• Diabetes is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. This results in a high blood sugar level, which can cause problems in many parts of your body. Diabetes is the leading cause of kidney disease.
• High blood pressure (also known as hypertension) is another common cause of kidney disease and other complications such as heart attacks and strokes. High blood pressure occurs when the force of blood against your artery walls increases.
• Glomerulonephritis is a disease that causes inflammation of the kidney's tiny filtering units called the glomeruli. Glomerulonephritis may happen suddenly, for example, after a strep throat, and the individual may get well again. However, the disease may develop slowly over several years and it may cause progressive loss of kidney function.
• Polycystic kidney disease is the most common inherited kidney disease. It is characterized by the formation of kidney cysts that enlarge over time and may cause serious kidney damage and even kidney failure.
• Kidney stones are very common, and when they pass, they may cause severe pain in your back and side. There are many possible causes of kidney stones, including an inherited disorder that causes too much calcium to be absorbed from foods and urinary tract infections or obstructions. Sometimes, medications and diet can help to prevent recurrent stone formation.
• Urinary tract infections occur when germs enter the urinary tract and cause symptoms such as pain and/or burning during urination and more frequent need to urinate. These infections most often affect the bladder, but they sometimes spread to the kidneys, and they may cause fever and pain in your back.
• Congenital diseases may also affect the kidneys. These usually involve some problem that occurs in the urinary tract when a baby is developing in its mother's womb. One of the most common occurs when a valve-like mechanism between the bladder and ureter (urine tube) fails to work properly and allows urine to back up (reflux) to the kidneys, causing infections and possible kidney damage.
• Drugs and toxins can also cause kidney problems. Using large numbers of over-the-counter pain relievers for a long time may be harmful to the kidneys. Certain other medications, toxins, pesticides and "street" drugs such as heroin and crack can also cause kidney damage.

How is Chronic Kidney Disease Detected?

Early detection and treatment of chronic kidney disease are the keys to keeping kidney disease from progressing to kidney failure. Some simple tests can be done to detect early kidney disease. They are:

1. Blood pressure measurement
2. A test for protein in the urine. An excess amount of protein in your urine may mean your kidney's filtering units have been damaged by disease. One positive result could be due to fever or heavy exercise, so your doctor will want to confirm your test over several weeks.
3. A test for blood creatinine. Your doctor should use your results, along with your age, race, gender and other factors, to calculate your glomerular filtration rate (GFR). Your GFR tells how much kidney function you have.

It is especially important that people who have an increased risk for chronic kidney disease have these tests. You may have an increased risk for kidney disease if you:

• are older
• have diabetes
• have high blood pressure
• have a family member who has chronic kidney disease
• are an African American, Hispanic American, Asians and Pacific Islander or American Indian.

If you are in one of these groups or think you may have an increased risk for kidney disease, ask your doctor about getting tested.

What Are the Warning Signs of Kidney Disease?

Kidney disease usually affects both kidneys. If the kidneys' ability to filter the blood is seriously damaged by disease, wastes and excess fluid may build up in the body. Although many forms of kidney disease do not produce symptoms until late in the course of the disease, there are six warning signs of kidney disease:

1. High blood pressure.
2. Blood and/or protein in the urine.
3. A creatinine and Blood Urea Nitrogen (BUN) blood test, outside the normal range. BUN and creatinine are waste that build up in your blood when your kidney function is reduced.
4. A glomerular filtration rate (GFR) less than 60. GFR is a measure of kidney function.
5. More frequent urination, particularly at night; difficult or painful urination.
6. Puffiness around eyes, swelling of hands and feet.

What are the symptoms?

Most people do not have any severe symptoms until their kidney disease gets worse. However, you may:

• feel more tired
• have less energy
• have trouble thinking clearly
• have a poor appetite
• have trouble sleeping
• have dry, itchy skin
• have muscle cramping at night
• have swollen feet and ankles
• have puffiness around your eyes, especially in the morning
• need to urinate more often, especially at night.

Why are African Americans and other ethnic groups at increased risk for chronic kidney disease?

Diabetes, the leading cause of chronic kidney disease, is more common in these groups. Also, high blood pressure, the second leading cause of chronic kidney disease, appears more often in African Americans than in other ethnic groups. Many experts believe these groups may have an inherited tendency to develop these diseases. When combined with other things, such as being overweight, this tendency may lead to disease. Staying at a normal weight and getting enough exercise is very important for these groups to help prevent diabetes and high blood pressure.

Can Chronic Kidney Disease progression be prevented?

Most likely. Early detection and treatment can often slow or stop chronic kidney disease. How well your treatment can achieve this goal depends on:

• Your stage of chronic kidney disease when you start treatment. The earlier you start, the better you are likely to do.
• How carefully you follow your treatment plan. Learn all you can about chronic kidney disease and its treatment, and make sure to follow all the steps of your treatment faithfully.
• The cause of your kidney disease. Some kidney diseases are more difficult to control.