Chronic Kidney Disease: What Happens

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What Happens

Chronic kidney disease can greatly impact your life as it gets worse (progresses). At first, the kidneys are still able to regulate the balance of fluids, salts, and waste products in your body. But as kidney function decreases, complications begin to develop. The number and severity of complications caused by chronic kidney disease increase as kidney function gets worse.

If you are not able to control the disease, your kidney function will continue to get worse. When kidney function falls below a certain point, it is called kidney failure. Kidney failure has harmful effects throughout your body. It can cause serious heart, bone, and brain problems and make you feel very ill.

After you develop kidney failure, either you will need to have dialysis or you will need a new kidney. Both choices have risks and benefits. Talk with your doctor to decide which would be best for you.

Chronic kidney disease increases your risk of getting heart disease. For more information, see the topics Heart Attack and Unstable Angina, Coronary Artery Disease, and Heart Failure.

Complications of chronic kidney disease

Regardless of what causes chronic kidney disease, serious problems occur when the kidneys cannot adequately filter and remove all of the waste products from the body. As these waste products build up, symptoms and serious complications start to occur. Complications of severe chronic kidney disease may include:

• Uremic syndrome. In uremic syndrome, urea and creatinine levels in the bloodstream rise. Fatigue and weight loss are common symptoms. Uremic syndrome can affect many body systems, such as the intestines, nerves, and heart.
• Anemia. Anemia occurs when the kidneys do not produce enough of a protein called erythropoietin for the body to make new red blood cells. The more damage that has occurred in the kidneys, the more severe the anemia may be.
• Electrolyte imbalance. Electrolyte imbalance occurs when the kidneys cannot adequately filter out certain chemicals from the blood , such as potassium, phosphate, and acids.
• Heart disease. Chronic kidney disease speeds up hardening of the arteries (atherosclerosis) and increases the risk of heart attack and heart failure. Heart disease is the most common cause of death in people with kidney failure.
• Bone disease (osteodystrophy). The kidneys must be able to maintain a healthy balance of substances such as calcium, phosphate, and vitamin D to help keep bones strong. Kidney disease causes abnormal levels of these substances. This leads to renal bone disease.
• Fluid imbalances. As kidney function continues to decline, the kidneys are increasingly unable to filter fluids and maintain salt balance. When the kidneys are no longer able to properly remove salt and water from the body, fluid builds up in the tissues of the body (edema). Fluid buildup in the lungs (pulmonary edema) can cause heart failure.

Last updated:	November 13, 2007
Author:	Jeannette Curtis
Reviewed By:	E. Gregory Thompson, MD - Internal Medicine, D.C. Mendelssohn, MD, FRCPC - Nephrology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC