney function is very low. Dialysis or a kidney transplant is then needed for survival. Kidney failure treated with dialysis or a kidney transplant is called end-stage renal disease (ESRD). CKD is more likely to lead to kidney failure, especially in older adults, if the kidneys are damaged by the inability to manage risk factors, repeated kidney infections, or drugs or toxins that are harmful to the kidneys. Social factors such as lower income and related factors of food insecurity and poorer access to quality health care are also associated with worsening CKD. However, not everyone with CKD develops kidney failure. If CKD is detected early, treatment may slow the decline in kidney function and delay kidney failure. In some cases, kidney failure develops even with treatment. Renal is a medical term meaning “having to do with the kidneys.” Talk to a kidney doctor about treatment options if CKD is severe and kidney function is very low. Facts About ESRD ● In 2018, about 131,600 people in the United States started treatment for ESRD. ● Nearly 786,000 people in the United States, or 2 in every 1,000 people, are currently living with ESRD: 71% are on dialysis and 29% are living with a kidney transplant. ● For every 2 women who develop ESRD, 3 men develop ESRD. ● For every non-Hispanic White person who develops ESRD, 3 non-Hispanic Black people develop ESRD. ● For every 3 non-Hispanic people who develop ESRD, 4 Hispanic people develop ESRD. ● Among adults aged 18 years or older in the United States, diabetes and high blood pressure are the main causes of ESRD. ● Among children and adolescents younger than 18 years in the United States, polycystic kidney disease and glomerulonephritis (inflammation of the kidneys) are the main causes of ESRD. Reported Causes of End-Stage Renal Disease in the United States 39% 26% 15% 15% 5% Diabetes High Blood Pressure Glomerulonephritis Other Cause* Unknown Cause N=785,883 (all ages, 2018) Source: US Renal Data System *Includes polycystic kidney disease, among other causes. ● Learn about CKD from a primary care doctor or a kidney doctor (nephrologist) to better understand treatment options and protect the kidneys. People with glomerulonephritis, polycystic kidney disease, or other kidney disease should talk about specific treatment options with a kidney doctor. ● Monitor and manage blood sugar and blood pressure. ○ Have blood sugar and blood pressure checked regularly. ○ Use medicines if prescribed to lower blood sugar and blood pressure. ● Manage CKD: ○ Make lifestyle changes (e.g., healthy eating, physical activity) to prevent more kidney damage. Meet with a dietitian to create a kidney-healthy eating plan that is low in salt and fat and has the right amount and source of protein. As CKD gets worse, the plan may also include limiting phosphorus and potassium. ○ Use medicines as directed to slow the decline in kidney function. ○ Stop smoking or do not start smoking. ○ Avoid exposures that can harm the kidneys or cause kidney function to suddenly get worse: Certain medicines: ● Over-the-counter pain medicines like ibuprofen and naproxen, which are also called non-steroidal antiinflammatory drugs. ● Some antibiotics. Certain herbal supplements. Excessive alcohol intake. ○ Review with health care providers all prescription and over-the-counter medications to make sure they are safe for the kidneys. Always talk to a doctor before taking any supplements. ○ Check with a doctor about other behaviors or substances that can harm the kidneys or about special precautions to take when doing medical tests or procedures, such as imaging studies or colonoscopies. People with CKD Can Lower Their Risk for Kidney Failure People with diabetes, high blood pressure, or CKD need to talk to their doctor about how to protect their kidneys. Acknowledgments The following organizations** collaborated in developing and reviewing this fact sheet. Check their websites for CKD online resources for patients or providers: Centers for Disease Control and Prevention www.cdc.gov/kidneydisease Centers for Medicare & Medicaid Services www.cms.gov US Department of Defense