Chronic Kidney Disease

Chronic kidney disease (CKD) is a long-term condition in which the kidneys are damaged or gradually lose their ability to filter blood effectively. As kidney function declines, waste products and excess fluid can accumulate in the body.[1] CKD usually progresses slowly and is often irreversible. In its most severe form, it can progress to kidney failure, requiring dialysis or kidney transplantation to sustain life.[1]

Global Impact

Chronic kidney disease is a major and growing global health problem. WHO estimates that approximately 674 million people worldwide are living with CKD, with most residing in low- and middle-income countries.[1]

The Global Burden of Disease Study 2023 estimated an even higher burden among adults, with approximately 788 million adults aged 20 years and older living with CKD in 2023.[2]

Impact in India

India has one of the largest CKD populations in the world. GBD 2023 estimated that approximately 138 million adults in India were living with CKD, second only to China in absolute numbers.[2]
In 2021, CKD was estimated to cause approximately 175,637 deaths and 6.49 million disability-adjusted life years (DALYs) in India.[3]

A population-based comparison using data from the Punjab WHO STEPS Survey (2014–2015) and the US National Health and Nutrition Examination Survey (NHANES 2013–2014) found that albuminuria was substantially more prevalent among adults aged 18–69 years in Punjab than in the USA (46.7% vs 8.9%). In contrast, reduced kidney function (eGFR <60 mL/min/1.73 m²) was reported in 2.0% in Punjab and 3.8% in the USA.[4]

Risk Factors and Causes

The most common causes of CKD in adults are diabetes and high blood pressure.[1,5] Other important causes and risk factors include cardiovascular disease, glomerular diseases, recurrent or severe acute kidney injury, polycystic and other genetic kidney diseases, kidney infections, certain medicines and toxins, obesity, family history of kidney disease and increasing age.[5]

Signs and Symptoms

CKD is often asymptomatic in its early stages, and many people remain unaware of the condition until kidney function has significantly declined.[1]

Symptoms of advanced CKD may include:

  • Fatigue and weakness
  • Swelling of the feet, ankles or legs
  • Shortness of breath
  • Nausea or vomiting
  • Loss of appetite
  • Muscle cramps
  • Persistent itching
  • Changes in urination.[1,6]

Complications

Progressive CKD can lead to several serious health complications, including:

  • Cardiovascular disease, heart attack and stroke
  • High blood pressure
  • Anaemia
  • Mineral and bone disorders
  • Electrolyte abnormalities
  • Malnutrition
  • Kidney failure.[6]

Diagnosis and Early Detection

CKD can be detected using simple blood and urine tests. A blood test measuring serum creatinine is used to estimate the glomerular filtration rate (eGFR), while a urine test measures albuminuria, an important marker of kidney damage.[1]

WHO recommends targeted testing for people at increased risk, particularly those with diabetes, hypertension and cardiovascular disease, to identify CKD at an early stage.[1]

Prevention and Management

CKD management aims to slow disease progression, reduce cardiovascular risk and prevent complications.[1] Important measures include controlling blood pressure and blood glucose, reducing dietary salt, maintaining a healthy weight, being physically active, avoiding tobacco and avoiding unnecessary use of medicines that may damage the kidneys.[1,5]

Medicines may be prescribed to control blood pressure, reduce albuminuria and slow the progression of kidney disease. People who progress to kidney failure may require dialysis or kidney transplantation.[1,7]

References

    1. World Health Organization. Kidney disease. Geneva: World Health Organization; 2026 Apr 20. Available from: https://www.who.int/news-room/fact-sheets/detail/kidney-disease
    2. GBD 2023 Chronic Kidney Disease Collaborators. Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406. Available from: https://eprints.gla.ac.uk/365862/
    3. Meshram HS, et al. Burden of chronic kidney disease in India: past, present, and future projections to 2040 from the Global Burden of Disease 2021 Study. Int Urol Nephrol. 2026. Available from: https://pubmed.ncbi.nlm.nih.gov/41484514/
    4. Bragg-Gresham J, Thakur JS, Jeet G, Jain S, Pal A, Prasad R, et al. Population-based comparison of chronic kidney disease prevalence and risk factors among adults living in the Punjab, Northern India and the USA (2013–2015). BMJ Open. 2020;10(12):e040444. doi:10.1136/bmjopen-2020-040444. Available from: https://bmjopen.bmj.com/content/10/12/e040444
    5. National Institute of Diabetes and Digestive and Kidney Diseases. Causes of chronic kidney disease in adults. Bethesda (MD): National Institutes of Health; 2025 Feb. Available from: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/causes
    6. National Institute of Diabetes and Digestive and Kidney Diseases. What is chronic kidney disease in adults?. Bethesda (MD): National Institutes of Health. Available from: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease
    7. National Institute of Diabetes and Digestive and Kidney Diseases. Managing chronic kidney disease. Bethesdan (MD): National Institutes of Health. Available from: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/managing