Banner Representing CKD

Chronic kidney disease

The most important information on chronic kidney disease

Chronic kidney disease (CKD) is a progressive disease, characterised by structural and functional changes in the kidney.1 Worldwide, more than 10% of the population are affected by chronic kidney disease, including Switzerland.2,3 Nine out of ten people with CKD are unaware that they have the disease.3
The mortality rate due to CKD increased by 41.5% between 1990 and 2017 and it is predicted that by 2040, CKD will be the 5th most common cause of death worldwide.2,4

CKD can be triggered by numerous causes, but is often a consequence of diabetes mellitus and hypertension.1,13 Approximately 1 in 3 adults with diabetes mellitus and 1 in 5 with hypertension develop CKD.6

CKD is bidirectionally linked to heart failure: A deterioration of one disease appears to accelerate the onset and progression of the other disease.7 Patients with stage 3+ CKD have double the risk of heart failure or cardiovascular-related death.8

As the disease progresses, chronic kidney disease can lead to end-stage renal failure with uraemia.9 At this stage of the disease, dialysis is unavoidable if renal failure persists for a long time.9

ECG Representing the Death Mortality

Mortality

CKD causes 1.2 million deaths worldwide every year10

Image Highlighting Internal Organs regarding Secondary Disease Development

Secondary disease

Approximately 1 in 3 adults with diabetes and 1 in 5 with hypertension develop CKD6

Kidney Icon Representing the Early CKD Detection

Importance of early detection

Early diagnosis of CKD and adequate management can delay dialysis in patients with chronic kidney disease11

ckd-symptoms-representing-graphics.jpg

Symptoms

Many patients are asymptomatic or have non-specific symptoms.12

According to KDIGO (international guideline for improving the global CKD situation), the symptoms of chronic kidney disease can be summarised as follows:13

  • Fatigue (70% of patients)
  • Poor mobility (56%)
  • Bone and joint pain (55%)
  • Drowsiness (53%)
  • Pain (53%)
  • Poor sleep (49%)
  • Sexual dysfunction (48%)
  • Muscle cramps (46%)
  • Heartburn (46%)
  • Itching (46%)
  • Swollen legs (45%)
  • Shortness of breath (42%)
  • Decreased appetite (42%)
Graphics Representing CKD Diagnosis

Diagnosis

Chronic kidney disease is defined as “abnormalities of renal structure or function that persist for more than 3 months and have an impact on health”.13

Important laboratory parameters for the diagnosis are:13

  • UACR: Urine albumin-creatinine ratio; a measure of albuminuria and renal permeability; given in mg/g ≈ mg albumin in 24h urine
  • eGFR: estimated glomerular filtration rate; a measure of the filtration capacity of the kidney; given in ml/min/1.73 m2

If at least one of the two criteria is present for more than 3 months, the diagnosis of CKD is confirmed:13

  • eGFR < 60 ml/min/1.73 m2          or
  • ACR ≥ 30 mg/g (3 mg/mmol).

The diagnosis of CKD is often made too late or only once the symptoms are serious.12
Patients with arterial hypertension, diabetes mellitus and cardiovascular diseases should therefore be tested at least once a year for the presence of CKD.3

Graphics Representing CKD Treatment

Treatment

Therapeutic goals in the treatment of chronic kidney disease are, on the one hand, to delay the progression of kidney disease (prevention of terminal renal insufficiency, necessity of dialysis or kidney transplant) and, on the other hand, to avoid secondary diseases.3,13

Preservation of renal function can be achieved with non-pharmacological strategies (e.g. dietary and lifestyle adjustments, avoidance of nephrotoxic medication) as well as through targeted and pharmacological interventions.1,3,13

Pharmacological therapies that alter intrarenal haemodynamics (e.g. 

modulators of renin-angiotensin-aldosterone metabolism and SGLT2-inhibitors) can preserve renal function by lowering intraglomerular pressure.1 Other active substances (e.g. non-steroidal mineralocorticoid receptor antagonists) may protect the kidney through anti-inflammatory or anti-fibrotic mechanisms.1

In the end-stage of kidney failure, renal replacement therapy, either in the form of dialysis or a kidney transplant, is the life-sustaining treatment for people with kidney failure.1,13

ACR: albumin-creatinine ratio; CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; KDIGO: Kidney Disease: lmproving Global Outcomes; SGLT2i: sodium-glucose cotransporter-2 inhibitor; UACR: urine albumin-creatinine ratio.

References:

  1. Kalantar-Zadeh K, et al. Chronic kidney disease. Lancet. 2021 Aug 28;398(10302):786-802. 
  2. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022 Apr;12(1):7-11. 
  3. Mark P., et al. Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023. The Lancet, 2025; 406, 2461–2482. 
  4. Foreman KJ, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet. 2018 Nov 10;392(10159):2052-2090. 
  5. Senanayake S, et al. Symptom burden in chronic kidney disease; a population based cross sectional study. BMC Nephrol. 2017 Jul 10;18(1):228. 
  6. Centers for Disease Control and Prevention (CDC). Diabetes and Chronic Kidney[MS1] Disease. Available at: https:ttwww.cdc.gov/diabetes/managing/diabetes-kidney-disease.html. Last accessed: 22-6-2026. 
  7. House AA, et al. Heart failure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019 Jun;95(6):1304-1317. 
  8. Dhingra R et al. Chronic kidney disease and the risk of heart failure in men. Circ Heart Fail. 2011;4(2):138-144. 
  9. Bello AK, et al. Complications of chronic kidney disease: current state, knowledge gaps, and strategy for action. Kidney Int Suppl (2011). 2017 Oct;7(2):122-129. 
  10. Hirst JA, et al. Prevalence of chronic kidney disease in the community using data from OxRen: a UK population-based cohort study. British Journal of General Practice. 2020 Apr 1;70(693):e285-93. 
  11. Jaeckel E et al. Früh entdecken, früh behandeln - Einsatz von SGLT-2i zur Therapie von metabolischen und kardiorenalen Erkrankungen. Diabetes Stoffw Herz 2022;31:82-90. 
  12. Webster AC, et al. Chronic Kidney Disease. Lancet. 2017 Mar 25;389(10075):1238-1252. 
  13. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024 Apr;105(4S):S117-S314.

 

Healthcare professionals may request the referenced publications from AstraZeneca.

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CH-12901 Revision date 05/2026

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