By Cory Martin 

Updated on September 19, 2023

 Medically reviewed by Matthew Wosnitzer, MD

Chronic kidney disease (CKD) occurs when there is damage to the kidneys and they no longer filter blood the way they should. One job of the kidneys is to filter waste and fluid from the blood to produce urine. When the kidneys are damaged, waste and fluid can build up in the body and lead to other health problems.

Chronic kidney disease is a common condition. People with diabetes, high blood pressure, heart disease, and a family history of CKD are more likely to develop the disease. Chronic kidney disease slowly progresses over time. Early diagnosis and treatment are key to slowing or stopping progression through the stages of the disease.¹

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There are five stages of chronic kidney disease. In stages 1 and 2, there is minimal damage to the kidneys, and they still work well. There may be no symptoms and few indications that something is wrong, such as protein in the urine.

In stage 3, the damage to the kidneys has progressed, and the kidneys no longer function as well as they should. Symptoms such as fatigue may become noticeable. With treatment and healthy lifestyle changes, many people do not progress to stages 4 and 5.

In stages 4 and 5, damage to the kidneys is severe, and the kidneys barely function or may not function at all. In stage 5, complete kidney failure is possible.² As CKD patients progress through the stages of the disease, complications may arise.

This article will discuss common and serious complications associated with chronic kidney disease, how to prevent and treat complications, and when to see a healthcare provider.

Common Complications

Chronic kidney disease can cause a variety of other conditions as the kidneys’ ability to function properly decreases.

Fluid Retention

Fluid retention can cause swelling in the hands and feet and other areas of the body. This occurs due to the kidneys' inability to filter excess sodium from the body, causing it to retain water. Swelling can negatively affect the quality of life.³

Anemia

It's common to have both kidney disease and anemia. Anemia is a condition in which the amount of healthy red blood cells in the body is lower than normal.

Red blood cells are responsible for delivering oxygen to the body’s organs. In CKD, the heart can be affected by anemia because it has to work harder to deliver oxygen to the tissues and organs of the body. Anemia can also cause fatigue.⁴

Gout

Gout is an inflammatory arthritis in which urate crystals build up in the body, most often in the joints, causing pain and immobility. Urate excretion (removal from the blood) normally occurs through the kidneys. In CKD, when the kidneys are not functioning as well as they should, urate accumulates and gout becomes more common.⁵

Mineral Imbalances

Mineral and bone disorder is a condition that occurs when the kidneys damaged by CKD can’t regulate hormones the way they should. Levels of minerals such as calcium and phosphorus, which help keep bones strong and healthy, then become imbalanced.⁶

Metabolic Acidosis

CKD can affect the pH balance (acid/base balance) of the blood, causing it to become more acidic. This is known as metabolic acidosis.

Metabolic acidosis affects the systems of the body and can cause muscle wasting, heart failure (the heart cannot pump enough blood to meet the body's needs), and insulin resistance (impaired sugar metabolism), among other conditions.⁷

Gastrointestinal Issues

A buildup of waste in the body can cause problems with the digestive system. Chronic diarrhea is common, as well as inflammation of the stomach lining, ulcers in the esophagus (food tube), and inflammation in the small intestine.⁸

Sexual Dysfunction

Erectile dysfunction (ED) commonly occurs with CKD due to a lack of blood flow. Treating ED can improve the quality of life. If you experience erectile dysfunction (inability to achieve or maintain an erection sufficient for penetration), you should also be screened for heart disease as ED often occurs before heart disease.⁹

Low testosterone can slo occur in CKD. In addition to ED, low testosterone can also lead to low energy, clairy of thinking, and libido.

Weakened Bones

Due to the mineral imbalances that can occur with CKD, bones can become weakened making you more susceptible to fractures and osteoporosis (meaning "porous bones," when bone mass and mineral density decrease).⁶

High Blood Pressure

High blood pressure is one of the most damaging complications of CKD and is believed to speed up the decline in kidney function.³

Reduced Immune Response

The immune system in people with CKD is often impaired. Normally, the immune system fights off infection and disease. In people with CKD, the immune response does not function the way it should.

Chronic inflammation and wasting of antibodies in the urine (which does not happen normally) can all contribute to the reduced immune response.¹⁰

Heart Disease

The risk of heart disease increases as CKD progresses. Heart disease is the leading cause of death in CKD. Imbalanced minerals and hormones, high blood pressure, and hardened arteries can all contribute to heart disease in CKD.³

Preventing Complications

While kidney damage cannot be reversed, there are steps you can take to prevent complications and slow the progression of CKD.

Diet and Nutrition

Making changes to your diet can help protect your kidneys from further damage and limit complications. While a dietitian can help you create a meal plan that works best for your body, healthy changes anyone with CKD can make to their diet include:

• Limit salt and sodium.

• Eat heart-healthy foods such as fruits and vegetables.

• Avoid fried foods and saturated fats.

• Eat smaller portions of proteins so as not to overburden the kidneys.¹¹

Lifestyle Changes

Lifestyle changes can also help prevent further damage to your kidneys and improve your overall health. Changes you can make include:

• Achieve and maintain a healthy weight.

• Remain or become physically active.

• Get enough sleep.

• Stop smoking.

• Stop using recreational drugs, such as cocaine and methamphetamine.¹²

Mental Health

Depression and anxiety commonly occur with CKD. Talking to a mental health professional can help you deal with the stress of the disease itself and also the depression and anxiety that may occur along with it.

Finding ways to manage stress such as meditation or physical activity can also help with mental health.¹³

Treating Complications

Treating complications of CKD and CKD itself require a multidisciplinary approach (involving different types of healthcare providers).

Managing the disease includes monitoring trends in kidney function through blood and urine tests, medical treatments such as prescription drugs to treat high blood pressure, and lifestyle modifications, such as quitting smoking and maintaining a healthy weight.

Depending on the nature of the complication, treatment could include medications, dietary changes, or a referral to a specialist, such as a cardiologist to treat heart disease.¹⁴

When to See a Healthcare Provider

It is important to maintain a regular schedule with your healthcare provider so that they can monitor the function of your kidneys. Changes in kidney function cannot always be felt and need to be monitored through blood and urine tests.

If you experience complications, or your symptoms become worse, it is important to talk to your healthcare provider so they can recommend a proper treatment plan.

Summary

Chronic kidney disease can cause other conditions and complications, such as fluid retention, sexual dysfunction, and heart disease. Maintaining a regular schedule with your healthcare provider, eating a kidney supportive diet, making healthy lifestyle changes, and taking care of your mental health can all help you live well with the disease.