Many Patients Unaware They Have Silent Chronic Kidney Disease

Dr Philippa Kaye faces a grim reality after every surgery when she reviews that day's blood results and matches them to specific patients. Most entries show normal values, yet some demand an immediate phone call while others are so alarming the lab contacts her before she opens her laptop. There is one particular result that appears again and again for a condition most of her patients have never heard of because it rarely causes any symptoms at all. Dr Kaye worries that countless individuals across the country do not realise they carry this disease either.

Consider Linda, whom I spoke to last week. She manages high blood pressure with medication and undergoes annual blood tests as part of her routine care. One specific test checks kidney function, and when combined with a urine analysis, it revealed she had something called chronic kidney disease. Her first questions were simple yet urgent: What does that even mean? And is it serious?

Chronic kidney disease, or CKD, affects one in ten adults in Britain, which translates to around 7.2 million people living with the condition. Every year it contributes to an estimated 45,000 deaths, a figure that exceeds the combined number of breast and prostate cancer fatalities each year. And yet the vast majority walk around without any idea they have it at all. That is because CKD does not behave like other serious diseases where clear warning signs appear early on. Think of it less as a single illness and more as a significant risk factor that hides in plain sight.

The kidneys essentially clean the blood by removing waste and excess water to make urine. But for those with CKD, the kidneys slowly stop functioning properly, meaning they remove less waste and water from the system over time. If symptoms of the condition do appear, they tend to be vague at first. Tiredness is most common, alongside brain fog and itchy skin that patients often ignore until it becomes severe. Eventually, the kidneys can give out completely in a state known as kidney failure, meaning dialysis or an organ transplant will be needed for survival.

Thankfully, however, this total organ failure only affects around 2 per cent of CKD patients according to available statistics. Instead the real danger, even when the disease is mild, is the extra strain it puts on the heart and blood vessels throughout the body. People with CKD are around 20 times more likely to die of a heart attack or stroke than they are to ever reach kidney failure in their lifetime. Like Linda, most people with CKD have no symptoms at all in the early stages because the body compensates so well for a decline in kidney function.

That is exactly why most cases are only picked up by chance when a blood or urine test is done for something else entirely. If symptoms do appear later on, you may notice weight loss, swollen ankles, feet or hands, breathlessness, blood in your urine, needing to urinate more often, or muscle cramps that disrupt daily life. By the time you notice any of this, the disease has often been present for years without detection. And unlike many other diseases, there is no reversing CKD once it has taken hold within the body.

Dr Philippa Kaye, who works as a GP, broadcaster, and author, makes a stark point: this condition cannot be cured and the damage inflicted on the body cannot be healed. So what actually triggers Chronic Kidney Disease? The answer lies closely tied to diabetes and high blood pressure, with that relationship flowing in both directions. High blood sugar and elevated blood pressure can hurt the kidneys, yet damaged kidneys also push blood sugar levels up and drive blood pressure higher.

Most cases stem from poor lifestyle choices. Think of an unhealthy diet, a lack of physical exercise, excessive drinking, and smoking. For the vast majority of patients, diagnosis happens only through two simple tests that a GP can order immediately. One test checks the blood for creatinine, a waste product the healthy kidneys should be clearing out to calculate how well those organs function. The second test examines urine for albumin, a protein that leaks into the fluid when kidney damage is present.

Anyone living with diabetes or high blood pressure needs to ask their doctor for these specific tests right away. Finding the disease early matters because while you cannot reverse the condition, you can certainly stop it from getting worse. Getting blood pressure down and keeping diabetes under control are essential steps. This often means losing weight if necessary, eating a balanced diet rich in fruit, vegetables, and wholegrains but low in salt and sugar. Staying active counts for an enormous amount too. Exercise cuts the risk of heart disease significantly, and remember that CKD is fundamentally a heart problem in disguise.

If you smoke, quit. Keep alcohol well under 14 units a week, ideally much lower. Alongside these lifestyle shifts, effective medicines now exist. A decade ago, there were very few drugs to help patients with this condition. But genuine breakthroughs have happened recently. Doctors now use a class of medicines called SGLT2 inhibitors. The most well-known ones are dapagliflozin and empagliflozin. Originally developed for diabetes, major trials showed they significantly slow the decline in kidney function. They also cut the risk of heart failure and death in people with CKD, regardless of whether they have diabetes or not.

Any patient with CKD who has not been offered one of these tablets should speak to their GP about starting them. There are many more cases out there right now where people do not yet know they have this disease. If you are aged between 40 and 74 and have no other health conditions, you are entitled to an NHS health check every five years. These checks cover blood pressure, blood glucose, and cholesterol. If your blood pressure is raised, the test also covers kidney function. Do not wait until symptoms appear or even until a heart attack strikes. Get checked now before it becomes too late.