What Is Urine – And What Is In It?
May 5, 2026
What Is Urine – And What Is In It? Urine is liquid waste produced by the kidneys to remove excess fluids and toxins from the blood. Function: The primary function of urine is to remove waste and...
Managing Chronic Kidney Disease (CKD) can feel overwhelming, especially since it is often a “silent” condition. Being proactive during your appointments is the best way to protect your kidney function.
Here are 10 critical questions to ask your kidney specialist (nephrologist) to help you take control of your health.
Most kidney diseases are asymptomatic in the early stages (Stages 1–3A). You likely won’t feel “sick” until your kidneys are at Stage 4 or 5 (less than 30% capacity). Diagnosis is based on two key markers:
eGFR (Estimated Glomerular Filtration Rate): Measures how well your kidneys filter waste (Normal is ~120 mL/min).
Urine ACR (Albumin-to-Creatinine Ratio): Checks for protein leakage, a sign of kidney damage.
Pro Tip: Always ask for your latest numbers. Use digital portals like Patients Know Best (PKB) to track your trends over time.
Fortunately only 1 in 100 patients with CKD will ever need dialysis or a kidney transplant.
But for the 1 in 100 .. your doctor will monitor your creatinine and eGFR levels regularly. Generally, the conversation about dialysis or transplantation begins when you reach the end of Stage 4 or the start of Stage 5 (Kidney Failure).
While some damage is irreversible, you can slow the decline by:
Quitting smoking: Smoking restricts blood flow to the kidneys.
Managing Blood Pressure: Aim for a target of 130/80 mmHg (or 120/70 if you have diabetes).
Medication Safety: Avoid long-term use of NSAIDs (like Ibuprofen or Naproxen).
Conditions like Diabetes, Heart Failure, and Hypertension are “kidney stressors.” If these are poorly managed, your CKD will progress faster. Ensure your nephrologist is coordinating care with your GP or other specialists.
Many common substances are processed by the kidneys and can cause further damage:
NSAIDs/Analgesics: Common over-the-counter pain relievers.
Certain Antibiotics: Always tell prescribing doctors you have CKD.
IV Contrast Dye: Used in some CT scans; your kidneys may need “pre-hydration” before the test.
Herbal Supplements: Specifically, certain Chinese herbal medicines have been linked to irreversible kidney scarring.
It’s often both. CKD causes high blood pressure, and high blood pressure accelerates CKD. Treating your BP is the #1 priority for kidney preservation.
If your kidney function drops significantly, you may notice:
Shortness of breath (fluid in the lungs).
Ankle swelling (oedema).
Extreme muscle weakness (difficulty getting out of a chair).
New-onset nausea or metallic taste in the mouth.
Surprisingly, no – or at least, rarely.
Most kidney diseases do not cause physical pain. Back pain is usually related to the spine or muscles. Exceptions include kidney stones or certain types of cysts (like Polycystic Kidney Disease).
It depends. Factors including your (biological) age, and other medical and surgical conditions, will affect this question.
But for many (younger) patients, if your GFR is dropping toward 25 mL/min, you should ask for a “transplant workup”.
The Wait: In the UK, the average wait for a deceased donor is 3 years.
Living Donors: A transplant from a friend or family member is the “gold standard” and can often happen before you ever need dialysis.
Don’t wait for a crisis. Ask for the direct phone number or email for the Renal Specialist Nurse or the consultant’s secretary. Knowing who to call for a quick medication check can prevent an ER visit.
| CKD Stage | GFR Level (mL/min) | Status |
| Stage 1-2 | 60+ | Mild/Early (Monitor) |
| Stage 3A-3B | 30 – 59 | Moderate (Active Management) |
| Stage 4 | 15 – 29 | Severe (Prepare for Treatment) |
| Stage 5 | < 15 | Kidney Failure (Dialysis/Transplant) |
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