UC San Diego Health is a national and international leader in the care of people aged 18 years and older with chronic kidney disease
stages 2-5. In 2010, our program received the nation’s first chronic kidney disease certificate of distinction from
The Joint Commission for helping patients achieve long-term success by delivering:
Our program has earned the Gold Seal of Approval from The Joint Commission, which signifies the highest level of quality care for patients.
Treating chronic kidney disease is a complex process, often requiring management of coinciding conditions (e.g., diabetes, hypertension) that can increase risk for cardiovascular disease and death.
Our multidisciplinary team has the expertise, support and tools that can help you effectively manage chronic kidney disease and its complications.
Chronic kidney disease (CKD) affects an estimated
26 million adults in the U.S. – and millions more are at risk. It is an irreversible condition that increases risk for heart and blood vessel disease. While there is no cure for chronic kidney disease, there are treatment and preventive strategies to slow disease progression and avoid end-stage renal disease.
The kidneys have an important function of filtering waste and removing excess fluid out of the blood, balancing minerals, and helping to control blood pressure.
Chronic kidney disease is the gradual loss of kidney function over time. It can take months or years for the condition to develop. As the disease progresses, wastes accumulate to unhealthy levels in your blood, which can make you feel ill.
This buildup can lead to complications such as:
The goal of treatment is to keep chronic kidney disease from progressing to kidney failure. Early detection and intervention is essential. Note that routine screening is NOT advised for those who are under 50 and considered to be low risk.
We recommend early, routine screenings for those who:
We use two simple tests to check kidney function:
Your glomerular filtration rate (GFR) determines the stage of kidney disease.
GFR is expressed in mL/min/1.73m2.
Normal value is considered to be above 90 mL/min/1.73m2.
You may not have any symptoms until your kidney disease is advanced.
Symptoms can include:
The top two causes of chronic kidney disease are diabetes and high blood pressure. Together they account for nearly two-thirds of all cases of chronic kidney disease. The other one-third of cases may be a result of other conditions that can damage the kidney:
Diabetes is the leading cause of chronic kidney disease and kidney failure in the U.S. And the number of people with diabetes is growing – it’s predicted that diabetes will soon account for half of all cases of kidney failure.
If you have diabetes and chronic kidney disease, getting blood glucose under control is critical.
Learn more about diabetes self-management at UC San Diego Health.
Kidney damage rarely occurs in the first 10 years of diabetes. However, many people are not aware of having diabetes for years before diagnosis, and may already have kidney damage by the time they are diagnosed with diabetes.
People who have had diabetes for more than 25 years without signs of kidney disease have a lower risk of ever developing it.
Preventing and slowing kidney disease in those with diabetes may involve:
The National Institutes of Health (NIH) and the American Diabetes Association recommend that people with diabetes get screened annually for kidney disease.
Hypertension, or high blood pressure, can damage the blood vessels inside the kidneys, hindering their ability to function. This can lead to waste and fluid buildup, which can raise blood pressure even more. This dangerous cycle can progress kidney damage and increase your risk for cardiovascular disease and kidney failure. Cardiovascular disease is currently the leading cause of death in people with chronic kidney disease.
Blood pressure monitoring is an essential component of chronic kidney disease management.
Home Blood Pressure MonitoringFrequent blood pressure monitoring allows more opportunities to spot blood pressure that is higher than desired. It can also help quickly determine the effectiveness of a new blood pressure medication.
We provide blood pressure monitors and cuffs to patients who cannot afford them, as well as training on how and when to use them. By making the management of hypertension easy and convenient, we are able to help you gain better control of your blood pressure and, consequently, better control of chronic kidney disease.
Since there is no cure for chronic kidney disease, the goal of treatment is to keep the disease from progressing to kidney failure, or end-stage renal disease (ESRD).
Our team promotes a holistic approach that embraces both conventional and alternative therapies.
Your individualized treatment plan may involve:
We recognize the importance you play in your health. By providing continuing, hands-on information and self-management tools, we empower you to play an active role in the decision-making process.
You can help avoid complications by staying up to date on vaccinations, following the recommendations made by your doctor, and communicating any issues regarding your current treatment plan with your care team. How often you meet with the doctor depends on the rate of your chronic kidney disease progression.
Changing your diet can help prevent and treat common complications of chronic kidney disease.
Recommended modifications may include:
Our kidney health-focused dietician provides instruction on healthy eating and can help tailor your diet plan to suit your specific needs. Also available are dietician-led field trips to the grocery store where you can receive firsthand knowledge of what kinds of foods to buy.
Adopting certain lifestyle behaviors may help slow down chronic kidney disease progression.
Most people with chronic kidney disease need to take medication to help slow disease progression.
Types of treatment include medicines that:
Ensuring that other medications you may be taking for conditions do not interfere with your chronic kidney disease medicines is critical. At each doctor visit you will meet with our team pharmacist who may review or update your medications.
The ultimate goal of chronic kidney disease treatment is to help you effectively manage your condition and keep you off dialysis. We try to bypass dialysis when possible by referring patients directly to
Determining if you need to begin dialysis is based on several factors including:
Low level of kidney function by itself (even if below 10 percent normal) does not automatically place you on dialysis. If the rate of decline in your GFR is slow, you may be able to stay off dialysis for quite some time, or even avoid it altogether.
Learn more about dialysis at UC San Diego Health.
In this video, Danuta Trzebinska, MD, discusses causes and complications of chronic kidney disease and the role of the kidney.
Check out all of our patient education videos on chronic kidney disease.