Your kidneys are remarkable organs. Each about the size of a fist, they filter approximately 180 litres of blood every day, removing waste products and excess fluid to produce urine. They also regulate blood pressure, produce hormones, and maintain the balance of minerals in your blood.
Chronic kidney disease (CKD) affects an estimated 10% of the global adult population. In the UAE, where diabetes and hypertension are common, CKD is a significant health concern. The challenge is that kidney disease often has no symptoms until it reaches an advanced stage.
Risk Factors for Kidney Disease
Major Risk Factors
- Diabetes: The leading cause of CKD worldwide. High blood sugar damages the tiny blood vessels in the kidneys over time
- High blood pressure: The second leading cause. Elevated pressure damages kidney blood vessels
- Family history of kidney disease
- Obesity
- Age over 60
- Cardiovascular disease
Other Risk Factors
- Smoking
- Frequent use of NSAIDs (ibuprofen, diclofenac) and other kidney-toxic medications
- Kidney stones (recurrent)
- Urinary tract obstruction
- Autoimmune conditions (e.g., lupus)
- Previous acute kidney injury
Warning Signs
Early CKD usually has no symptoms. As kidney function declines, you may notice:
- Fatigue and low energy
- Swelling in the feet, ankles, or around the eyes (oedema)
- Foamy or bubbly urine (may indicate protein in urine)
- Blood in the urine
- Increased need to urinate, especially at night
- Decreased appetite and nausea
- Difficulty concentrating
- Dry, itchy skin
- Muscle cramps
How Kidney Disease Is Detected
Blood Tests
- Serum creatinine and eGFR (estimated glomerular filtration rate): eGFR is the best measure of kidney function. An eGFR below 60 (sustained for more than 3 months) indicates CKD
- Normal kidney function: eGFR above 90 mL/min
Urine Tests
- Albumin-creatinine ratio (ACR): Detects protein (albumin) in the urine. Protein in the urine is an early sign of kidney damage
- Normal ACR: below 3 mg/mmol
CKD Stages (NICE NG203)
| Stage | eGFR (mL/min) | Description |
|---|---|---|
| 1 | 90 or above | Normal function but evidence of damage (e.g., protein in urine) |
| 2 | 60-89 | Mildly reduced function |
| 3a | 45-59 | Mild to moderate reduction |
| 3b | 30-44 | Moderate to severe reduction |
| 4 | 15-29 | Severely reduced |
| 5 | Below 15 | Kidney failure (may need dialysis or transplant) |
Protecting Your Kidneys
Manage Diabetes
- Keep HbA1c within your individual target (usually below 53 mmol/mol or 7%)
- Regular blood sugar monitoring
- Take medications as prescribed
Control Blood Pressure
- Target blood pressure for people with CKD: below 140/90 mmHg (or lower if you have diabetes or significant proteinuria)
- NICE recommends ACE inhibitors or ARBs as first-choice medications for CKD patients with proteinuria
Stay Hydrated
- Drink adequate water (approximately 1.5-2 litres per day unless advised otherwise)
- Reduce drinks high in sugar
Medication Safety
- Avoid prolonged or frequent use of NSAIDs (ibuprofen, diclofenac, naproxen) unless prescribed
- Tell your doctor about all medications you take, including over-the-counter and herbal supplements
- Some herbal remedies can be harmful to the kidneys
Healthy Lifestyle
- Maintain a healthy weight
- Exercise regularly
- Eat a balanced diet with moderate salt intake (less than 6 g per day)
- Do not smoke
- Limit alcohol
Screening Recommendations
NICE recommends annual kidney function testing (eGFR and urine ACR) for people with:
- Diabetes
- Hypertension
- Cardiovascular disease
- Family history of CKD
- Conditions requiring nephrotoxic medications
Early detection allows treatment to slow or prevent progression.
This article is for informational purposes only and does not replace professional medical advice. Always consult your doctor for personalised guidance.