What is chronic kidney disease (CKD) and why do its symptoms not appear early?

Chronic Kidney Disease (CKD) is a medical condition involving structural or functional damage to the kidneys that prevents them from filtering blood properly. The kidneys are two vital organs, each about the size of a fist, whose primary function is to filter waste and excess fluid from the blood and eliminate them through urine [1]. In addition, the kidneys play pivotal roles in maintaining the balance of body chemicals, regulating blood pressure, and producing hormones essential for overall health [1]. When kidneys lose their ability to filter, waste products and toxins accumulate in the body, paving the way for widespread health complications [2].

Why is chronic kidney disease characterized as a silent progression?

Many wonder about the absence of clear symptoms at the beginning of the condition; the truth is that chronic kidney disease usually develops very slowly over years [1]. Most patients do not notice any warning signs in the early stages, and many do not feel any symptoms at all until the disease reaches very advanced stages [2]. This high capacity of the kidneys to compensate and function despite structural damage makes it difficult to detect the disease clinically without periodic testing [1].

Diagnosis: The only path to early detection

Since symptoms are often absent in the early stages, laboratory tests (blood and urine tests) are the only reliable way to know if a person has this disease [1]. People with specific risk factors are advised to discuss with their doctor the necessity of conducting these tests periodically. It is extremely important to monitor conditions that increase the risk of infection, primarily diabetes, high blood pressure, cardiovascular diseases, and a family history of kidney disease [2].

Slowing the disease's progression and management

Although chronic kidney disease may not be fully curable, early intervention provides significant opportunities to slow its progression and protect the kidneys from further damage [2]. Effective strategies include:

• Strict control of blood sugar and blood pressure levels, as these factors are the main drivers of kidney damage [1].
• Adopting a healthy lifestyle that includes reducing salt intake, maintaining an ideal weight, exercising, and quitting smoking [1].
• Using prescribed medications carefully, such as Angiotensin-Converting Enzyme (ACE) inhibitors, which help lower blood pressure and protect kidney function, especially in patients with diabetes [3].
• Avoiding the intake of medications or supplements that may increase stress on the kidneys without medical consultation [2].

For more details on preventive measures, you can review our specialized article on Chronic Kidney Disease: Silent Progression and How to Slow It (Arabic).

When do symptoms become an emergency?

As the disease progresses, signs such as swelling in the legs or feet (edema), a change in the frequency of urination, or foamy urine may appear [2]. You must contact a doctor immediately upon the appearance of any unusual symptoms. In the event of sudden swelling of the tongue or lips when taking any medication, you must go to the emergency room immediately, as this may indicate a serious allergic reaction [3].

Medical references

• Chronic Kidney Disease
• What Is Chronic Kidney Disease in Adults?
• ACE inhibitors