Chronic Kidney Disease Program

For most people, kidney damage occurs slowly over many years. Chronic kidney disease (CKD) is a common, irreversible condition in which your kidneys don’t work properly and worsen over time. It can limit your ability to perform day-to-day activities.

There is no cure for CKD, but you can take steps to preserve kidney function and live a productive life. Early detection can slow the disease progression, delay complications and prevent or delay kidney failure.

Our nephrologists (kidney specialists) at the Chronic Kidney Disease Program are global leaders in providing outstanding care and treatment. We focus on people ages 18 years and older.

• See Kidney Care 

Nationally Recognized Kidney Care

Our program received the nation’s first chronic kidney disease certificate of distinction in 2010 from The Joint Commission, an independent, not-for-profit organization and the nation’s leading standards-setting and accrediting body in health care. 

Its gold seal of approval means you can be confident that UC San Diego Health follows the highest national standards for safety and quality of care and is committed to continually improving patient care.

We are one of only two such certified programs in the United States. Ours is the first chronic kidney disease program in the nation to receive this disease-specific certification.

Multidisciplinary Care Team

Treating chronic kidney disease is a complex process, often requiring skilled management of complications and coinciding conditions, such as diabetes or high blood pressure, which damage your kidneys over time.

Your experienced care team includes physicians, pharmacists, dietitians, case managers and social workers. We also coordinate with experts in other UC San Diego Health specialties to provide care across the entire kidney disease spectrum.

From diagnosis to disease management, rest assured that we follow evidence-based guidelines defined by the National Kidney Foundation to provide the best care possible.

Early Screening and Intervention

CKD is a silent disease. You may not have any clear symptoms until the disease is advanced. That’s why early screening and detection are so important, along with lifestyle changes to help you stay healthy and slow disease progression.

When kidneys are damaged, they can't balance minerals and filter out waste and extra water from your blood as they should. Fluid and toxins can build up in your blood to unhealthy levels over the years, making you ill. Symptoms may include appetite loss, headaches, dry and itchy skin, fatigue, headaches, muscle cramps, nausea and vomiting, sleeping problems, urination issues and weight loss.

Diabetes and high blood pressure are the most common causes for CKD. Other causes include genetic disorders like polycystic kidney disease and infections or other conditions that cause kidney problems.

Chronic kidney disease can lead to other complications such as anemia, blood vessel disease, heart disease, a weakened immune system and malnutrition. There are five stages of chronic kidney disease. In stage 5, kidneys fail and patients need dialysis or a kidney transplant for survival.

Blood and urine tests typically are the best way to know how well your kidneys are working. Such routine tests during an annual physical or a doctor's visit for other problems can help in diagnosing CKD.

Routine Early Screenings for CKD

We recommend early routine screenings for those who are at increased risk for developing CKD. This includes people who:

• Have hypertension
• Have diabetes
• Have cardiovascular disease
• Have a personal history of cancer or use of medications that damage kidneys
  
• Have a family history of chronic kidney diseases
• Are African American, American Indian, Alaskan Native or Hispanic. These groups have a higher rate of diabetes and high blood pressure, and therefore an increased risk of developing kidney failure.
  

Note: Routine screening is not advised for those who are under 50 and considered to be at low risk for CKD.

Diagnosing Chronic Kidney Disease

Your doctor will take your medical history, conduct a physical exam, check your blood pressure and ask about your physical activity, medications and any symptoms. 

We use two simple tests to check kidney function and detect signs of CKD:

1. Urine test to check for protein, which can signal kidney disease. This test has other names, including proteinuria, urine albumin-to-creatinine ratio, microalbuminuria and macroalbuminuria.
2. Blood test to check your glomerular filtration rate (GFR). This measures how efficiently your kidneys filter blood. It is used to determine the stage of kidney disease. GFR is based on several factors, including your age, gender, ethnicity, height, weight and the amount of creatinine (a waste product) found in your blood. The lower the GFR, the more severe the disease.

We may also do imaging tests, such as a CT scan, to look for any structural problems with your kidneys. The results of your examination and testing will help your doctor make an accurate diagnosis.

Tailored Treatment Plans for CKD

There is no cure for chronic kidney disease, but there are treatment and preventive strategies to slow the progression of kidney damage, usually by controlling the cause. We want to help you better manage CKD to improve your health, delay or prevent kidney failure, or end-stage renal disease (ESRD). If needed, we streamline the transition to dialysis or kidney transplant.

Our team promotes a holistic approach that embraces both conventional and alternative therapies. Treating chronic kidney disease is a complex process, so a healthy lifestyle is important to prevent kidney disease progression. Your nephrologist will personalize a treatment plan for you, which may involve:

• Medications to help slow CKD progression
  
• Review of all your other medications to ensure they aren’t harmful to your kidneys
• Lifestyle and dietary changes, including regular exercise, stopping smoking and weight management
• Patient education classes and wellness programs
• Psychosocial support for dealing with a chronic illness
• Referrals for vascular surgery, dialysis and kidney transplant or other specialties, if needed
• Managing other health conditions to slow the progression of CKD, including:
• Diabetes: If you have diabetes and chronic kidney disease, getting blood glucose under control is critical. UC San Diego Health's Diabetes Self-Management Clinic has classes that can help you.
• Hypertension: Hypertension, or high blood pressure, can damage the blood vessels inside the kidneys, hindering their ability to function. Medications and frequent blood pressure monitoring can be helpful. We provide blood pressure monitors and cuffs to patients who cannot afford them, as well as training on how and when to use them.